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1. Assessing general versus specific liability for externalizing problems in adolescence: Concurrent and prospective prediction of symptoms of conduct disorder, ADHD, and substance use.

Author: Perkins, Emily, Foell, Jens, Drislane, Laura, Brislin, Sarah, Frick, Paul, Yancey, James, Soto, Elia, Ganley, Colleen, Keel, Pamela, Sica, Claudio, Flor, Herta, Nees, Frauke, Banaschewski, Tobias, Bokde, Arun, Desrivières, Sylvane, Grigis, Antoine, Garavan, Hugh, Gowland, Penny, Heinz, Andreas, Ittermann, Bernd, Martinot, Jean-Luc, Paillère Martinot, Marie-Laure, Artiges, Eric, Papadopoulos Orfanos, Dimitri, Poustka, Luise, Hohmann, Sarah, Fröhner, Juliane, Smolka, Michael, Walter, Henrik, Whelan, Robert, Schumann, Gunter, Patrick, Christopher, and Joyner, Keanan
Subjects: Adolescent, Alcoholism, Attention Deficit Disorder with Hyperactivity, Conduct Disorder, Female, Humans, Male, Prospective Studies, Substance-Related Disorders
Abstract: This study explored the generality versus specificity of two trait-liability factors for externalizing problems-disinhibition and callousness-in the concurrent and prospective prediction of symptoms of conduct disorder, attention-deficit/hyperactivity disorder (ADHD), and substance use (i.e., alcohol use disorder and history of illicit substance use). Disinhibition involves an impulsive, unrestrained cognitive-behavioral style; callousness entails a dispositional lack of social-emotional sensitivity. Participants were European adolescents from the multisite IMAGEN project who completed questionnaires and clinical interviews at ages 14 (N = 1,504, Mage = 14.41, 51.13% female) and 16 (N = 1,407, Mage = 16.46, 51.88% female). Disinhibition was related concurrently and prospectively to greater symptoms of conduct disorder, ADHD, and alcohol use disorder; higher scores on a general externalizing factor; and greater likelihood of having tried an illicit substance. Callousness was selectively related to greater conduct disorder symptoms. These findings indicate disinhibition confers broad liability for externalizing spectrum disorders, perhaps due to its affiliated deficits in executive function. In contrast, callousness appears to represent more specific liability for antagonistic (aggressive/exploitative) forms of externalizing, as exemplified by antisocial behavior. Results support the utility of developmental-ontogenetic and hierarchical-dimensional models of psychopathology and have important implications for early assessment of risk for externalizing problems. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Published: 2022

2. Combination Therapy with Oral Treprostinil for Pulmonary Arterial Hypertension. A Double-Blind Placebo-controlled Clinical Trial

Author: White, R James, Jerjes-Sanchez, Carlos, Bohns Meyer, Gisela Martina, Pulido, Tomas, Sepulveda, Pablo, Wang, Kuo Yang, Grünig, Ekkehard, Hiremath, Shirish, Yu, Zaixin, Gangcheng, Zhang, Yip, Wei Luen James, Zhang, Shuyang, Khan, Akram, Deng, CQ, Grover, Rob, Tapson, Victor F, Svetliza, Graciela Noemi, Lescano, Adrian Jose, Bortman, Guillermo Roberto, Diez, Fabian Antonio, Botta, Christian Edgardo, Fitzgerald, John, Feenstra, Eelke, Kermeen, Fiona Dawn, Keogh, Anne Margaret, Williams, Trevor John, Yousseff, Peter Paul, Ng, Benjamin Joh-Han, Smallwood, David McNaughton, Dwyer, Nathan Brent, Brown, Martin Russell, Lang, Irene M, Steringer-Mascherbauer, Regina, Arakaki, Jaquelina Sonoe Ota, Campos, Frederico Thadeu Assis Figueiredo, de Amorim Correa, Ricardo, de Souza, Rogerio, Bohns Meyer, Gisela M, Moreira, Maria Auxiliadora Carmo, Yoo, Hugo Hyung Bok, Lapa, Monica Silveira, Swiston, John, Hirani, Naushad, Mehta, Sanjay, Michelakis, Evangelos, Sepulveda, Pablo Andres, Blancaire, Monica Maria Zagolin, Liu, Jimming, Shuyang, Zhang, Pan, Lei, Chunde, Bao, Qun, Yi, Xiaoshu, Cheng, Zaixin, Yu, Li, Xinli, Hua, Yao, Zhu, Xianyang, Chen, Yundai, Zhaozhong, Cheng, Yang, Yuanhua, Daxin, Zhou, Jieyan, Shen, Nielsen-Kudsk, Jens Erik, Carlsen, Jorn, Bourdin, Arnaud, Hachulla, Eric, Dromer, Claire, Chaouat, Ari, Reynaud-Gauber, Martine, Seronde, Marie-France, Klose, Hans, Halank, Michael, Hoffken, Gert, Ewert, Ralf, Rosenkranz, Stephan, Grunig, Ekkehard, Kruger, Ulrich, Kronsbein, Juliane, Hauptmeier, Barbara Monika, Koch, Andrea, Held, Matthias, Lange, Tobias Johannes, Neurohr, Claus, Wilkens, Heinrike, Wilhelm Wirtz, Hubert Rolf, Konstantinides, Stavros, Argyropoulou-Pataka, Paraskevi, Orfanos, Stylianos, Kerkar, Prafulla Gopinath, Suresh, Pujar Venkateshacharya, Baxi, Hemang Ashwinkumar, Oomman, Abraham, Abhaichand, Rajpal Kanaklal, Arjun, Padma Kumar Edla, Chopra, Vijay, Mehrotra, Rahul, Rajput, Rajeev Kumar, and Sawhney, Jitendra Pal Singh
Subjects: Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Clinical Trials and Supportive Activities, Rare Diseases, Patient Safety, Digestive Diseases, Clinical Research, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Good Health and Well Being, Administration, Oral, Adolescent, Adult, Aged, Antihypertensive Agents, Double-Blind Method, Epoprostenol, Female, Humans, Male, Middle Aged, Placebos, Pulmonary Arterial Hypertension, Young Adult, FREEDOM-EV Investigators, clinical study, combination therapy, oral treprostinil, pulmonary arterial hypertension, sequential therapy, Medical and Health Sciences, Respiratory System, Cardiovascular medicine and haematology, Clinical sciences
Abstract: Rationale: Oral treprostinil improves exercise capacity in patients with pulmonary arterial hypertension (PAH), but the effect on clinical outcomes was unknown.Objectives: To evaluate the effect of oral treprostinil compared with placebo on time to first adjudicated clinical worsening event in participants with PAH who recently began approved oral monotherapy.Methods: In this event-driven, double-blind study, we randomly allocated 690 participants (1:1 ratio) with PAH to receive placebo or oral treprostinil extended-release tablets three times daily. Eligible participants were using approved oral monotherapy for over 30 days before randomization and had a 6-minute-walk distance 150 m or greater. The primary endpoint was the time to first adjudicated clinical worsening event: death; hospitalization due to worsening PAH; initiation of inhaled or parenteral prostacyclin therapy; disease progression; or unsatisfactory long-term clinical response.Measurements and Main Results: Clinical worsening occurred in 26% of the oral treprostinil group compared with 36% of placebo participants (hazard ratio, 0.74; 95% confidence interval, 0.56-0.97; P = 0.028). Key measures of disease status, including functional class, Borg dyspnea score, and N-terminal pro-brain natriuretic peptide, all favored oral treprostinil treatment at Week 24 and beyond. A noninvasive risk stratification analysis demonstrated that oral treprostinil-assigned participants had a substantially higher mortality risk at baseline but achieved a lower risk profile from Study Weeks 12-60. The most common adverse events in the oral treprostinil group were headache, diarrhea, flushing, nausea, and vomiting.Conclusions: In participants with PAH, addition of oral treprostinil to approved oral monotherapy reduced the risk of clinical worsening.Clinical trial registered with www.clinicaltrials.gov (NCT01560624).
Published: 2020

3. Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction.

Author: Tardif, Jean-Claude, Kouz, Simon, Waters, David D, Bertrand, Olivier F, Diaz, Rafael, Maggioni, Aldo P, Pinto, Fausto J, Ibrahim, Reda, Gamra, Habib, Kiwan, Ghassan S, Berry, Colin, López-Sendón, José, Ostadal, Petr, Koenig, Wolfgang, Angoulvant, Denis, Grégoire, Jean C, Lavoie, Marc-André, Dubé, Marie-Pierre, Rhainds, David, Provencher, Mylène, Blondeau, Lucie, Orfanos, Andreas, L'Allier, Philippe L, Guertin, Marie-Claude, and Roubille, François
Subjects: Humans, Cardiovascular Diseases, Angina Pectoris, Myocardial Infarction, Recurrence, Colchicine, C-Reactive Protein, Anti-Inflammatory Agents, Incidence, Proportional Hazards Models, Double-Blind Method, Aged, Middle Aged, Female, Male, Stroke, Intention to Treat Analysis, Kaplan-Meier Estimate, Percutaneous Coronary Intervention, Biomarkers, General & Internal Medicine, Medical and Health Sciences
Abstract: BackgroundExperimental and clinical evidence supports the role of inflammation in atherosclerosis and its complications. Colchicine is an orally administered, potent antiinflammatory medication that is indicated for the treatment of gout and pericarditis.MethodsWe performed a randomized, double-blind trial involving patients recruited within 30 days after a myocardial infarction. The patients were randomly assigned to receive either low-dose colchicine (0.5 mg once daily) or placebo. The primary efficacy end point was a composite of death from cardiovascular causes, resuscitated cardiac arrest, myocardial infarction, stroke, or urgent hospitalization for angina leading to coronary revascularization. The components of the primary end point and safety were also assessed.ResultsA total of 4745 patients were enrolled; 2366 patients were assigned to the colchicine group, and 2379 to the placebo group. Patients were followed for a median of 22.6 months. The primary end point occurred in 5.5% of the patients in the colchicine group, as compared with 7.1% of those in the placebo group (hazard ratio, 0.77; 95% confidence interval [CI], 0.61 to 0.96; P = 0.02). The hazard ratios were 0.84 (95% CI, 0.46 to 1.52) for death from cardiovascular causes, 0.83 (95% CI, 0.25 to 2.73) for resuscitated cardiac arrest, 0.91 (95% CI, 0.68 to 1.21) for myocardial infarction, 0.26 (95% CI, 0.10 to 0.70) for stroke, and 0.50 (95% CI, 0.31 to 0.81) for urgent hospitalization for angina leading to coronary revascularization. Diarrhea was reported in 9.7% of the patients in the colchicine group and in 8.9% of those in the placebo group (P = 0.35). Pneumonia was reported as a serious adverse event in 0.9% of the patients in the colchicine group and in 0.4% of those in the placebo group (P = 0.03).ConclusionsAmong patients with a recent myocardial infarction, colchicine at a dose of 0.5 mg daily led to a significantly lower risk of ischemic cardiovascular events than placebo. (Funded by the Government of Quebec and others; COLCOT ClinicalTrials.gov number, NCT02551094.).
Published: 2019

4. Maternal Black Race and Persistent Wheezing Illness in Former Extremely Low Gestational Age Newborns: Secondary Analysis of a Randomized Trial

Author: Wai, Katherine C, Hibbs, Anna M, Steurer, Martina A, Black, Dennis M, Asselin, Jeanette M, Eichenwald, Eric C, Ballard, Philip L, Ballard, Roberta A, Keller, Roberta L, Group, Trial of Late Surfactant Study, Strong, Suzanne Hamilton, Immamura-Ching, Jill, Orfanos-Villalobos, Margaret, Williams, Cassandra, Durand, David J, Merrill, Jeffrey D, Horton, Dolia, Pacello, Loretta, Willard, April, Truog, William E, Gauldin, Cheryl, Holmes, Anne, Johnson, Patrice, Meinert, Kerrie, Reynolds, Anne Marie, Lucie, Janine, Conway, Patrick, Sacilowski, Michael, Leadersdorff, Michael, Orbank, Pam, Wynn, Karen, Steinhorn, Robin H, deUngria, Maria, Khan, Janine Yasmin, Hamann, Karin, Schau, Molly, Hopkins, Brad, Jenson, James, Garcia, Carmen, Parekh, Aruna, Shariff, Jila, McGovern, Rose, Adelman, Jeff, Combs, Adrienne, Tjersland, Mary, Mayock, Dennis E, Howland, Elizabeth, Walker, Susan, Longoria, Jim, Meo, Holly, Khan, Amir, McDavid, Georgia, Burson, Katrina, Hinojosa, Richard, Johnson, Christopher, Martin, Karen, Martin, Sarah, Rogers, Shawna, Wright, Sharon, Hudak, Mark L, Barnette, Kimberly, Kellum, Amanda, Burcke, Michelle, Hayes, Christie, Chadwick, Stephanie, Howard, Danielle, Kennedy, Carla, Prince, Renee, Helderman, Jennifer, O'Shea, T Michael, Stefanescu, Beatrice, Warden, Kelly, Brown, Patty, Griffin, Jennifer, Conley, Laura, Bendel, Catherine M, Georgieff, Michael, Davern, Bridget, Mills, Marla, Ritter, Sharon, Wagner, Carol, Ryan, Rita M, Fanning, Deanna, Roberson, Jimmy, Mammel, Mark C, Lampland, Andrea, Meyers, Pat, Brey, Angela, Bendel-Stenzel, Ellen M, Mulrooney, Neil, Worwa, Cathy, Dixon, Pam, Ebert, Gerald, Hejl, Cathy, Maxwell, Molly, McCullough, Kristin, Dhanireddy, Ramasubbareddy, Abiad, Mohammed T El, Talati, Ajay, and Dempsey, Sheila
Subjects: Paediatrics, Reproductive Medicine, Biomedical and Clinical Sciences, Women's Health, Pediatric, Perinatal Period - Conditions Originating in Perinatal Period, Prevention, Asthma, Preterm, Low Birth Weight and Health of the Newborn, Nutrition, Minority Health, Clinical Trials and Supportive Activities, Clinical Research, Lung, Behavioral and Social Science, Black or African American, Child, Preschool, Female, Humans, Infant, Infant, Extremely Premature, Infant, Newborn, Infant, Premature, Diseases, Male, Mothers, Respiration, Artificial, Respiratory Sounds, Risk Factors, Trial of Late Surfactant (TOLSURF) Study Group, asthma, prematurity, socioeconomic factors, Human Movement and Sports Sciences, Paediatrics and Reproductive Medicine, Pediatrics
Abstract: ObjectiveTo evaluate the relationship between maternal self-reported race/ethnicity and persistent wheezing illness in former high-risk, extremely low gestational age newborns, and to quantify the contribution of socioeconomic, environmental, and biological factors on this relationship.Study designWe assessed persistent wheezing illness determined at 18-24 months corrected (for prematurity) age in survivors of a randomized trial. Parents/caregivers were surveyed for wheeze and inhaled asthma medication use quarterly to 12 months, and at 18 and 24 months. We used multivariable analysis to evaluate the relationship of maternal race to persistent wheezing illness, and identified mediators for this relationship via formal mediation analysis.ResultsOf 420 infants (25.2 ± 1.2 weeks of gestation and 714 ± 166 g at birth, 57% male, 34% maternal black race), 189 (45%) had persistent wheezing illness. After adjustment for gestational age, birth weight, and sex, infants of black mothers had increased odds of persistent wheeze compared with infants of nonblack mothers (OR = 2.9, 95% CI 1.9, 4.5). Only bronchopulmonary dysplasia, breast milk diet, and public insurance status were identified as mediators. In this model, the direct effect of race accounted for 69% of the relationship between maternal race and persistent wheeze, whereas breast milk diet, public insurance status, and bronchopulmonary dysplasia accounted for 8%, 12%, and 10%, respectively.ConclusionsAmong former high-risk extremely low gestational age newborns, infants of black mothers have increased odds of developing persistent wheeze. A substantial proportion of this effect is directly accounted for by race, which may reflect unmeasured environmental influences, and acquired and innate biological differences.Trial registrationClinicalTrials.gov: NCT01022580.
Published: 2018

5. Main nutrient patterns are associated with prospective weight change in adults from 10 European countries

Author: Freisling, Heinz, Pisa, Pedro T, Ferrari, Pietro, Byrnes, Graham, Moskal, Aurelie, Dahm, Christina C, Vergnaud, Anne-Claire, Boutron-Ruault, Marie-Christine, Fagherazzi, Guy, Cadeau, Claire, Kühn, Tilman, Neamat-Allah, Jasmine, Buijsse, Brian, Boeing, Heiner, Halkjær, Jytte, Tjonneland, Anne, Hansen, Camilla P, Quirós, J Ramón, Travier, Noémie, Molina-Montes, Esther, Amiano, Pilar, Huerta, José M, Barricarte, Aurelio, Khaw, Kay-Tee, Wareham, Nicholas, Key, Tim J, Romaguera, Dora, Lu, Yunxia, Lassale, Camille M, Naska, Androniki, Orfanos, Philippos, Trichopoulou, Antonia, Masala, Giovanna, Pala, Valeria, Berrino, Franco, Tumino, Rosario, Ricceri, Fulvio, de Magistris, Maria Santucci, Bueno-de-Mesquita, H Bas, Ocké, Marga C, Sonestedt, Emily, Ericson, Ulrika, Johansson, Mattias, Skeie, Guri, Weiderpass, Elisabete, Braaten, Tonje, Peeters, Petra HM, and Slimani, Nadia
Subjects: Public Health, Biomedical and Clinical Sciences, Nutrition and Dietetics, Health Sciences, Clinical Research, Prevention, Nutrition, Metabolic and endocrine, Adult, Aged, Ascorbic Acid, Calcium, Dietary, Diet, Dietary Fiber, Dietary Proteins, Europe, Female, Folic Acid, Follow-Up Studies, Humans, Linear Models, Male, Middle Aged, Nutrition Assessment, Phosphorus, Dietary, Prospective Studies, Riboflavin, Surveys and Questionnaires, Weight Gain, beta Carotene, Dietary patterns, Energy balance, Nutrients, Obesity, Public health, Weight gain, Nutrition & Dietetics, Nutrition and dietetics, Epidemiology
Abstract: PurposeVarious food patterns have been associated with weight change in adults, but it is unknown which combinations of nutrients may account for such observations. We investigated associations between main nutrient patterns and prospective weight change in adults.MethodsThis study includes 235,880 participants, 25-70 years old, recruited between 1992 and 2000 in 10 European countries. Intakes of 23 nutrients were estimated from country-specific validated dietary questionnaires using the harmonized EPIC Nutrient DataBase. Four nutrient patterns, explaining 67 % of the total variance of nutrient intakes, were previously identified from principal component analysis. Body weight was measured at recruitment and self-reported 5 years later. The relationship between nutrient patterns and annual weight change was examined separately for men and women using linear mixed models with random effect according to center controlling for confounders.ResultsMean weight gain was 460 g/year (SD 950) and 420 g/year (SD 940) for men and women, respectively. The annual differences in weight gain per one SD increase in the pattern scores were as follows: principal component (PC) 1, characterized by nutrients from plant food sources, was inversely associated with weight gain in men (-22 g/year; 95 % CI -33 to -10) and women (-18 g/year; 95 % CI -26 to -11). In contrast, PC4, characterized by protein, vitamin B2, phosphorus, and calcium, was associated with a weight gain of +41 g/year (95 % CI +2 to +80) and +88 g/year (95 % CI +36 to +140) in men and women, respectively. Associations with PC2, a pattern driven by many micro-nutrients, and with PC3, a pattern driven by vitamin D, were less consistent and/or non-significant.ConclusionsWe identified two main nutrient patterns that are associated with moderate but significant long-term differences in weight gain in adults.
Published: 2016

6. Randomized Trial of Late Surfactant Treatment in Ventilated Preterm Infants Receiving Inhaled Nitric Oxide

Author: Ballard, Roberta A, Keller, Roberta L, Black, Dennis M, Ballard, Philip L, Merrill, Jeffrey D, Eichenwald, Eric C, Truog, William E, Mammel, Mark C, Steinhorn, Robin H, Rogers, Elizabeth E, Ryan, Rita M, Durand, David J, Asselin, Jeanette M, Bendel, Catherine M, Bendel-Stenzel, Ellen M, Courtney, Sherry E, Dhanireddy, Ramasubbareddy, Hudak, Mark L, Koch, Frances R, Mayock, Dennis E, McKay, Victor J, O'Shea, T Michael, Porta, Nicolas F, Wadhawan, Rajan, Palermo, Lisa, Strong, S Hamilton, Immamura-Ching, J, Orfanos-Villalobos, M, Williams, C, Horton, D, Pacello, L, Willard, A, Gauldin, C, Holmes, A, Johnson, P, Meinert, K, Reynolds, AM, Lucie, J, Conway, P, Sacilowski, ML, Leadersdorff, M, Orbank, P, Wynn, K, deUngria, M, Khan, J, Hamann, K, Schau, M, Hopkins, B, Jenson, J, Garcia, C, Shariff, J, McGovern, R, Adelman, J, Combs, A, Tjersland, M, Walker, S, Howland, E, Longoria, J, Meo, H, McDavid, G, Burson, K, Hinojosa, R, Johnson, C, Miller, K, Rogers, S, Wright, S, Barnette, K, Kellum, A, Burke, M, Hayes, C, Chadwick, S, Howard, D, Kennedy, C, Prince, R, Stefanescu, B, Helderman, J, Warden, K, Brown, P, Griffin, J, Conley, L, Georgieff, M, Davern, B, Mills, M, Ritter, S, Wagner, C, Fanning, D, Roberson, J, Lampland, A, Meyers, P, Brey, A, Worwa, C, Dixon, P, Ebert, G, Hejl, C, Maxwell, M, McCullough, K, Abiad, MT El, Talati, A, Dempsey, S, and Gammage, K
Subjects: Paediatrics, Biomedical and Clinical Sciences, Clinical Research, Preterm, Low Birth Weight and Health of the Newborn, Pediatric, Clinical Trials and Supportive Activities, Perinatal Period - Conditions Originating in Perinatal Period, Neonatal Respiratory Distress, Patient Safety, Lung, Reproductive health and childbirth, Administration, Inhalation, Bronchopulmonary Dysplasia, Female, Humans, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases, Infant, Very Low Birth Weight, Male, Nitric Oxide, Pulmonary Surfactants, Respiration, Artificial, Survival Rate, United States, TOLSURF Study Group, Human Movement and Sports Sciences, Paediatrics and Reproductive Medicine, Pediatrics
Abstract: ObjectiveTo assess whether late surfactant treatment in extremely low gestational age (GA) newborn infants requiring ventilation at 7-14 days, who often have surfactant deficiency and dysfunction, safely improves survival without bronchopulmonary dysplasia (BPD).Study designExtremely low GA newborn infants (GA ≤28 0/7 weeks) who required mechanical ventilation at 7-14 days were enrolled in a randomized, masked controlled trial at 25 US centers. All infants received inhaled nitric oxide and either surfactant (calfactant/Infasurf) or sham instillation every 1-3 days to a maximum of 5 doses while intubated. The primary outcome was survival at 36 weeks postmenstrual age (PMA) without BPD, as evaluated by physiological oxygen/flow reduction.ResultsA total of 511 infants were enrolled between January 2010 and September 2013. There were no differences between the treated and control groups in mean birth weight (701 ± 164 g), GA (25.2 ± 1.2 weeks), percentage born at GA
Published: 2016

7. Burden of hip fracture using disability-adjusted life-years: a pooled analysis of prospective cohorts in the CHANCES consortium

Author: Tsilidis, K, Papadimitriou, N, Orfanos, P, Benetou, V, Ntzani, E, Soerjomataram, I, Künn-Nelen, A, Pettersson-Kymmer, U, Eriksson, S, Brenner, H, Schöttker, B, Saum, K, Holleczek, B, Grodstein, F, Feskanich, D, Orsini, N, Wolk, A, Bellavia, A, Wilsgaard, T, Jørgensen, L, Boffetta, P, Trichopoulos, D, Trichopoulou, A, Papadimitriou, N. and Tsilidis, K.K. and Orfanos, P. and Benetou, V. and Ntzani, E.E. and Soerjomataram, I. and Künn-Nelen, A. and Pettersson-Kymmer, U. and Eriksson, S. and Brenner, H. and Schöttker, B. and Saum, K.-U. and Holleczek, B. and Grodstein, F.D. and Feskanich, D. and Orsini, N. and Wolk, A. and Bellavia, A. and Wilsgaard, T. and Jørgensen, L. and Boffetta, P. and Trichopoulos, D. and Trichopoulou, A., ROA / Labour market and training, and RS: GSBE DUHR
Subjects: Male, VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Orthopedic surgery: 784, very elderly, disability adjusted life year, mortality rate, Cost of Illness, Risk Factors, Quality-Adjusted Life Year, quality adjusted life year, statistics and numerical data, osteoporosi, Prospective Studies, disabled person, lcsh:Public aspects of medicine, public health, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, Europe, priority journal, health impact assessment, oral contraceptive agent, adult, Female, pregnancy, Quality-Adjusted Life Years, prospective study, non insulin dependent diabetes mellitu, alcohol consumption, cohort analysi, Geriatrik, United States, Aged, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Ortopedisk kirurgi: 784, Article, smoking, Hip Fracture, cost of illne, follow up, Humans, Disabled Persons, human, Aged, Hip Fractures, Risk Factor, lcsh:RA1-1270, hormone substitution, major clinical study, United States, Prospective Studie, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Geriatrics, life expectancy, physical inactivity, body ma
Abstract: Source at https://doi.org/10.1016/S2468-2667(17)30046-4. Background: No studies have estimated disability-adjusted life-years (DALYs) lost due to hip fractures using real-life follow-up cohort data. We aimed to quantify the burden of disease due to incident hip fracture using DALYs in prospective cohorts in the CHANCES consortium, and to calculate population attributable fractions based on DALYs for specific risk factors. Methods: We used data from six cohorts of participants aged 50 years or older at recruitment to calculate DALYs. We applied disability weights proposed by the National Osteoporosis Foundation and did a series of sensitivity analyses to examine the robustness of DALY estimates. We calculated population attributable fractions for smoking, body-mass index (BMI), physical activity, alcohol intake, type 2 diabetes and parity, use of hormone replacement therapy, and oral contraceptives in women. We calculated summary risk estimates across cohorts with pooled analysis and random-effects meta-analysis methods. Findings: 223 880 men and women were followed up for a mean of 13 years (SD 6). 7724 (3·5%) participants developed an incident hip fracture, of whom 413 (5·3%) died as a result. 5964 DALYs (27 per 1000 individuals) were lost due to hip fractures, 1230 (20·6%) of which were in the group aged 75–79 years. 4150 (69·6%) DALYs were attributed to disability. Current smoking was the risk factor responsible for the greatest hip fracture burden (7·5%, 95% CI 5·2–9·7) followed by physical inactivity (5·5%, 2·1–8·5), history of diabetes (2·8%, 2·1–4·0), and low to average BMI (2·0%, 1·4–2·7), whereas low alcohol consumption (0·01–2·5 g per day) and high BMI had a protective effect. Interpretation: Hip fracture can lead to a substantial loss of healthy life-years in elderly people. National public health policies should be strengthened to reduce hip fracture incidence and mortality. Primary prevention measures should be strengthened to prevent falls, and reduce smoking and a sedentary lifestyle.
Published: 2016

8. Overweight duration in older adults and cancer risk: a study of cohorts in Europe and the United States

Author: Arnold, M., Freisling, H., Stolzenberg-Solomon, R., Kee, F., O’Doherty, M. G., Ordóñez-Mena, J. M., Wilsgaard, T., May, A. M., Bueno-de-Mesquita, H. B., Tjønneland, A., Orfanos, P., Trichopoulou, A., Boffetta, P., Bray, F., Jenab, M., Soerjomataram, I., Baceviciene, M., Boer, J. M. A., Drygas, W., Eriksson, S., Feskens, E., Gafarov, V., Gardiner, J., Hakansson, N., Jansson, J. -H., Jousilahti, P., Kampman, E., Kontto, J., Kubinova, R., Leenders, M., Linneberg, A., Lochen, M. -L., Lorbeer, R., Malyutina, S., Mathiesen, E. B., Melhus, H., Michaëlsson, K., Njolstad, I., Orsini, N., Pajak, A., Pikhart, H., Pisinger, C., Salomaa, V., Sánchez, M. -J., Sans, S., Schaan, B., Schneider, A., Siganos, G., Söderberg, S., Streppel, M., Tamošiunas, A., Veronesi, G., Waterham, E., Wennberg, P., on behalf of the CHANCES consortium, Arnold, M., Freisling, H., Stolzenberg-Solomon, R., Kee, F., O’Doherty, M.G., Ordóñez-Mena, J.M., Wilsgaard, T., May, A.M., Bueno-de-Mesquita, H.B., Tjønneland, A., Orfanos, P., Trichopoulou, A., Boffetta, P., Bray, F., Jenab, M., Soerjomataram, I., Baceviciene, M., Boer, J.M.A., Drygas, W., Eriksson, S., Feskens, E., Gafarov, V., Gardiner, J., Hakansson, N., Jansson, J.-H., Jousilahti, P., Kampman, E., Kontto, J., Kubinova, R., Leenders, M., Linneberg, A., Lochen, M.-L., Lorbeer, R., Malyutina, S., Mathiesen, E.B., Melhus, H., Michaëlsson, K., Njolstad, I., Orsini, N., Pajak, A., Pikhart, H., Pisinger, C., Salomaa, V., Sánchez, M.-J., Sans, S., Schaan, B., Schneider, A., Siganos, G., Söderberg, S., Streppel, M., Tamošiunas, A., Veronesi, G., Waterham, E., Wennberg, P., and on behalf of the CHANCES consortium
Subjects: Gerontology, Male, Time Factors, Epidemiology, Overweight, Body Mass Index, Cohort Studies, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, Risk Factors, Neoplasms, 030212 general & internal medicine, Cancer, 2. Zero hunger, Overweight and cancer risk, Hazard ratio, Smoking, Cohort, Confounding Factors, Epidemiologic, Middle Aged, 3. Good health, Europe, 030220 oncology & carcinogenesis, Female, medicine.symptom, Cohort study, Hormone Replacement Therapy, Article, Diabetes Complications, 03 medical and health sciences, Breast cancer, Sex Factors, SDG 3 - Good Health and Well-being, Journal Article, medicine, Humans, Obesity, CHANCES, VLAG, Aged, Proportional Hazards Models, Global Nutrition, Wereldvoeding, Cancer prevention, Epidemiologic, business.industry, Prevention, medicine.disease, Confounding Factors, United States, Ageing, business, Body mass index, Demography
Abstract: Recent studies have shown that cancer risk related to overweight and obesity is mediated by time and might be better approximated by using life years lived with excess weight. In this study we aimed to assess the impact of overweight duration and intensity in older adults on the risk of developing different forms of cancer. Study participants from seven European and one US cohort study with two or more weight assessments during follow-up were included (n = 329,576). Trajectories of body mass index (BMI) across ages were estimated using a quadratic growth model; overweight duration (BMI = 25) and cumulative weighted overweight years were calculated. In multivariate Cox models and random effects analyses, a longer duration of overweight was significantly associated with the incidence of obesity-related cancer [overall hazard ratio (HR) per 10-year increment: 1.36; 95 % CI 1.12–1.60], but also increased the risk of postmenopausal breast and colorectal cancer. Additionally accounting for the degree of overweight further increased the risk of obesity-related cancer. Risks associated with a longer overweight duration were higher in men than in women and were attenuated by smoking. For postmenopausal breast cancer, increased risks were confined to women who never used hormone therapy. Overall, 8.4 % of all obesity-related cancers could be attributed to overweight at any age. These findings provide further insights into the role of overweight duration in the etiology of cancer and indicate that weight control is relevant at all ages. This knowledge is vital for the development of effective and targeted cancer prevention strategies. © 2016, Springer Science+Business Media Dordrecht.
Published: 2016
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9. Smoking and All-cause Mortality in Older Adults: Results From the CHANCES Consortium

Author: Müezzinler A, Mons U, Gellert C, Schöttker B, Jansen E, Kee F, Doherty Mg, O., Kuulasmaa K, Nd, Freedman, Cc, Abnet, Wolk A, Håkansson N, Orsini N, Wilsgaard T, Bueno-de-Mesquita B, Yt, Schouw, Ph, Peeters, Lc, Groot, Peters A, Orfanos P, Linneberg A, Pisinger C, Tamosiunas A, Baceviciene M, Luksiene D, Bernotiene G, Jousilahti P, Petterson-Kymmer U, Jh, Jansson, Söderberg S, Eriksson S, Jankovic N, Mj, Sánchez, Giovanni Veronesi, Sans S, Drygas W, Trichopoulou A, Boffetta P, Brenner H, Müezzinler, A., Mons, U., Gellert, C., Schöttker, B., Jansen, E., Kee, F., O'Doherty, M.G., Kuulasmaa, K., Freedman, N.D., Abnet, C.C., Wolk, A., Håkansson, N., Orsini, N., Wilsgaard, T., Bueno-De-Mesquita, B., Van Der Schouw, Y.T., Peeters, P.H.M., De Groot, L.C.P.G.M., Peters, A., Orfanos, P., Linneberg, A., Pisinger, C., Tamosiunas, A., Baceviciene, M., Luksiene, D., Bernotiene, G., Jousilahti, P., Petterson-Kymmer, U., Jansson, J.H., Söderberg, S., Eriksson, S., Jankovic, N., Sánchez, M.-J., Veronesi, G., Sans, S., Drygas, W., Trichopoulou, A., Boffetta, P., and Brenner, H.
Subjects: Aged, 80 and over, Male, Epidemiology, Smoking, Environmental and Occupational Health, Age Factors, Public Health, Environmental and Occupational Health, Middle Aged, United States, Cohort Studies, Europe, Risk Factors, Smoking and All-cause Mortality, Humans, Female, Smoking Cessation, Public Health, Mortality, Aged, Proportional Hazards Models
Abstract: Introduction Smoking is known to be a major cause of death among middle-aged adults, but evidence on its impact and the benefits of smoking cessation among older adults has remained limited. Therefore, we aimed to estimate the influence of smoking and smoking cessation on all-cause mortality in people aged =60 years. Methods Relative mortality and mortality rate advancement periods (RAPs) were estimated by Cox proportional hazards models for the population-based prospective cohort studies from Europe and the U.S. (CHANCES [Consortium on Health and Ageing: Network of Cohorts in Europe and the U.S.]), and subsequently pooled by individual participant meta-analysis. Statistical analyses were performed from June 2013 to March 2014. Results A total of 489,056 participants aged =60 years at baseline from 22 population-based cohort studies were included. Overall, 99,298 deaths were recorded. Current smokers had 2-fold and former smokers had 1.3-fold increased mortality compared with never smokers. These increases in mortality translated to RAPs of 6.4 (95% CI=4.8, 7.9) and 2.4 (95% CI=1.5, 3.4) years, respectively. A clear positive dose-response relationship was observed between number of currently smoked cigarettes and mortality. For former smokers, excess mortality and RAPs decreased with time since cessation, with RAPs of 3.9 (95% CI=3.0, 4.7), 2.7 (95% CI=1.8, 3.6), and 0.7 (95% CI=0.2, 1.1) for those who had quit

10. Meal patterns across ten European countries - results from the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study

Author: E Huseinovic, A Winkvist, N Slimani, MK Park, H Freisling, H Boeing, G Buckland, L Schwingshackl, E Weiderpass, AL Rostgaard-Hansen, A Tjønneland, A Affret, MC Boutron-Ruault, G Fagherazzi, V Katzke, T Kühn, A Naska, P Orfanos, A Trichopoulou, V Pala, D Palli, F Ricceri, M Santucci de Magistris, R Tumino, D Engeset, T Enget, G Skeie, A Barricarte, CB Bonet, MD Chirlaque, P Amiano, JR Quirós, MJ Sánchez, JA Dias, I Drake, M Wennberg, JMA Boer, MC Ocké, WMM Verschuren, C Lassale, A Perez-Cornago, E Riboli, H Ward, H Bertéus Forslund, [Huseinovic, E.] Univ Gothenburg, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Box 459, SE-40530 Gothenburg, Sweden, [Winkvist, A.] Univ Gothenburg, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Box 459, SE-40530 Gothenburg, Sweden, [Forslund, H. Berteus] Univ Gothenburg, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Box 459, SE-40530 Gothenburg, Sweden, [Winkvist, A.] Umea Univ, Nutr Res, Dept Publ Hlth & Clin Med, Umea, Sweden, [Wennberg, M.] Umea Univ, Nutr Res, Dept Publ Hlth & Clin Med, Umea, Sweden, [Slimani, N.] Int Agcy Res Canc, Dietary Exposure Assessment Grp, Lyon, France, [Park, M. K.] Int Agcy Res Canc, Dietary Exposure Assessment Grp, Lyon, France, [Freisling, H.] Int Agcy Res Canc, Dietary Exposure Assessment Grp, Lyon, France, [Boeing, H.] German Inst Human Nutr, Dept Epidemiol, Nuthetal, Germany, [Schwingshackl, L.] German Inst Human Nutr, Dept Epidemiol, Nuthetal, Germany, [Buckland, G.] Catalan Inst Oncol ICO IDIBELL, Unit Nutr & Canc, Canc Epidemiol Res Programme, Barcelona, Spain, [Bonet, C. B.] Catalan Inst Oncol ICO IDIBELL, Unit Nutr & Canc, Canc Epidemiol Res Programme, Barcelona, Spain, [Weiderpass, E.] Univ Tromso, Arctic Univ Norway, Dept Community Med, Fac Hlth Sci, Tromso, Norway, [Enget, T.] Univ Tromso, Arctic Univ Norway, Dept Community Med, Fac Hlth Sci, Tromso, Norway, [Skeie, G.] Univ Tromso, Arctic Univ Norway, Dept Community Med, Fac Hlth Sci, Tromso, Norway, [Weiderpass, E.] Inst Populat Based Canc Res, Canc Registry Norway, Dept Res, Oslo, Norway, [Weiderpass, E.] Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden, [Weiderpass, E.] Folkhalsan Res Ctr, Genet Epidemiol Grp, Helsinki, Finland, [Rostgaard-Hansen, A. L.] Danish Canc Soc Res Ctr, Copenhagen, Denmark, [Tjonneland, A.] Danish Canc Soc Res Ctr, Copenhagen, Denmark, [Affret, A.] Univ Paris Sud, Univ Paris Saclay, UVSQ, CESP,INSERM, Villejuif, France, [Boutron-Ruault, M. C.] Univ Paris Sud, Univ Paris Saclay, UVSQ, CESP,INSERM, Villejuif, France, [Fagherazzi, G.] Univ Paris Sud, Univ Paris Saclay, UVSQ, CESP,INSERM, Villejuif, France, [Affret, A.] Gustave Roussy, Villejuif, France, [Boutron-Ruault, M. C.] Gustave Roussy, Villejuif, France, [Fagherazzi, G.] Gustave Roussy, Villejuif, France, [Katzke, V.] German Canc Res Ctr, Div Canc Epidemiol, Heidelberg, Germany, [Kuehn, T.] German Canc Res Ctr, Div Canc Epidemiol, Heidelberg, Germany, [Naska, A.] Hellen Hlth Fdn, Athens, Greece, [Orfanos, P.] Hellen Hlth Fdn, Athens, Greece, [Trichopoulou, A.] Hellen Hlth Fdn, Athens, Greece, [Naska, A.] Univ Athens, WHO Collaborating Ctr Nutr & Hlth, Unit Nutr Epidemiol & Nutr Publ Hlth, Dept Hyg Epidemiol & Med Stat,Med Sch, Athens, Greece, [Orfanos, P.] Univ Athens, WHO Collaborating Ctr Nutr & Hlth, Unit Nutr Epidemiol & Nutr Publ Hlth, Dept Hyg Epidemiol & Med Stat,Med Sch, Athens, Greece, [Trichopoulou, A.] Univ Athens, WHO Collaborating Ctr Nutr & Hlth, Unit Nutr Epidemiol & Nutr Publ Hlth, Dept Hyg Epidemiol & Med Stat,Med Sch, Athens, Greece, [Pala, V.] Fdn IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, Epidemiol & Prevent Unit, Milan, Italy, [Palli, D.] Canc Res & Prevent Inst ISPO, Mol & Nutr Epidemiol Unit, Florence, Italy, [Ricceri, F.] Reg Hlth Serv ASL TO3, Unit Epidemiol, Grugliasco, TO, Italy, [Ricceri, F.] Univ Turin, Dept Med Sci, Unit Canc Epidemiol, Turin, Italy, [de Magistris, M. Santucci] AOU Federico II, Naples, Italy, [Tumino, R.] ASP Ragusa, Civ MP Arezzo Hosp, Canc Registry & Histopathol Unit, Ragusa, Italy, [Engeset, D.] Norwegian Food Safety Author, Head Off, Oslo, Norway, [Barricarte, A.] Navarra Publ Hlth Inst, Pamplona, Spain, [Barricarte, A.] Navarra Inst Hlth Res IdiSNA, Pamplona, Spain, [Barricarte, A.] CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain, [Chirlaque, M. D.] CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain, [Amiano, P.] CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain, [Sanchez, M. J.] CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain, [Chirlaque, M. D.] IMIB Arrixaca, Reg Hlth Council, Dept Epidemiol, Murcia, Spain, [Chirlaque, M. D.] Univ Murcia, Dept Hlth & Social Sci, Murcia, Spain, [Amiano, P.] BioDonostia Res Inst, Publ Hlth Div Gipuzkoa, San Sebastian, Spain, [Quiros, J. R.] Publ Hlth Directorate, Asturias, Spain, [Sanchez, M. J.] Univ Granada, Hosp Univ Granada, Inst Invest Biosanitaria Ibs GRANADA, Escuela Andaluza Salud Publ, Granada, Spain, [Dias, J. A.] Lund Univ, Dept Clin Sci Malmo, Lund, Sweden, [Drake, I.] Lund Univ, Dept Clin Sci Malmo, Lund, Sweden, [Boer, J. M. A.] Natl Inst Publ Hlth & Environm RIVM, Ctr Nutr Prevent & Hlth Serv, Bilthoven, Netherlands, [Ocke, M. C.] Natl Inst Publ Hlth & Environm RIVM, Ctr Nutr Prevent & Hlth Serv, Bilthoven, Netherlands, [Verschuren, W. M. M.] Natl Inst Publ Hlth & Environm RIVM, Ctr Nutr Prevent & Hlth Serv, Bilthoven, Netherlands, [Verschuren, W. M. M.] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands, [Lassale, C.] Imperial Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England, [Riboli, E.] Imperial Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England, [Ward, H.] Imperial Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England, [Perez-Cornago, A.] Univ Oxford, Nuffield Dept Populat Hlth, Canc Epidemiol Unit, Oxford, England, European Commission (DG-SANCO), International Agency for Research on Cancer, Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Generale de l'Education Nationale, Institut National de la Sante et de la Recherche Medicale (INSERM) (France), German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum, Federal Ministry of Education and Research (Germany), Hellenic Health Foundation (Greece), Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy, National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands), Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway), Health Research Fund (FIS), Regional Governments of Andalucia, Asturias, Basque Country, Murcia, Navarra, ISCIII RETIC (Spain), Swedish Cancer Society, Swedish Research Council and County Councils of Skane and Vasterbotten (Sweden), Cancer Research UK, Medical Research Council, MRC, and National Institute for Health Research
Subjects: 0301 basic medicine, Gerontology, Male, Cross-sectional study, Calibration (statistics), Medicine (miscellaneous), EPIC, VDP::Medical disciplines: 700::Health sciences: 800::Nutrition: 811, Intake occasion, Feeding behavior, Medicine, Prospective Studies, Dietary-intake, Prospective cohort study, Meals, Meal patterns, Nutrition and Dietetics, 11 Medical And Health Sciences, Middle Aged, Research Papers, Nutrient intake, European Prospective Investigation into Cancer and Nutrition, Europe, Snacking, Female, 24 h dietary recall, Energy intake, Intake frequency, Snacks, Standardization, Adult, Aged, Cross-Sectional Studies, Energy Intake, Humans, Diet, Diet Surveys, Feeding Behavior, Cutoff, Population, VDP::Medisinske Fag: 700::Helsefag: 800::Ernæring: 811, 03 medical and health sciences, Environmental health, 030109 nutrition & dietetics, Nutrition & Dietetics, business.industry, Public Health, Environmental and Occupational Health, Frequency, Overweight, Recalls, Weight-loss, Energy-intake, business
Abstract: ObjectiveTo characterize meal patterns across ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study.DesignCross-sectional study utilizing dietary data collected through a standardized 24 h diet recall during 1995–2000. Eleven predefined intake occasions across a 24 h period were assessed during the interview. In the present descriptive report, meal patterns were analysed in terms of daily number of intake occasions, the proportion reporting each intake occasion and the energy contributions from each intake occasion.SettingTwenty-seven centres across ten European countries.SubjectsWomen (64 %) and men (36 %) aged 35–74 years (n 36 020).ResultsPronounced differences in meal patterns emerged both across centres within the same country and across different countries, with a trend for fewer intake occasions per day in Mediterranean countries compared with central and northern Europe. Differences were also found for daily energy intake provided by lunch, with 38–43 % for women and 41–45 % for men within Mediterranean countries compared with 16–27 % for women and 20–26 % for men in central and northern European countries. Likewise, a south–north gradient was found for daily energy intake from snacks, with 13–20 % (women) and 10–17 % (men) in Mediterranean countries compared with 24–34 % (women) and 23–35 % (men) in central/northern Europe.ConclusionsWe found distinct differences in meal patterns with marked diversity for intake frequency and lunch and snack consumption between Mediterranean and central/northern European countries. Monitoring of meal patterns across various cultures and populations could provide critical context to the research efforts to characterize relationships between dietary intake and health.
Published: 2016

11. Modified Mediterranean diet and survival after myocardial infarction

Author: Y. T. van der Schouw, Philippos Orfanos, B. Van Guelpen, V. Pala, C. A. Gonzalez, Petra H.M. Peeters, Anne Tjønneland, María José Sánchez, Antonia Trichopoulou, Vassiliki Benetou, S Bingham, Timothy J. Key, S. Rohrmann, Theodora Psaltopoulou, Kay-Tee Khaw, Christina Bamia, Kim Overvad, Erik Berg Schmidt, Concha Moreno, Nerea Larrañaga, F. Clavel-Chapelon, J. Linseisen, Salvatore Panico, J. H. Jansson, M. C. Boutron-Ruault, M-D Chirlaque, Teresa Norat, Giovanna Masala, Jytte Halkjær, Cornelia Weikert, H. Boeing, Paolo Boffetta, Dimitrios Trichopoulos, R. Tumino, Carlotta Sacerdote, Marga C. Ocké, Marie-Noël Vercambre, H. B. Bueno-De-Mesquita, Elio Riboli, E. A. Spencer, Trichopoulou, A, Bamia, C, Norat, T, Overvad, K, Schmidt, Eb, Tjonneland, A, Halkjaer, J, CLAVEL CHAPELON, F, Vercambre, Mn, BOUTRON RUAULT, Mc, Linseisen, J, Rohrmann, S, Boeing, H, Weikert, C, Benetou, V, Psaltopoulou, T, Orfanos, P, Boffetta, P, Masala, G, Pala, V, Panico, Salvatore, Tumino, R, Sacerdote, C, BUENO DE MESQUITA, Hb, Ocke, Mc, Peeters, Ph, VAN DER SCHOUW, Yt, Gonzalez, C, Sanchez, Mj, Chirlaque, Md, Moreno, C, Larranaga, N, VAN GUELPEN, B, Jansson, Jh, Bingham, S, Khaw, Kt, Spencer, Ea, Key, T, Riboli, E, Trichopoulos, D., Trichopoulou, A., Bamia, C., Norat, T., Overvad, K., Schmidt, E.B., Tjønneland, A., Halkjær, J., Clavel-Chapelon, F., Vercambre, M.-N., Boutron-Ruault, M.-C., Linseisen, J., Rohrmann, S., Boeing, H., Weikert, C., Benetou, V., Psaltopoulou, T., Orfanos, P., Boffetta, P., Masala, G., Pala, V., Panico, S., Tumino, R., Sacerdote, C., Bueno-De-Mesquita, H.B., Ocke, M.C., Peeters, P.H., Van Der Schouw, Y.T., González, C., Sanchez, M.J., Chirlaque, M.D., Moreno, C., Larrañaga, N., Van Guelpen, B., Jansson, J.-H., Bingham, S., Khaw, K.-T., Spencer, E.A., Key, T., Riboli, E., and University of Groningen
Subjects: Male, COUNTRIES, medicine.medical_specialty, Mediterranean diet, Epidemiology, ALCOHOL, Diet, Mediterranean, survival, elderly, Modified Mediterranean diet survival myocardial infarction EPIC-Elderly study, Food group, PEOPLE, medicine, Humans, CORONARY-HEART-DISEASE, COHORT, Prospective Studies, Myocardial infarction, ddc:610, Survival rate, Aged, Proportional Hazards Models, RISK, business.industry, Proportional hazards model, Mortality rate, MORTALITY, Middle Aged, Nutrition Surveys, medicine.disease, CANCER, European Prospective Investigation into Cancer and Nutrition, Surgery, Europe, Survival Rate, Standardized mortality ratio, myocardial infarction, Female, NUTRITION, business, FOLLOW-UP, Demography
Abstract: Mediterranean diet is associated with lower incidence of coronary heart disease, and two randomised trials indicated that it improves prognosis of coronary patients. These trials, however, relied on a total of 100 deaths and evaluated designer diets in the clinical context. We have evaluated the association of adherence to the modified Mediterranean diet, in which unsaturates were substituted for monounsaturates, with survival among elderly with previous myocardial infarction within the European Prospective Investigation into Cancer and nutrition (EPIC) study. As of December 2003, after a median follow-up of 6.7 years, 2671 EPIC participants from nine countries were 60 years or older and had prevalent myocardial infarction but no stroke or cancer at enrolment, complete information on dietary intakes and important covariates and known survival status. Adherence to the modified Mediterranean diet was assessed through a 10-unit-scale. Mortality ratio in relation to modified Mediterranean diet was estimated through Cox regression controlling for possible confounding. Increased adherence to modified Mediterranean diet by two units was associated with 18% lower overall mortality rate (95% confidence interval 7-27%, fixed effects model). There was no significant heterogeneity by sex, age at enrolment, or country, although the association tended to be less evident among northern Europeans. Associations between food groups contributing to the modified Mediterranean diet and mortality were generally weak. A diet inspired by the Mediterranean pattern that can be easily adopted by Western populations is associated with substantial reduction of total mortality of coronary patients in the community. © 2007 Springer Science+Business Media B.V.
Published: 2007
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12. Development and Validation of a Risk Score Predicting Substantial Weight Gain over 5 Years in Middle-Aged European Men and Women

Author: Philippos Orfanos, Lefkos T. Middleton, Vittorio Krogh, Kuanrong Li, J. Ramón Quirós, Sven Knüppel, Birgit Teucher, Eva Ardanaz, Heiner Boeing, Anne M. May, Laureen Dartois, Guy Fagherazzi, Domenico Palli, Peter Wallström, Bo Hedblad, Jytte Halkjær, Rosario Tumino, Annika Steffen, José María Huerta, María José Sánchez, Amalia Mattiello, Nicholas J. Wareham, Kim Overvad, H. Bas Bueno-de-Mesquita, Kay-Tee Khaw, Daphne L. van der A, Antonia Trichopoulou, Miren Dorronsoro, Anne Tjønneland, Paolo Vineis, Thorkild I. A. Sørensen, Dimitrios Trichopoulos, Noémie Travier, Petra H.M. Peeters, Francesca L. Crowe, [Steffen,A, Knüppel,S, Boeing,H] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany. [Sørensen,TIA] Instiute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals – Part of Copenhagen University Hospital, The Capital Region, Denmark. [Travier,N] Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology, Barcelona, Spain. [Sánchez,MJ] Andalusian School of Public Health, Granada, Spain. [Huerta,JM] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. [Sánchez,MJ, Huerta,JM, Ardanaz,E] CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. [Quirós,JR] Public Health Directorate, Asturias, Spain. [Ardanaz,E] Navarre Public Health Institute, Pamplona, Spain. [Dorronsoro,M] Basque Regional Health Department and Ciberesp – Biodonostia, San Sebastian, Spain. [Teucher,B, Li,K] Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany. [Bueno-de-Mesquita,HB, A,D] National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. [Bueno-de-Mesquita,HB] Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. [Mattiello,A] Dipartimento di Medicina Clinica e Chirurgia, Frederico II University, Naples, Italy. [Palli,D] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute, Florence, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, ‘‘Civile – M.P.Arezzo’’ Hospital, Ragusa, Italy. [Krogh,V] Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Vineis,P] HuGeF Foundation Torino, Italy. [Trichopoulou,A, Orfanos,P, Trichopoulos,D] Hellenic Health Foundation, Athens, Greece. [Trichopoulou,A, Orfanos,P] WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Trichopoulos,D] Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America. [Trichopoulos,D] Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece. [Hedblad,B] Department of Clinical Sciences in Malmö, Clinical Research Centre, Skane University Hospital, Malmö, Sweden. [Wallström,P] Nutrition Epidemiology Research Group, Department of Clinical Sciences, Lund University, Malmö, Sweden. [Overvad,K] Section of Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark. [Halkjær,J, Tjønneland,A] Danish Cancer Society Research Center, Copenhagen, Denmark. [Fagherazzi,G, Dartois,L] Inserm, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Villejuif, France. Paris South University, Villejuif, France. [Crowe,F] Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom. [Khaw,K] Clinical Gerontology Unit, University of Cambridge, Cambridge, United Kingdom. [Wareham,N] Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. [Vineis,P, Middleton,L] School of Public Health, Imperial College, London, United Kingdom. [May,AM, Peeters,PHM] Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands. [Peeters,PHM] Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom., This publication arises from a collaboration of two EU projects, the Diet, Obesity and Genes (DiOGenes) project and the Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating out of Home and Obesity (PANACEA) project. DiOGenes is a pan-European study within the EU Sixth Framework Programme for Research and Technological Development (2005-2009) (FOOD-CT-2005-513946, http://www.diogenes.eu.org). PANACEA received funding from the EU in the framework of the Public Health Programme (project 2005328). This work was further supported by the European Commission: Public Health and Consumer Protection Directorate 1993–2004, the Research Directorate-General 2005, the Ligue contre le Cancer, the Societe´ 3M, the Mutuelle Ge´ne´ rale de l’Education Nationale, and the Institut National de la Sante´ et de la Recherche Me´ dicale, German Cancer Aid, the German Cancer Research Center, and the Federal Ministry of Education and Research (Germany), the Danish Cancer Society (Denmark), Health Research Fund (FIS) of the Spanish Ministry of Health RTICC ’Red Tema´tica de Investigacio´n Cooperativa en Ca´ncer (grant number C03/10, R06/0020), the participating regional governments and institutions of Spain, Cancer Research United Kingdom, the Medical Research Council, the Stroke Association, the British Heart Foundation, the Department of Health, the Food Standards Agency, and the Wellcome Trust (United Kingdom), the Italian Association for Research on Cancer and the National Research Council (Italy), the Dutch Ministry of Public Health, Welfare and Sports, the Dutch Ministry of Health, Dutch Prevention Funds, LK Research Funds, the Dutch Zorg Onderzoek Nederland, and the World Cancer Research Fund (Netherlands), and the Swedish Cancer Society, the Swedish Scientific Council, and the Regional Government of Skane. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Subjects: Male, Gerontology, Research Validity, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings], Non-Clinical Medicine, Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight::Body Weight Changes::Weight Gain [Medical Subject Headings], Epidemiology, lcsh:Medicine, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Weight Gain, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Cohort Studies, Mediana Edad, 0302 clinical medicine, Risk Factors, Positive predicative value, Aumento de Peso, Cardiac and Cardiovascular Systems, Prospective Studies, 030212 general & internal medicine, Masculino, lcsh:Science, Factores de Riesgo, education.field_of_study, Multidisciplinary, Framingham Risk Score, Nutrition and Dietetics, Adulto, Femenino, Geographicals::Geographic Locations::Europe [Medical Subject Headings], Epidemiology of Aging, Estudios Prospectivos, Middle Aged, Research Assessment, Humanos, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, Medicine, Female, Public Health, medicine.symptom, Europa, Research Article, Adult, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings], Clinical Research Design, Science Policy, Anciano, Population, Check Tags::Male [Medical Subject Headings], 030209 endocrinology & metabolism, External validity, 03 medical and health sciences, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], medicine, Humans, Obesity, Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Statistical Methods, education, Aged, Proportional Hazards Models, Nutrition, Health Care Policy, Receiver operating characteristic, business.industry, Proportional hazards model, lcsh:R, Health Risk Analysis, Check Tags::Female [Medical Subject Headings], lcsh:Q, Modelos de Riesgos Proporcionales, business, Weight gain, Demography
Abstract: Journal Article; Research Support, Non-U.S. Gov't; BACKGROUND Identifying individuals at high risk of excess weight gain may help targeting prevention efforts at those at risk of various metabolic diseases associated with weight gain. Our aim was to develop a risk score to identify these individuals and validate it in an external population. METHODS We used lifestyle and nutritional data from 53°758 individuals followed for a median of 5.4 years from six centers of the European Prospective Investigation into Cancer and Nutrition (EPIC) to develop a risk score to predict substantial weight gain (SWG) for the next 5 years (derivation sample). Assuming linear weight gain, SWG was defined as gaining ≥ 10% of baseline weight during follow-up. Proportional hazards models were used to identify significant predictors of SWG separately by EPIC center. Regression coefficients of predictors were pooled using random-effects meta-analysis. Pooled coefficients were used to assign weights to each predictor. The risk score was calculated as a linear combination of the predictors. External validity of the score was evaluated in nine other centers of the EPIC study (validation sample). RESULTS Our final model included age, sex, baseline weight, level of education, baseline smoking, sports activity, alcohol use, and intake of six food groups. The model's discriminatory ability measured by the area under a receiver operating characteristic curve was 0.64 (95% CI = 0.63-0.65) in the derivation sample and 0.57 (95% CI = 0.56-0.58) in the validation sample, with variation between centers. Positive and negative predictive values for the optimal cut-off value of ≥ 200 points were 9% and 96%, respectively. CONCLUSION The present risk score confidently excluded a large proportion of individuals from being at any appreciable risk to develop SWG within the next 5 years. Future studies, however, may attempt to further refine the positive prediction of the score. Yes
Published: 2013
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13. Plasma Elaidic Acid Level as Biomarker of Industrial Trans Fatty Acids and Risk of Weight Change: Report from the EPIC Study

Author: Petra H.M. Peeters, Kay-Tee Khaw, Guri Skeie, Ingegerd Johansson, NJ Wareham, Ursula Bachlechner, María José Sánchez, José María Huerta, Jasmine Neamat-Allah, Pietro Ferrari, Antonia Trichopoulou, Androniki Naska, Emily Sonested, Veronique Chajes, Elisabete Weiderpass, Marc J. Gunter, Carine Biessy, Anna Winkvist, Eva Ardanaz, Philippos Orfanos, Antonio Agudo, Franҫoise Clavel-Chapelon, Isabelle Romieu, Timothy J. Key, Paolo Vineis, Guy Fagherazzi, Miren Dorronsoro, Augustin Scalbert, Heinz Freisling, Nadia Slimani, Amalia Mattiello, Marianne Uhre Jakobsen, Verana Katzke, José Ramón Quirós, Valeria Pala, Dora Romaguera, Bas Bueno de Mesquita, Giovanna Masala, Heiner Boeing, Marie-Christine Boutron-Ruault, Inge Huybrechts, Camilla Plambeck Hansen, [Chajès,V, Biessy,C, Ferrari,P, Romieu,I, Freisling,H, Huybrechts,I, Scalbert,A, Sliman,N] Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France. [Bueno de Mesquita,B, Romaguera,D, Gunter,MJ, Vineis,P, Peeters,PHM] Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom. [Bueno de Mesquita,B] Department For Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. [Plambeck Hansen,C, Uhre Jakobsen,M] Department of Public Health, Section of Epidemiology, Aarhus University, Aarhus, Denmark. [Clavel-Chapelon,F, Fagherazz,G, Boutron-Ruaul,M] INSERM, Centre for research in Epidemiology and Population Health (CESP), Nutrition, Hormones and Women’s Health team, Villejuif, France. [Clavel- Chapelon,F, Boutron-Ruaul,M] University Paris Sud, UMRS 1018, Villejuif, France. [Clavel-Chapelon,F, Boutron-Ruaul,M] Institute Gustave Roussy, Villejuif, France. [Katzke,V, Neamat-Allah,J] The German Cancer Research Center (DKFZ), Heildelberg, Germany. [Boeing,H, Bachlechner,U] Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany. [Trichopoulou,A, Naska,A, Orfanos,P] Hellenic Health Foundation, Athens, Greece. [Trichopoulou,A, Orfanos,P] Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Pala,V] Epidemiology and Prevention Unit, IRCCS Foundation, National Cancer Institute, Milan, Italy. [Masala,G] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy. [Mattiello,A] Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. [Skeie,G, Weiderpass,E] Department of Community Medicine, University of Tromsø-The Arctic University of Norway, Norway. [Romaguera,D] Instituto de Investigacion Sanitaria de Palma (IdISPa) and CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain. [Agudo,A] Unit of Nutrition, Environment, and Cancer, Catalan Institute of Oncology-ICO, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain. [Huerta,JM] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. [Huerta,JM, Ardanaz,E, Sánchez,MJ] CIBER Epidemiology and Public Health CIBERESP, Spain. [Ardanaz,E] Navarre Public Health Institute, Pamplona, Spain. [Sánchez,MJ Andalusian School of Public Health, Granada, Spain. [Dorronsoro,M] Public health Direction and Biodonostia- CIBERESP, Basque Regional Health Department, San Sebastian, Spain. [Quirós,JR] Public Health Directorate, Asturias, Spain. [Johansson,I] Department of odontology, Umeå University, Sweden. [Winkvis,A] Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Sweden. [Sonested,E] Department of Clinical Sciences in Malmö, Nutrition Epidemiology, Lund University, Malmö, Sweden. [Key,T] The Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom. [Khaw,K] Clinical Gerontology Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, United Kingdom. [Wareham,NJ] MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, United Kingdom. [Peeters,PHM] Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands., Funding: The EPIC- PANACEA ((European Prospective Investigation into Cancer-Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating out of home And obesity) project received funding from the Public Health Programme of the European Union (2005328). EPIC was financially supported by the European Commission: Public Health and Consumer Protection Directorate 1993–2004, and Research Directorate-General 2005. Ligue contre le Cancer, Société 3M, Mutuelle
Subjects: Male, riesgo, ácidos grasos trans, humanos, RATIONALE, lcsh:Medicine, Àcids grassos, Oleic Acids, Ácidos Oléicos, estudios de seguimiento, Biochemistry, chemistry.chemical_compound, Biomarkers, Fatty acids, Isomers, Phospholipids, Weight gain, Fats, Alcohol consumption, Weight loss, Surveys and Questionnaires, estudios prospectivos, Medicine and Health Sciences, PARTICIPANTS, Public Health Surveillance, Prospective Studies, Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Nutritional Status [Medical Subject Headings], Food science, lcsh:Science, Estado Nutricional, Prospective cohort study, Ácidos grasos, ASSOCIATIONS, Medicine(all), 2. Zero hunger, Nutrition and Dietetics, Multidisciplinary, Agricultural and Biological Sciences(all), NUTRITION TRANSITION, Marcadores biológicos, Biochemical markers, Chemicals and Drugs::Lipids::Fatty Acids [Medical Subject Headings], Trans Fatty Acids, Diseases::Neoplasms [Medical Subject Headings], CANCER, Elaidic acid, Neoplasias, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Multidisciplinary Sciences, Europe, Näringslära, ácido oleico, ADIPOSE-TISSUE, BODY-WEIGHT, Chemicals and Drugs::Lipids::Fatty Acids::Fatty Acids, Unsaturated::Fatty Acids, Monounsaturated::Oleic Acids [Medical Subject Headings], Marcadors bioquímics, Science & Technology - Other Topics, Obesitat, Biomarker (medicine), Female, Dieta, medicine.symptom, Research Article, Risk, General Science & Technology, ácidos oleicos, PROCESSED FOODS, Endocrinology and Diabetes, Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], DIET, MD Multidisciplinary, Chemicals and Drugs::Biological Factors::Biological Markers [Medical Subject Headings], medicine, Humans, VDP::Medisinske Fag: 700, vigilancia en salud pública, Obesity, obesidad, Science & Technology, Biochemistry, Genetics and Molecular Biology(all), business.industry, lcsh:R, Body Weight, peso corporal, Weight change, Peso corporal, VDP::Medical disciplines: 700, Oleic acid, chemistry, Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight [Medical Subject Headings], lcsh:Q, business, Genetics and Molecular Biology(all), Follow-Up Studies, Oleic Acid, Estudios epidemiológicos, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies [Medical Subject Headings]
Abstract: Background Few epidemiological studies have examined the association between dietary trans fatty acids and weight gain, and the evidence remains inconsistent. The main objective of the study was to investigate the prospective association between biomarker of industrial trans fatty acids and change in weight within the large study European Prospective Investigation into Cancer and Nutrition ( EPIC) cohort. Methods Baseline plasma fatty acid concentrations were determined in a representative EPIC sample from the 23 participating EPIC centers. A total of 1,945 individuals were followed for a median of 4.9 years to monitor weight change. The association between elaidic acid level and percent change of weight was investigated using a multinomial logistic regression model, adjusted by length of follow- up, age, energy, alcohol, smoking status, physical activity, and region. Results In women, doubling elaidic acid was associated with a decreased risk of weight loss ( odds ratio ( OR) = 0.69, 95% confidence interval ( CI) = 0.55- 0.88, p = 0.002) and a trend was observed with an increased risk of weight gain during the 5- year follow- up ( OR = 1.23, 95% CI = 0.97- 1.56, p = 0.082) ( p- trend, The EPIC-PANACEA ((European Prospective Investigation into Cancer-Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating out of home And obesity) project received funding from the Public Health Programme of the European Union (2005328). EPIC was financially supported by the European Commission: Public Health and Consumer Protection Directorate 1993-2004; Research Directorate-General 2005. Ligue contre le Cancer, Societe 3M, Mutuelle Generale de l'Education Nationale, Institut National de la Sante et de la Recherche Medicale (INSERM) (France); German Cancer Aid, German Cancer Research Center, Federal Ministry of Education and Research (Germany); Danish Cancer Society (Denmark); Health Research Institute Carlos III (RTICC Rd06/0020/0091 and Rd12/0036/0018) from the Spanish Ministry of Health, the participating regional governments and institutions (Spain); Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, the Wellcome Trust (United Kingdom); Hellenic Health Foundation (Greece); Italian Association for Research on Cancer, National Research Council, Associazione Italiana per la Ricerca sul Cancro-AIRC (Italy); Dutch Ministry of Public Health, Welfare and Sports, Dutch Ministry of Health, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF) (The Netherlands); Swedish Cancer Society, Swedish Scientific Council, Regional Government of Skane (Sweden); Norwegian Cancer Society (Norway). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Published: 2015
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14. Dietary patterns among older Europeans: the EPIC-Elderly study

Author: Domenico Palli, Kay-Tee Khaw, Françoise Clavel-Chapelon, Göran Hallmans, Göran Berglund, Vittorio Krogh, Sheila Bingham, Emmanuelle Kesse, Petra H.M. Peeters, Christina Bamia, Miren Dorronsoro, Nadia Slimani, Carlotta Sacerdote, Caroline T M van Rossum, Anja Olsen, Gabriele Nagel, H. B. Bueno-De-Mesquita, Aurelio Barricarte, Theodora Psaltopoulou, Heidi H. Hundborg, Heiner Boeing, María José Sánchez, Kim Overvad, Marga C. Ocké, Elio Riboli, Carmen Navarro, Philippos Orfanos, Pietro Ferrari, Rosario Tumino, Andrew W. Roddam, Paolo Boffetta, Kurt Hoffmann, Antonia Trichopoulou, Elisabet Wirfält, Salvatore Panico, Nikos Baibas, Marie-Christine Boutron-Ruault, J. R. Quirós, Ingegerd Johansson, Anne Tjønneland, Dimitrios Trichopoulos, Teresa Norat, Elizabeth A Spencer, Bamia, C., Orfanos, P., Ferrari, P., Overvad, K., Hundborg, H.H., Tjøonneland, A., Olsen, A., Kesse, E., Boutron-Ruault, M.-C., Clavel-Chapelon, F., Nagel, G., Boffetta, P., Boeing, H., Hoffmann, K., Trichopoulos, D., Baibas, N., Psaltopoulou, T., Norat, T., Slimani, N., Palli, D., Krogh, V., Panico, S., Tumino, R., Sacerdote, C., Bueno-de-Mesquita, H.B., Ocké, M.C., Peeters, P.H., van Rossum, C.T., Quirós, J.-R., Sánchez, M.-J., Navarro, C., Barricarte, A., Dorronsoro, M., Berglund, G., Wirfält, E., Hallmans, G., Johansson, I., Bingham, S., Khaw, K.-T., Spencer, E.A., Roddam, A.W., Riboli, E., Trichopoulou, A., Bamia, C, Orfanos, P, Ferrari, P, Overvad, K, Hundborg, Hh, Tjonneland, A, Olsen, A, Kesse, E, BOUTRON RUAULT, Mc, CLAVEL CHAPELON, F, Nagel, G, Boffetta, P, Boeing, H, Hoffmann, K, Trichopoulos, D, Baibas, N, Psaltopoulou, T, Norat, T, Slimani, N, Palli, D, Krogh, V, Panico, Salvatore, Tumino, R, Sacerdote, C, BUENO DE MESQUITA, Hb, Ocke, Mc, Peeters, Ph, VAN ROSSUM, Ct, Quiros, Jr, Sanchez, Mj, Navarro, C, Barricarte, A, Dorronsoro, M, Berglund, G, Wirfalt, E, Hallmans, G, Johansson, I, Bingham, S, Khaw, Kt, Spencer, Ea, Roddam, Aw, and Riboli, E
Subjects: Gerontology, Male, medicine.medical_specialty, endocrine system, Waist, Medicine (miscellaneous), Disease cluster, Body Mass Index, Age Distribution, Epidemiology, Vegetables, Medicine, Cluster Analysis, Humans, Prospective Studies, Dietary patterns, Sex Distribution, Prospective cohort study, Exercise, Aged, Principal Component Analysis, Nutrition and Dietetics, business.industry, Smoking, food and beverages, Feeding Behavior, Middle Aged, Dietary Fats, European Prospective Investigation into Cancer and Nutrition, Europe, Food, Cohort, Educational Status, Regression Analysis, Female, business, Energy Intake, Body mass index, Demography, Cohort study
Abstract: Overall dietary patterns have been associated with health and longevity. We used principal component (PC) and cluster analyses to identify the prevailing dietary patterns of 99 744 participants, aged 60 years or older, living in nine European countries and participating in the European Prospective Investigation into Cancer and Nutrition (EPIC-Elderly cohort) and to examine their socio-demographic and lifestyle correlates. Two PC were identified: PC1 reflects a 'vegetable-based' diet with an emphasis on foods of plant origin, rice, pasta and other grain rather than on margarine, potatoes and non-alcoholic beverages. PC2 indicates a 'sweet- and fat-dominated' diet with a preference for sweets, added fat and dairy products but not meat, alcohol, bread and eggs. PC1 was associated with a younger age, a higher level of education, physical activity, a higher BMI, a lower waist:hip ratio and never and past smoking. PC2 was associated with older age, less education, never having smoked, a lower BMI and waist:hip ratio and lower levels of physical activity. Elderly individuals in southern Europe scored positively on PC1 and about zero on PC2, whereas the elderly in northern Europe scored negatively on PC1 and variably on PC2. The results of cluster analysis were compatible with the indicated dietary patterns. 'Vegetable-based' and a 'sweet- and fat-dominated' diets are prevalent among the elderly across Europe, and there is a north - south gradient regarding their dietary choices. Our study contributes to the identification of groups of elderly who are likely to have different prospects for long-term disease occurrence and survival. © The Authors 2005.
Published: 2005

15. Mediterranean diet and hip fracture incidence among older adults : the CHANCES project

Author: L. C. P. G. M. De Groot, Sture Eriksson, Diane Feskanich, Alicja Wolk, Liisa Byberg, Ulrika Pettersson-Kymmer, Vassiliki Benetou, Philippos Orfanos, Antonia Trichopoulou, Karl Michaëlsson, Nicole Jankovic, Francine Grodstein, Paolo Boffetta, and Benetou, V. and Orfanos, P. and Feskanich, D. and Michaëlsson, K. and Pettersson-Kymmer, U. and Byberg, L. and Eriksson, S. and Grodstein, F. and Wolk, A. and Jankovic, N. and de Groot, L.C.P.G.M. and Boffetta, P. and Trichopoulou, A.
Subjects: Male, Aging, Mediterranean diet, food frequency questionnaire, Endocrinology, Diabetes and Metabolism, Medizin, Diet, Mediterranean, Hip fracture, Cohort Studies, 0302 clinical medicine, 030212 general & internal medicine, Dietary patterns, modified Mediterranean diet score, Geriatrics, Greece, adult, Incidence (epidemiology), Incidence, dietary compliance, Middle Aged, nutritional assessment, priority journal, Hip fractures, Female, Risk assessment, Cohort study, United State, medicine.medical_specialty, Dietary pattern, 030209 endocrinology & metabolism, Diet Surveys, Risk Assessment, Article, Bone health, 03 medical and health sciences, Food Preferences, medicine, Humans, human, CHANCES, Aged, VLAG, Sweden, Global Nutrition, Wereldvoeding, business.industry, medicine.disease, major clinical study, United States, Orthopedic surgery, business, human activities, Demography, Follow-Up Studies
Abstract: Summary: The association between adherence to Mediterranean diet (MD) and hip fracture incidence is not yet established. In a diverse population of elderly, increased adherence to MD was associated with lower hip fracture incidence. Except preventing major chronic diseases, adhering to MD might have additional benefits in lowering hip fracture risk. Introduction: Hip fractures constitute a major public health problem among older adults. Latest evidence links adherence to Mediterranean diet (MD) with reduced hip fracture risk, but still more research is needed to elucidate this relationship. The potential association of adherence to MD with hip fracture incidence was explored among older adults. Methods: A total of 140,775 adults (116,176 women, 24,599 men) 60 years and older, from five cohorts from Europe and the USA, were followed-up for 1,896,219 person-years experiencing 5454 hip fractures. Diet was assessed at baseline by validated, cohort-specific, food-frequency questionnaires, and hip fractures were ascertained through patient registers or telephone interviews/questionnaires. Adherence to MD was evaluated by a scoring system on a 10-point scale modified to be applied also to non-Mediterranean populations. In order to evaluate the association between MD and hip fracture incidence, cohort-specific hazard ratios (HR), adjusted for potential confounders, were estimated using Cox proportional-hazards regression and pooled estimates were subsequently derived implementing random-effects meta-analysis. Results: A two-point increase in the score was associated with a significant 4% decrease in hip fracture risk (pooled adjusted HR 0.96; 95% confidence interval (95% CI) 0.92–0.99, pheterogeneity = 0.446). In categorical analyses, hip fracture risk was lower among men and women with moderate (HR 0.93; 95% CI 0.87–0.99) and high (HR 0.94; 95% CI 0.87–1.01) adherence to the score compared with those with low adherence. Conclusions: In this large sample of older adults from Europe and the USA, increased adherence to MD was associated with lower hip fracture incidence. © 2018, International Osteoporosis Foundation and National Osteoporosis Foundation.
Published: 2018
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16. Pre-diagnostic vitamin D concentrations and cancer risks in older individuals: an analysis of cohorts participating in the CHANCES consortium

Author: Petra H.M. Peeters, Anja Olsen, Paolo Boffetta, Philippos Orfanos, Tom Wilsgaard, Ellen Kampman, H. Bas Bueno-de-Mesquita, Ben Schöttker, Veronika Fedirko, Lisette C. P. G. M. de Groot, Ulrika Pettersson-Kymmer, Antonia Trichopoulou, Mazda Jenab, José M Ordóñez-Mena, Galatios Siganos, Laura Perna, Eugene Jansen, Bernd Holleczek, Hermann Brenner, Jytte Halkjær, Ordóñez-Mena, J.M., Schöttker, B., Fedirko, V., Jenab, M., Olsen, A., Halkjær, J., Kampman, E., de Groot, L., Jansen, E., Bueno-de-Mesquita, H.B., Peeters, P.H., Siganos, G., Wilsgaard, T., Perna, L., Holleczek, B., Pettersson-Kymmer, U., Orfanos, P., Trichopoulou, A., Boffetta, P., and Brenner, H.
Subjects: Male, Gerontology, Aging, Nutrition and Disease, Epidemiology, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, Risk Factors, Neoplasms, Voeding en Ziekte, Odds Ratio, Medicine, 030212 general & internal medicine, Vitamin D, Non-U.S. Gov't, Cancer, Aged, 80 and over, Research Support, Non-U.S. Gov't, Incidence, Incidence (epidemiology), Cohort, Vitamins, Middle Aged, Europe, Vitamin D concentrations - cancer risks in older individuals, Population Surveillance, 030220 oncology & carcinogenesis, Female, Cohort study, Adult, Research Support, White People, 03 medical and health sciences, Breast cancer, Vitamin D and neurology, Journal Article, Humans, CHANCES, Aged, VLAG, Global Nutrition, Wereldvoeding, Proportional hazards model, business.industry, Odds ratio, medicine.disease, Ageing, Logistic Models, business, Demography
Abstract: The associations of circulating 25-hydroxyvitamin D [25(OH)D] concentrations with total and site-specific cancer incidence have been examined in several epidemiological studies with overall inconclusive findings. Very little is known about the association of vitamin D with cancer incidence in older populations. We assessed the association of pre-diagnostic serum 25(OH)D levels with incidence of all cancers combined and incidence of lung, colorectal, breast, prostate and lymphoid malignancies among older adults. Pre-diagnostic 25(OH)D concentrations and cancer incidence were available in total for 15,486 older adults (mean age 63, range 50–84 years) participating in two cohort studies: ESTHER (Germany) and TROMSØ (Norway); and a subset of previously published nested-case control data from a another cohort study: EPIC-Elderly (Greece, Denmark, Netherlands, Spain and Sweden) from the CHANCES consortium on health and aging. Cox proportional hazards or logistic regression were used to derive multivariable adjusted hazard and odds ratios, respectively, and their 95 % confidence intervals across 25(OH)D categories. Meta-analyses with random effects models were used to pool study-specific risk estimates. Overall, lower 25(OH)D concentrations were not significantly associated with increased incidence of most of the cancers assessed. However, there was some evidence of increased breast cancer and decreased lymphoma risk with higher 25(OH)D concentrations. Our meta-analyses with individual participant data from three large European population-based cohort studies provide at best limited support for the hypothesis that vitamin D may have a major role in cancer development and prevention among European older adults. © 2015, Springer Science+Business Media Dordrecht.
Published: 2016

17. Education, marital status, and risk of hip fractures in older men and women: the CHANCES project

Author: E. Klinaki, Philippos Orfanos, Vassiliki Benetou, Andrea Bellavia, E. M. Papatesta, Tom Wilsgaard, Elisavet Valanou, Anne Peasey, Karl Michaëlsson, Martin Bobak, Antonia Trichopoulou, Ben Schöttker, Diane Feskanich, Hermann Brenner, Alicja Wolk, Ulrika Pettersson-Kymmer, Luai A. Ahmed, Paolo Boffetta, Kai-Uwe Saum, Francine Grodstein, Benetou, V., Orfanos, P., Feskanich, D., Michaëlsson, K., Pettersson-Kymmer, U., Ahmed, L.A., Peasey, A., Wolk, A., Brenner, H., Bobak, M., Wilsgaard, T., Schöttker, B., Saum, K.-U., Bellavia, A., Grodstein, F., Klinaki, E., Valanou, E., Papatesta, E.-M., Boffetta, P., and Trichopoulou, A.
Subjects: Male, Gerontology, medicine.medical_specialty, Higher education, Endocrinology, Diabetes and Metabolism, Population, Cohort Studies, Residence Characteristics, Risk Factors, medicine, Humans, education, Prospective cohort study, Socioeconomic status, Aged, Aged, 80 and over, Geriatrics, Hip fracture, education.field_of_study, Marital Status, Hip Fractures, business.industry, Incidence, Incidence (epidemiology), Middle Aged, medicine.disease, United States, humanities, Europe, Educational Status, Marital status, Female, business, human activities
Abstract: Summary: The role of socioeconomic status in hip fracture incidence is unclear. In a diverse population of elderly, higher education was found to be associated with lower, whereas living alone, compared to being married/cohabiting, with higher hip fracture risk. Educational level and marital status may contribute to hip fracture risk. Introduction: The evidence on the association between socioeconomic status and hip fracture incidence is limited and inconsistent. We investigated the potential association of education and marital status with hip fracture incidence in older individuals from Europe and USA. Methods: A total of 155,940 participants (79 % women) aged 60 years and older from seven cohorts were followed up accumulating 6456 incident hip fractures. Information on education and marital status was harmonized across cohorts. Hip fractures were ascertained through telephone interviews/questionnaires or through record linkage with registries. Associations were assessed through Cox proportional hazard regression adjusting for several factors. Summary estimates were derived using random effects models. Results: Individuals with higher education, compared to those with low education, had lower hip fracture risk [hazard ratio (HR) = 0.84, 95 % confidence interval (CI) 0.72–0.95]. Respective HRs were 0.97 (95 % CI 0.82–1.13) for men and 0.75 (95 % CI 0.65–0.85) for women. Overall, individuals living alone, especially those aged 60–69 years, compared to those being married/cohabiting, tended to have a higher hip fracture risk (HR = 1.12, 95 % CI 1.02–1.22). There was no suggestion for heterogeneity across cohorts (Pheterogeneity > 0.05). Conclusions: The combined data from >150,000 individuals 60 years and older suggest that higher education may contribute to lower hip fracture risk. Furthermore, this risk may be higher among individuals living alone, especially among the age group 60–69 years, when compared to those being married/cohabiting. © 2015, International Osteoporosis Foundation and National Osteoporosis Foundation.
Published: 2015
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18. Adherence to a Healthy Diet According to the World Health Organization Guidelines and All-Cause Mortality in Elderly Adults From Europe and the United States

Author: Martinette T Streppel, Hynek Pikhart, Oscar H. Franco, Frank Kee, Edith J. M. Feskens, Nicole Jankovic, Růžena Kubínová, Ellen Kampman, Sofia Malyutina, Yikyung Park, Lisette C. P. G. M. de Groot, Pilar Amiano, Anouk Geelen, Anne Tjønneland, Martin Bobak, Antonia Trichopoulou, Göran Hallmans, Edith H. van den Hooven, Anne M. May, Philippos Orfanos, H. B. Bueno-De-Mesquita, Andrzej Pajak, Paolo Boffetta, Epidemiology, Jankovic, N., Geelen, A., Streppel, M.T., De Groot, L.C.P.G.M., Orfanos, P., Van Den Hooven, E.H., Pikhart, H., Boffetta, P., Trichopoulou, A., Bobak, M., Bueno-De-Mesquita, H.B., Kee, F., Franco, O.H., Park, Y., Hallmans, G., Tjønneland, A., May, A.M., Pajak, A., Malyutina, S., Kubinova, R., Amiano, P., Kampman, E., and Feskens, E.J.
Subjects: Male, Gerontology, Mediterranean diet, Nutrition and Disease, Epidemiology, epic project, Original Contributions, design, cardiovascular-disease, Diet, Mediterranean, Body Mass Index, Food group, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], scores, prevention, Risk Factors, Neoplasms, Surveys and Questionnaires, Voeding en Ziekte, Medicine, Prospective Studies, Prospective cohort study, risk, Hazard ratio, determinants, cohort, Middle Aged, Europe, Cardiovascular Diseases, quality, Cohort, Female, Guideline Adherence, rationale, Longevity, Guidelines as Topic, World Health Organization, Life Expectancy, Meta-Analysis as Topic, SDG 3 - Good Health and Well-being, Humans, Life Style, Aged, VLAG, Global Nutrition, Wereldvoeding, business.industry, United States, Confidence interval, Diet, Nutrition Assessment, aging, cohort, Consortium on Health and Ageing: Network of Cohorts in Europe and the United States, diet, longevity, meta-analysis, Life expectancy, business, Body mass index, Follow-Up Studies, Demography
Abstract: Item does not contain fulltext The World Health Organization (WHO) has formulated guidelines for a healthy diet to prevent chronic diseases and postpone death worldwide. Our objective was to investigate the association between the WHO guidelines, measured using the Healthy Diet Indicator (HDI), and all-cause mortality in elderly men and women from Europe and the United States. We analyzed data from 396,391 participants (42% women) in 11 prospective cohort studies who were 60 years of age or older at enrollment (in 1988-2005). HDI scores were based on 6 nutrients and 1 food group and ranged from 0 (least healthy diet) to 70 (healthiest diet). Adjusted cohort-specific hazard ratios were derived by using Cox proportional hazards regression and subsequently pooled using random-effects meta-analysis. During 4,497,957 person-years of follow-up, 84,978 deaths occurred. Median HDI scores ranged from 40 to 54 points across cohorts. For a 10-point increase in HDI score (representing adherence to an additional WHO guideline), the pooled adjusted hazard ratios were 0.90 (95% confidence interval (CI): 0.87, 0.93) for men and women combined, 0.89 (95% CI: 0.85, 0.92) for men, and 0.90 (95% CI: 0.85, 0.95) for women. These estimates translate to an increased life expectancy of 2 years at the age of 60 years. Greater adherence to the WHO guidelines is associated with greater longevity in elderly men and women in Europe and the United States.
Published: 2014

19. Fruit and vegetable intake and risk of incident of type 2 diabetes: Results from the consortium on health and ageing network of cohorts in Europe and the United States (CHANCES)

Author: Philippos Orfanos, Jayne V. Woodside, Antonia Trichopoulou, Paolo Boffetta, Georgios Saitakis, Linda M. Liao, Loubaba Mamluk, Rashmi Sinha, Frank Kee, Mark G. O'Doherty, Mamluk, L., O'Doherty, M.G., Orfanos, P., Saitakis, G., Woodside, J.V., Liao, L.M., Sinha, R., Boffetta, P., Trichopoulou, A., and Kee, F.
Subjects: Male, Multivariate analysis, Calorie, Medicine (miscellaneous), 030209 endocrinology & metabolism, Type 2 diabetes, Article, Eating, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Risk Factors, Environmental health, Vegetables, Fruit and vegetable intake and risk of incident of type 2 diabetes, Odds Ratio, Humans, Medicine, Prospective Studies, 030212 general & internal medicine, Food science, Aged, Nutrition and Dietetics, business.industry, Incidence, Incidence (epidemiology), Type 2 Diabetes Mellitus, Odds ratio, Middle Aged, medicine.disease, Obesity, United States, Europe, Logistic Models, Diabetes Mellitus, Type 2, Fruit, Multivariate Analysis, Female, business, Body mass index
Abstract: BACKGROUND/OBJECTIVES: There is limited information to support definitive recommendations concerning the role of diet in the development of type 2 Diabetes mellitus (T2DM). The results of the latest meta-analyses suggest that an increased consumption of green leafy vegetables may reduce the incidence of diabetes, with either no association or weak associations demonstrated for total fruit and vegetable intake. Few studies have, however, focused on older subjects.SUBJECTS/METHODS: The relationship between T2DM and fruit and vegetable intake was investigated using data from the NIH-AARP study and the EPIC Elderly study. All participants below the age of 50 and/or with a history of cancer, diabetes or coronary heart disease were excluded from the analysis. Multivariate logistic regression analysis was used to calculate the odds ratio of T2DM comparing the highest with the lowest estimated portions of fruit, vegetable, green leafy vegetables and cabbage intake.RESULTS: Comparing people with the highest and lowest estimated portions of fruit, vegetable or green leafy vegetable intake indicated no association with the risk of T2DM. However, although the pooled OR across all studies showed no effect overall, there was significant heterogeneity across cohorts and independent results from the NIH-AARP study showed that fruit and green leafy vegetable intake was associated with a reduced risk of T2DM OR 0.95 (95% CI 0.91,0.99) and OR 0.87 (95% CI 0.87,0.90) respectively.CONCLUSIONS: Fruit and vegetable intake was not shown to be related to incident T2DM in older subjects. Summary analysis also found no associations between green leafy vegetable and cabbage intake and the onset of T2DM. Future dietary pattern studies may shed light on the origin of the heterogeneity across populations.European Journal of Clinical Nutrition advance online publication, 17 August 2016
Published: 2017
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20. Adherence to the WCRF/AICR dietary recommendations for cancer prevention and risk of cancer in elderly from Europe and the United States : A meta-Analysis within the CHANCES Project

Author: Petra H.M. Peeters, Göran Hallmans, Hermann Brenner, Anouk Geelen, Nicole Jankovic, Veronika Fedirko, Oscar H. Franco, Anne Kathrin Illner, Antonio Agudo, Antonia Trichopoulou, Anne Tjønneland, Edith J. M. Feskens, José M Ordóñez-Mena, Jessica C. Kiefte-de Jong, Renate M. Winkels, Ellen Kampman, Philippos Orfanos, Yikyung Park, H. Bas Bueno-de-Mesquita, Blaise Mwungura, Paolo Boffetta, Lisette C. P. G. M. de Groot, Mazda Jenab, Epidemiology, Jankovic, N., Geelen, A., Winkels, R.M., Mwungura, B., Fedirko, V., Jenab, M., Illner, A.K., Brenner, H., Ordonez-Mena, J.M., De Jong, J.C.K., Franco, O.H., Orfanos, P., Trichopoulou, A., Boffetta, P., Agudo, A., Peeters, P.H., Tjønneland, A., Hallmans, G., BasBueno-De-Mesquita, H., Park, Y., Feskens, E.J., and De Groot, L.C.
Subjects: Male, Gerontology, Aging, Nutrition and Disease, Healthy Diet, Epidemiology, Medizin, 0302 clinical medicine, Neoplasms, Voeding en Ziekte, Prevalence, 030212 general & internal medicine, Càncer, Prospective cohort study, Cancer, Human Nutrition & Health, Aged, 80 and over, Factors de risc en les malalties, Incidence (epidemiology), Humane Voeding & Gezondheid, 11 Medical And Health Sciences, Europe, Primary Prevention, Oncology, 030220 oncology & carcinogenesis, Meta-analysis, Practice Guidelines as Topic, Female, Diet, Healthy, medicine.medical_specialty, Risk factors in diseases, Lower risk, Article, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Internal medicine, medicine, Journal Article, Life Science, Humans, Geriatric Assessment, Life Style, Aged, VLAG, Global Nutrition, Wereldvoeding, Cancer prevention, business.industry, Dietary recommendations for cancer prevention, risk of cancer in elderly, medicine.disease, United States, Confidence interval, Nutrition Assessment, business
Abstract: OA embargo tt is unknown whether dietary recommendations for cancer prevention are applicable to the elderly. We analyzed WCRF/AICR recommendations in cohorts of European and U.S. adults ages 60 years and above.Individual participant data meta-analysis included 362,114 participants (43% women), from seven prospective cohort studies, free from cancer at enrollment. The WCRF/AICR diet score was based on: (i) energy-dense foods and sugary drinks, (ii) plant foods, (iii) red and processed meat, and (iv) alcoholic drinks. Cox proportional hazards regression was used to examine the association between the diet score and cancer risks. Adjusted, cohort-specific HRs were pooled using random-effects meta-analysis. Risk advancement periods (RAP) were calculated to quantify the time period by which the risk of cancer was postponed among those adhering to the recommendations.After a median follow-up of 11 to 15 years across cohorts, 70,877 cancer cases were identified. Each one-point increase in the WCRF/AICR diet score [range, 0 (no) to 4 (complete adherence)] was significantly associated with a lower risk of total cancer [HR, 0.94; 95% confidence interval (CI), 0.92-0.97], cancers of the colorectum (HR, 0.84; 95% CI, 0.80-0.89) and prostate (HR, 0.94; 95% CI, 0.92-0.97), but not breast or lung. Adherence to an additional component of the WCRF/AICR diet score significantly postponed the incidence of cancer at any site by 1.6 years (RAP, -1.6; 95% CI, -4.09 to -2.16).Adherence to WCRF/AICR dietary recommendations is associated with lower risk of cancer among older adults.Dietary recommendations for cancer prevention are applicable to the elderly. Cancer Epidemiol Biomarkers Prev; 26(1); 136-44. ©2016 AACR. SHERPA/RoMEO Database Pre-Print: erlaubt Post-Print: bedingt Verlags-PDF: nein Details... American Association for Cancer Research ist ein SHERPA/RoMEO yellow Verlag, d.h. Zweitveröffentlichung der Pre-Print version (Entwurf vor Begutachtung) gestattet. Der Verlag bietet eine Open Access Option gegen Bezahlung an.
Published: 2017

21. Self-rated health and all-cause and cause-specific mortality of older adults : individual data meta-analysis of prospective cohort studies in the CHANCES Consortium

Author: Sture Eriksson, Andrzej Pajak, Eleni Klinaki, H. B. Bueno-De-Mesquita, Hermann Brenner, Kai Uwe Saum, Paolo Boffetta, Pagona Lagiou, Dimitrios Trichopoulos, Sofia Malyutina, Julian Gardiner, Philippos Orfanos, Hendrik Juerges, Mette Aadahl, Antonia Trichopoulou, Abdonas Tamosiunas, Ute Mons, Tom Wilsgaard, Roberto Lorbeer, Ruzena Kubinova, Christina Bamia, Charles E. Matthews, Lisette C. P. G. M. de Groot, Anne Peasey, Michael Katsoulis, Ben Schöttker, and Bamia, C. and Orfanos, P. and Juerges, H. and Schöttker, B. and Brenner, H. and Lorbeer, R. and Aadahl, M. and Matthews, C.E. and Klinaki, E. and Katsoulis, M. and Lagiou, P. and Bueno-de-mesquita, H.B. and Eriksson, S. and Mons, U. and Saum, K.-U. and Kubinova, R. and Pajak, A. and Tamosiunas, A. and Malyutina, S. and Gardiner, J. and Peasey, A. and de Groot, L.C. and Wilsgaard, T. and Boffetta, P. and Trichopoulou, A. and Trichopoulos, D.
Subjects: Gerontology, demography, proportional hazards model, Health Status, accounting, health statu, physical activity, cause of death, Elderly, 0302 clinical medicine, cardiovascular mortality, cardiovascular disease, Neoplasms, cancer mortality, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Self-rated health, Geriatrics, anthropometry, 030503 health policy & services, self report, Cardiovascular Disease, Cohort, Obstetrics and Gynecology, health, social psychology, All-cause mortality, medical history, Europe, aged, female, Cardiovascular Diseases, self rated health, Meta-analysis, epidemiology, 0305 other medical science, prospective study, United State, lifestyle, medicine.medical_specialty, alcohol consumption, education, cohort analysi, MEDLINE, European, Article, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, male, medicine, follow up, Humans, controlled study, human, marriage, CHANCES, VLAG, Proportional Hazards Models, Global Nutrition, Wereldvoeding, meta analysi, business.industry, Proportional hazards model, mortality, United States, body regions, Prospective Studie, Ageing, Neoplasm, Self Report, business, body ma, All cause mortality
Abstract: Objectives To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as “at-least-good”. Study design Individual data on SRH and important covariates were obtained for 424,791 European and United States residents, ≥60 years at recruitment (1982–2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses. Main outcome measures All-cause, cardiovascular and cancer mortality. Results Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH “fair” or “poor” vs. “at-least-good” was associated with increased mortality: HRs 1.46 (95% CI 1·23–1.74) and 2.31 (1.79–2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence). Conclusion SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to “feel healthy” and “be healthy”. © 2017
Published: 2017

22. Meat and fish consumption and risk of pancreatic cancer: results from the European Prospective Investigation into Cancer and Nutrition

Author: Françoise Clavel-Chapelon, Birigit Teucher, Björn Lindkvist, Tobias Pischon, Paolo Vineis, H. Bas Bueno-de-Mesquita, Philippos Orfanos, Magritt Brustad, Aurelio Barricarte, Petra H.M. Peeters, Laudina Rodríguez, Teresa Norat, Elio Riboli, Anne Tjønneland, Pietro Ferrari, Francesca L. Crowe, Guri Skeie, Marie-Christine Boutron-Ruault, Eric J. Duell, Dagrun Engeset, Ute Nöthlings, Weimin Ye, Rosario Tumino, Mazda Jenab, Pilar Amiano, Nicholas J. Wareham, Verena A. Grote, Kay-Tee Khaw, Salvatore Panico, Sabine Rohrmann, Antonia Trichopoulou, Ioulia Goufa, Esther Molina-Montes, Suzanne M. Jeurnink, Jakob Linseisen, Dorthe Johansen, Kim Overvad, Heather Ward, Valeria Pala, Rikke Egeberg, María José Tormo, Domenico Palli, Peter D. Siersema, Heiner Boeing, Malin Sund, Nadia Slimani, Vanessa Cottet, Rohrmann, S, Linseisen, J, N?thlings, U, Overvad, K, Egeberg, R, Tj?nneland, A, Boutron Ruault, Mc, Clavel Chapelon, F, Cottet, V, Pala, V, Tumino, R, Palli, D, Panico, Salvatore, Vineis, P, Boeing, H, Pischon, T, Grote, V, Teucher, B, Khaw, Kt, Wareham, Nj, Crowe, Fl, Goufa, I, Orfanos, P, Trichopoulou, A, Jeurnink, Sm, Siersema, Pd, Peeters, Ph, Brustad, M, Engeset, D, Skeie, G, Duell, Ej, Amiano, P, Barricarte, A, Molina Montes, E, Rodr?guez, L, Tormo, Mj, Sund, M, Ye, W, Lindkvist, B, Johansen, D, Ferrari, P, Jenab, M, Slimani, N, Ward, H, Riboli, E, Norat, T, Bueno de Mesquita, Hb, University of Zurich, and Rohrmann, Sabine
Subjects: Male, Oncology, Cancer Research, medicine.medical_specialty, Meat, Nutritional Status, Cohort, Epic, Fish, Pancreatic Cancer, 610 Medicine & health, Risk Assessment, Poultry, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Pancreatic cancer, Internal medicine, Fish Products, medicine, Animals, Humans, 1306 Cancer Research, Prospective Studies, 030212 general & internal medicine, ddc:610, Prospective cohort study, Life Style, 2. Zero hunger, business.industry, Fishes, Feeding Behavior, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), Middle Aged, medicine.disease, Diet, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Pancreatic Neoplasms, 030220 oncology & carcinogenesis, Relative risk, Red meat, Female, 2730 Oncology, business, Risk assessment, Cohort study
Abstract: Pancreatic cancer is the fourth most common cause of cancer death worldwide with large geographical variation, which implies the contribution of diet and lifestyle in its etiology. We examined the association of meat and fish consumption with risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). A total of 477,202 EPIC participants from 10 European countries recruited between 1992 and 2000 were included in our analysis. Until 2008, 865 nonendocrine pancreatic cancer cases have been observed. Calibrated relative risks (RRs) and 95% confidence intervals (CIs) were computed using multivariable-adjusted Cox hazard regression models. The consumption of red meat (RR per 50 g increase per day = 1.03, 95% CI = 0.93-1.14) and processed meat (RR per 50 g increase per day = 0.93, 95% CI = 0.71-1.23) were not associated with an increased pancreatic cancer risk. Poultry consumption tended to be associated with an increased pancreatic cancer risk (RR per 50 g increase per day = 1.72, 95% CI = 1.04-2.84); however, there was no association with fish consumption (RR per 50 g increase per day = 1.22, 95% CI = 0.92-1.62). Our results do not support the conclusion of the World Cancer Research Fund that red or processed meat consumption may possibly increase the risk of pancreatic cancer. The positive association of poultry consumption with pancreatic cancer might be a chance finding as it contradicts most previous findings.
Published: 2016

23. Modifiable causes of premature death in middle-age in Western Europe : Results from the EPIC cohort study

Author: Marc J. Gunter, Ellen A. Struijk, Paul Brennan, Paolo Vineis, Christina Bamia, Guri Skeie, David C. Muller, M. Luisa Redondo, Cornelia Weikert, Salvatore Panico, Elena Molina-Portillo, Antonio Agudo, Rosario Tumino, Françoise Clavel, W M Monique Verschuren, Petra H.M. Peeters, Olle Melander, Jone M. Altzibar, Heiner Boeing, H. Bas Bueno-de-Mesquita, Ruth C. Travis, Elisabete Weiderpass, Gunnar Engström, Malin Sund, Teresa Norat, Anne Tjønneland, Manuela M. Bergmann, Philippos Orfanos, Laureen Dartois, Nicholas J. Wareham, Mattias Johansson, Elio Riboli, Kuanrong Li, Kay-Tee Khaw, Neil Murphy, Eiliv Lund, Antonia Trichopoulou, Marie-Christine Boutron-Ruault, Domenico Palli, Rudolf Kaaks, Konstantinos K. Tsilidis, Lluís Cirera, Pietro Ferrari, Valeria Pala, Timothy J. Key, Kim Overvad, Eva Ardanaz, Muller, David C, Murphy, Neil, Johansson, Mattia, Ferrari, Pietro, Tsilidis, Konstantinos K, Boutron Ruault, Marie Christine, Clavel, Francoise, Dartois, Laureen, Li, Kuanrong, Kaaks, Rudolf, Weikert, Cornelia, Bergmann, Manuela, Boeing, Heiner, Tjønneland, Anne, Overvad, Kim, Redondo, M. Luisa, Agudo, Antonio, Molina Portillo, Elena, Altzibar, Jone M, Cirera, Lluí, Ardanaz, Eva, Khaw, Kay Tee, Wareham, Nicholas J, Key, Timothy J, Travis, Ruth C, Bamia, Christina, Orfanos, Philippo, Trichopoulou, Antonia, Palli, Domenico, Pala, Valeria, Tumino, Rosario, Vineis, Paolo, Panico, Salvatore, Bueno de Mesquita, H. Ba, Verschuren, W. M. Monique, Struijk, Ellen A, Peeters, Petra H, Engström, Gunnar, Melander, Olle, Sund, Malin, Weiderpass, Elisabete, Skeie, Guri, Lund, Eiliv, Norat, Teresa, Gunter, Marc, Riboli, Elio, Brennan, Paul, [Muller,DC, Johansson,M, Ferrari,P, Brennan,P] International Agency for Research on Cancer, Lyon, France. [Murphy,N, Vineis,P, Bueno-de-Mesquita,HB, Peeters,PH, Norat,T, Gunter,M, Riboli,E] School of Public Health, Imperial College London, London, UK] [Tsilidis,KK] Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. [Boutron-Ruault,M] Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France. [Boutron-Ruault,M, Clavel,F, Dartois,L] Université Paris Sud, Villejuif, France. [Boutron-Ruault,M, Dartois,L, Dartois,L] Inserm, Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France. [Li,K, Kaaks,R] Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. [Weikert,C, Bergmann,M, Boeing,H] German Institute of Human Nutrition Potsdam-Rehbrücke (DifE), Nuthetal, Germany. [Tjønneland,A] Danish Cancer Society Research Center, Copenhagen, Denmark. [Overvad,K] Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark. [Redondo,ML] Public Health Directorate, Asturias, Spain. [Agudo,A] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Barcelona, Spain. [Molina-Portillo,E] Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. [Molina-Portillo,E, Altzibar,JM, Cirera,M, Ardanaz,E] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain. [Altzibar,JM] Public Health Division of Gipuzkoa-BIODONOSTIA, Basque Regional Health Department, Donostia - San Sebastián, Spain. [Cirera, L] Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain. Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain. [Ardanaz,E] Navarra Public Health Institute, Pamplona, Spain. Navarra Institute for Health Research (IdiSNA) Pamplona, Pamplona, Spain. [Khaw,K] School of Clinical Medicine, University of Cambridge, Cambridge, UK. [Wareham,NJ] MRC Epidemiology Unit, University of Cambridge, Cambridge, UK. [Key,TJ, Travis,RC] Cancer Epidemiology Unit, University of Oxford, Oxford, UK. [Bamia,C, Orfanos,P, Trichopoulou,A] Hellenic Health Foundation, Athens, Greece. Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Palli,D] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy. [Pala,V] Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, 'Civic - M. P. Arezzo' Hospital, ASP Ragusa, Ragusa, Italy. [Vineis,P] Human Genetics Foundation (HuGeF), Torino, Italy. [Panico,S] Dipartimento di Medicina Clinica e Sperimentale, Federico II University, Naples, Italy. [Bueno-de-Mesquita,HB, Verschuren,WMM] Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. [Bueno-de-Mesquita,HB] Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. [Verschuren,WMM, Struijk,EA, Peeters,PH] Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. [Engström,G] Department of Clinical Science, Malmö Lund University, Lund, Sweden. [Melander,O] Department of Clinical Sciences, Hypertension & Cardiovascular Disease, Clinical Research Centre, Malmö University Hospital, Malmö, Sweden. [Sund,M] Department of Surgical and Perioperative Sciences, Umea University, Umea, Sweden. [Weiderpass,E, Skeie,G, Lund,E] Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. [Weiderpass,E] Department of Research, Cancer Registry of Norway, Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Samfundet Folkhälsan, Helsinki, Finland. [Skeie,G, Lund,E] The Arctic University of Norway, Tromsø, Norway., This work was supported by the French Social Affairs & Health Ministry, Department of Health (Direction Générale de la Santé). The work undertaken by David C Muller for this project was performed during the tenure of an IARC-Australia fellowship supported by Cancer Council Australia. Elio Riboli was supported by the Imperial College Biomedical Research Centre funded by the National Institute of Health Research of UK. The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany), the Hellenic Health Foundation (Greece), Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands), Nordic Centre of xcellence programme on Food, Nutrition and Health. (Norway), Health Research Fund (FIS), PI13/00061 to Granada, Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain), Swedish Cancer Society, Swedish Scientific Council and County Councils of Skåne and Västerbotten (Sweden), Cancer Research UK (14136 to EPIC-Norfolk, C570/A16491 to EPIC-Oxford),Medical Research Council (1000143 to EPIC-Norfolk) (United Kingdom). The sponsors did not have any input into study design, study conduct, data collection, analysis, or interpretation nor did they influence the preparation, review, or approval of the manuscript., Khaw, Kay-Tee [0000-0002-8802-2903], Wareham, Nicholas [0000-0003-1422-2993], and Apollo - University of Cambridge Repository
Subjects: Gerontology, Male, 030204 cardiovascular system & hematology, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings], Cohort Studies, Institut Gustave Roussy, 0302 clinical medicine, Risk Factors, Medicine, 030212 general & internal medicine, Prospective Studies, Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight::Overweight [Medical Subject Headings], Non-U.S. Gov't, media_common, Medicine(all), VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Mortality, Premature [Medical Subject Headings], Research Support, Non-U.S. Gov't, Smoking, Public Health, Global Health, Social Medicine and Epidemiology, 11 Medical And Health Sciences, General Medicine, Middle Aged, Europe, Hypertension, Absolute risk, Modifiable risk factors, Mortality, Premature death, Attributable fraction, language, Female, Cohort study, Research Article, Adult, medicine.medical_specialty, Alcohol Drinking, media_common.quotation_subject, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Habits::Smoking [Medical Subject Headings], Library science, Motor Activity, Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], Research Support, Danish, 03 medical and health sciences, Diseases::Cardiovascular Diseases::Vascular Diseases::Hypertension [Medical Subject Headings], Life Expectancy, Excellence, General & Internal Medicine, Journal Article, Humans, Obesity, Aged, business.industry, Mortality, Premature, Public health, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Life Expectancy [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Body Constitution::Body Weights and Measures::Waist-Hip Ratio [Medical Subject Headings], language.human_language, Cancer registry, Diseases::Nutritional and Metabolic Diseases::Nutrition Disorders::Overnutrition::Obesity [Medical Subject Headings], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Mortalidad, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Drinking Behavior::Alcohol Drinking [Medical Subject Headings], Life expectancy, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, business, Welfare, Modifiable risk factor, Mortalidad prematura
Abstract: Background: Life expectancy is increasing in Europe, yet a substantial proportion of adults still die prematurely before the age of 70 years. We sought to estimate the joint and relative contributions of tobacco smoking, hypertension, obesity, physical inactivity, alcohol and poor diet towards risk of premature death. Methods: We analysed data from 264,906 European adults from the EPIC prospective cohort study, aged between 40 and 70 years at the time of recruitment. Flexible parametric survival models were used to model risk of death conditional on risk factors, and survival functions and attributable fractions (AF) for deaths prior to age 70 years were calculated based on the fitted models. Results: We identified 11,930 deaths which occurred before the age of 70. The AF for premature mortality for smoking was 31 % (95 % confidence interval (CI), 31–32 %) and 14 % (95 % CI, 12–16 %) for poor diet. Important contributions were also observed for overweight and obesity measured by waist-hip ratio (10 %; 95 % CI, 8–12 %) and high blood pressure (9 %; 95 % CI, 7–11 %). AFs for physical inactivity and excessive alcohol intake were 7 % and 4 %, respectively. Collectively, the AF for all six risk factors was 57 % (95 % CI, 55–59 %), being 35 % (95 % CI, 32–37 %) among never smokers and 74 % (95 % CI, 73–75 %) among current smokers. Conclusions: While smoking remains the predominant risk factor for premature death in Europe, poor diet, overweight and obesity, hypertension, physical inactivity, and excessive alcohol consumption also contribute substantially. Any attempt to minimise premature deaths will ultimately require all six factors to be addressed., This work was supported by the French Social Affairs & Health Ministry, Department of Health (Direction Générale de la Santé). The work undertaken by David C Muller for this project was performed during the tenure of an IARC-Australia fellowship supported by Cancer Council Australia. Elio Riboli was supported by the Imperial College Biomedical Research Centre funded by the National Institute of Health Research of UK. The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Nordic Centre of Excellence programme on Food, Nutrition and Health. (Norway); Health Research Fund (FIS), PI13/00061 to Granada, Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Scientific Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk) (United Kingdom). The sponsors did not have any input into study design, study conduct, data collection, analysis, or interpretation nor did they influence the preparation, review, or approval of the manuscript.
Published: 2016
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24. Quantification of the smoking-associated cancer risk with rate advancement periods: Meta-analysis of individual participant data from cohorts of the CHANCES consortium

Author: Niclas Håkansson, Ute Mons, José M Ordóñez-Mena, Rikje Ruiter, Albert Hofman, Stefan Söderberg, Mark G. O'Doherty, Angela Scott, Heinz Freisling, Frank Kee, Catherine E. de Keyser, Paolo Boffetta, Abdonas Tamosiunas, Tom Wilsgaard, Lena Maria Nilsson, Andrzej Pająk, Kari Kuulasmaa, Antonia Trichopoulou, Martin Bobak, Sofia Malyutina, Ellen Kampman, Bruno H. Stricker, Philippos Orfanos, Mazda Jenab, Růžena Kubínová, Pekka Jousilahti, Lisette C. P. G. M. de Groot, Alicja Wolk, Neal D. Freedman, Nicola Orsini, Bas Bueno-de-Mesquita, Ben Schöttker, Michail Katsoulis, Anne Tjønneland, Hermann Brenner, Ordóñez-Mena, J.M., Schöttker, B., Mons, U., Jenab, M., Freisling, H., Bueno-de-Mesquita, B., O'Doherty, M.G., Scott, A., Kee, F., Stricker, B.H., Hofman, A., de Keyser, C.E., Ruiter, R., Söderberg, S., Jousilahti, P., Kuulasmaa, K., Freedman, N.D., Wilsgaard, T., de Groot, L.C.P.G.M., Kampman, E., Håkansson, N., Orsini, N., Wolk, A., Nilsson, L.M., Tjønneland, A., Pajak, A., Malyutina, S., Kubínová, R., Tamosiunas, A., Bobak, M., Katsoulis, M., Orfanos, P., Boffetta, P., Trichopoulou, A., Brenner, H., Erasmus MC other, and Epidemiology
Subjects: Male, Lung Neoplasms, Nutrition and Disease, medicine.medical_treatment, Cohort Studies, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, Risk Factors, Voeding en Ziekte, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Cancer, Medicine(all), education.field_of_study, VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Incidence, Smoking, Cohort, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, 3. Good health, 030220 oncology & carcinogenesis, Female, Cohort study, Research Article, medicine.medical_specialty, Population, Breast Neoplasms, 03 medical and health sciences, Breast cancer, SDG 3 - Good Health and Well-being, medicine, Humans, Smoking - lung, breast, colorectal, prostate, gastric, head and neck, and pancreatic cancer, Mortality, Lung cancer, education, VLAG, Proportional Hazards Models, Global Nutrition, Gynecology, Wereldvoeding, Cancer och onkologi, business.industry, Prostatic Neoplasms, medicine.disease, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Meta-analysis, Cancer and Oncology, Smoking cessation, Smoking Cessation, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, business, Demography
Abstract: Source: doi: 10.1186/s12916-016-0607-5 Background: Smoking is the most important individual risk factor for many cancer sites but its association with breast and prostate cancer is not entirely clear. Rate advancement periods (RAPs) may enhance communication of smoking related risk to the general population. Thus, we estimated RAPs for the association of smoking exposure (smoking status, time since smoking cessation, smoking intensity, and duration) with total and site-specific (lung, breast, colorectal, prostate, gastric, head and neck, and pancreatic) cancer incidence and mortality. Methods: This is a meta-analysis of 19 population-based prospective cohort studies with individual participant data for 897,021 European and American adults. For each cohort we calculated hazard ratios (HRs) for the association of smoking exposure with cancer outcomes using Cox regression adjusted for a common set of the most important potential confounding variables. RAPs (in years) were calculated as the ratio of the logarithms of the HRs for a given smoking exposure variable and age. Meta-analyses were employed to summarize cohort-specific HRs and RAPs. Results: Overall, 140,205 subjects had a first incident cancer, and 53,164 died from cancer, during an average follow-up of 12 years. Current smoking advanced the overall risk of developing and dying from cancer by eight and ten years, respectively, compared with never smokers. The greatest advancements in cancer risk and mortality were seen for lung cancer and the least for breast cancer. Smoking cessation was statistically significantly associated with delays in the risk of cancer development and mortality compared with continued smoking. Conclusions: This investigation shows that smoking, even among older adults, considerably advances, and cessation delays, the risk of developing and dying from cancer. These findings may be helpful in more effectively communicating the harmful effects of smoking and the beneficial effect of smoking cessation. Keywords: Smoking Cancer Incidence Mortality Cohort Meta-analysis
Published: 2016
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25. Educational level and risk of colorectal cancer in EPIC with specific reference to tumor location

Author: Aurelio Barricarte, Konstantinos K. Tsilidis, Domenico Palli, Philippos Orfanos, Carmen Navarro, Petra H.M. Peeters, Göran Hallmans, Salvatore Panico, Maria Jose Sanchez-Perez, Martin Almquist, Fränzel J.B. Van Duijnhoven, Nicholas J. Wareham, Ioulia Goufa, Birgit Teucher, Tonje Braaten, Anja Olsen, Tobias Pischon, H. Bas Bueno-de-Mesquita, Leila Lujan-Barroso, Traci Mouw, Anke M. Leufkens, Silvia Polidoro, Françoise Clavel-Chapelon, Valentina Gallo, Kim Overvad, Anne Tjønneland, Laudina Rodríguez, Guri Skeie, Rudolf Kaaks, Hendriek C. Boshuizen, Anton E. Kunst, Peter D. Siersema, Sophie Morois, Kay-Tee Khaw, Vittorio Krogh, Antonia Trichopoulou, Rosario Tumino, Marie-Christine Boutron-Ruault, Richard Palmqvist, Mazda Jenab, Sophia Zackrisson, Elio Riboli, APH - Amsterdam Public Health, Public and occupational health, Leufkens, Am, Van Duijnhoven, Fj, Boshuizen, Hc, Siersema, Pd, Kunst, Ae, Mouw, T, Tj?nneland, A, Olsen, A, Overvad, K, Boutron Ruault, Mc, Clavel Chapelon, F, Morois, S, Krogh, V, Tumino, R, Panico, Salvatore, Polidoro, S, Palli, D, Kaaks, R, Teucher, B, Pischon, T, Trichopoulou, A, Orfanos, P, Goufa, I, Peeters, Ph, Skeie, G, Braaten, T, Rodr?guez, L, Lujan Barroso, L, S?nchez P?rez, Mj, Navarro, C, Barricarte, A, Zackrisson, S, Almquist, M, Hallmans, G, Palmqvist, R, Tsilidis, Kk, Khaw, Kt, Wareham, N, Gallo, V, Jenab, M, Riboli, E, and Bueno de Mesquita, Hb
Subjects: Gerontology, Male, Cancer Research, Nutrition and Disease, Colorectal cancer, Wiskundige en Statistische Methoden - Biometris, deprivation, Cohort Studies, 0302 clinical medicine, Risk Factors, Voeding en Ziekte, Medicine, rectum, 030212 general & internal medicine, Prospective Studies, socioeconomic-status, Hazard ratio, Confounding, health, Middle Aged, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, nutrition, Oncology, 030220 oncology & carcinogenesis, Educational Status, Female, women, Colorectal Neoplasms, Adult, united-states, Lower risk, survival, 03 medical and health sciences, inequalities, Humans, Socioeconomic status, Mathematical and Statistical Methods - Biometris, VLAG, Aged, colon, business.industry, Proportional hazards model, medicine.disease, Confidence interval, digestive system diseases, Social Class, business, Demography, Follow-Up Studies
Abstract: Existing evidence is inconclusive on whether socioeconomic status (SES) and educational inequalities influence colorectal cancer (CRC) risk, and whether low or high SES/educational level is associated with developing CRC. The aim of our study was to investigate the relationship between educational level and CRC. We studied data from 400,510 participants in the EPIC (European Prospective Investigation into Cancer and Nutrition) study, of whom 2,447 developed CRC (colon: 1,551, rectum: 896, mean follow-up 8.3 years). Cox proportional hazard regression analysis stratified by age, gender and center, and adjusted for potential confounders were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). Relative indices of inequality (RII) for education were estimated using Cox regression models. We conducted separate analyses for tumor location, gender and geographical region. Compared with participants with college/university education, participants with vocational secondary education or less had a nonsignificantly lower risk of developing CRC. When further stratified for tumor location, adjusted risk estimates for the proximal colon were statistically significant for primary education or less (HR 0.73, 95% CI 0.57-0.94) and for vocational secondary education (HR 0.76, 95% CI 0.58-0.98). The inverse association between low education and CRC risk was particularly found in women and Southern Europe. These associations were statistically significant for CRC, for colon cancer and for proximal colon cancer. In conclusion, CRC risk, especially in the proximal colon, is lower in subjects with a lower educational level compared to those with a higher educational level. This association is most pronounced in women and Southern Europe
Published: 2012
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26. Nutrient Patterns and Their Food Sources in an International Study Setting: Report from the EPIC Study

Author: Andrea Wendt, Joline W.J. Beulens, H. Bas Bueno-de-Mesquita, Pilar Amiano, Stephanie E. Chiuve, Elio Riboli, Anette Hjartåker, Domenico Palli, Isabel Drake, Pietro Ferrari, Anne Tjønneland, Maria Santucci de Magistris, Esther Molina-Montes, Heinz Freisling, Timothy J. Key, Aurelio Barricarte Gurrea, Aurelie Moskal, Jytte Halkjær, Brian Buijsse, Carlotta Sacerdote, Valeria Pala, Philippos Orfanos, Pedro T. Pisa, Tilman Kühn, Heiner Boeing, Antonia Trichopoulou, José María Huerta Castaño, José Ramón Quirós, Ulrika Ericson, Lena Maria Nilsson, Elisabete Weiderpass, Anna Winkvist, Genevieve Buckland, Nadia Slimani, Laura Nailler, Marleen A. H. Lentjes, Anne-Claire Vergnaud, Marie-Christine Boutron-Ruault, Graham Byrnes, Kay-Tee Khaw, Christina C. Dahm, Christina Bamia, Claire Cadeau, Marga C. Ocké, Dora Romaguera, Rosario Tumino, Epidemiology and Data Science, ACS - Diabetes & metabolism, ACS - Heart failure & arrhythmias, APH - Health Behaviors & Chronic Diseases, [Moskal,A, Pisa,PT, Freisling,H, Slimani,N] Dietary Exposure Assessment Group, International Agency for Research on Cancer, Lyon, France. [Ferrari,P] Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon, France. [Byrnes,G] Biostatistics Group, International Agency for Research on Cancer, Lyon, France. [Boutron-Ruault,M, Cadeau,C, Nailler,L] Center for research in Epidemiology and Population Health, Nutrition, Hormones and Women’s Health, INSERM, Villejuif, France. Université Paris Sud, Villejuif, France. Institut Gustave-Roussy, Villejuif, France. [Wendt,A, Kühn,T] Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany. [Boeing,H, Buijsse,B] Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany. [Tjønneland,A, Halkjær,J] Danish Cancer Society Research Center, Diet, Genes and Environment, Copenhagen, Denmark. [Dahm,CC] Section for Epidemiology, Institute of Public Health, Aarhus University, Aarhus, Denmark. [Chiuve,SE] Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America. Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America. [Quirós,JR] Public Health and Health Planning Directorate, Asturias, Spain. [Buckland,G] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain. [Molina-Montes,E] Andalusian School of Public Health, Granada, Spain. [Amiano,P, Huerta,JM, Barricarte,A] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain. [Amiano,P] Public Health Division of Gipuzkoa, BIODonostia Research Institute, San Sebastian, Spain. [Barricarte,A] Navarre Public Health Institute, Pamplona, Spain. [Huerta,JM] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. [Khaw,K, Lentjes,MA] Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. [Key,TJ] Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom. [Romaguera,D, Vergnaud,A, Riboli,E] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. [Romaguera,D] CIBER Fisiopatología de la Obesidad y Nutrición, Madrid, Spain. [Trichopoulou,A, Bamia,C, Orfanos,P] WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of AthensMedical School, Athens, Greece. Hellenic Health Foundation, Athens, Greece. [Palli,D] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute ISPO, Florence, Italy. [Pala,V] Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, ‘‘Civile - M.P. Arezzo’’ Hospital, Ragusa, Italy. [Sacerdote,C] HuGeF Foundation and Center for Cancer Prevention CPOPiemonte, Torino, Italy. [Magistris,MS] Department of Clinical and ExperimentalMedicine, Federico II University, Naples, Italy. [Bueno-de-Mesquita,HB, Ocké,MC] The National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. [Bueno-de-Mesquita,HB] Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, The Netherlands. [Beulens,JWJ] Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. [Ericson,U] Diabetes and cardiovascular Disease, Genetic Epidemiology, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden. [Drake,I] Department of Clinical Sciences in Malmö, Research Group in Nutritional Epidemiology, Lund University, Malmö, Sweden. [Nilsson,LM] Department of Public Health and Clinical Medicine, Nutrition Research, Umea University, Umea, Sweden. [Winkvist,A] Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden. [Weiderpass,E] Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway. Department of Research, Cancer Registry of Norway, Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Samfundet Folkhälsan, Helsinki, Finland. [Hjartaker,A] Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway., Funding: The coordination of EPIC is supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Ge´ne´ rale de l’Education Nationale, Institut National de la Sante´ et de la Recherche Me´dicale (INSERM) (France), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany), Hellenic Health Foundation (Greece), Italian Association for Research on Cancer (AIRC) and National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands), [ERC-2009-AdG 232997] and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health. (Norway), Health Research Fund (FIS) of the Spanish Ministry of Health, Spanish Regional Governments of Andalucı´a, Asturias, Basque Country, Murcia [no. 6236] and Navarra and the Catalan Institute of Oncology, ISCIII RETIC [RD06/0020] (Spain), Swedish Cancer Society, Swedish Scientific Council and Regional Government of Ska°ne and Va¨sterbotten (Sweden), Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, and Wellcome Trust (United Kingdom)., and 16491, Cancer Research UK, United Kingdom
Subjects: Male, Epidemiology, EXPLORATORY FACTOR-ANALYSIS, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], VDP::Medical disciplines: 700::Health sciences: 800::Nutrition: 811, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 0302 clinical medicine, Surveys and Questionnaires, estudios prospectivos, Estudios prospectivos, Public and Occupational Health, Food science, Prospective Studies, Cuestionarios, lcsh:Science, mediana edad, Evaluación nutricional, Disciplines and Occupations::Natural Science Disciplines::Science::Research [Medical Subject Headings], 0303 health sciences, anciano, dieta, Geographicals::Geographic Locations::Europe [Medical Subject Headings], Vitamins, adulto, Explained variation, Food Analysis, 3. Good health, DIETARY PATTERNS, Näringslära, Micronutrient Deficiencies, 030220 oncology & carcinogenesis, estilo de vida, Physical Sciences, Science & Technology - Other Topics, evaluación nutricional, Statistics (Mathematics), Check Tags::Male [Medical Subject Headings], factores socioeconómicos, Biostatistics, Endocrinology and Diabetes, Technology, Industry, Agriculture::Food and Beverages::Food [Medical Subject Headings], Estilo de vida, VDP::Medisinske Fag: 700::Helsefag: 800::Ernæring: 811, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], BREAST-CANCER, Humans, Statistical Methods, Life Style, Aged, conducta alimentaria, Science & Technology, MULTIDISCIPLINARY SCIENCES, VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Oncology: 762, lcsh:R, OLDER EUROPEANS, Biology and Life Sciences, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Life Style [Medical Subject Headings], Food Patterns, LARYNGEAL-CANCER, Check Tags::Female [Medical Subject Headings], Food, lcsh:Q, EUROPEAN COUNTRIES, Mathematics, análisis de alimentos, 030309 nutrition & dietetics, Animal food, humanos, lcsh:Medicine, COLORECTAL-CANCER, Nutrient, Alimentos, Medicine and Health Sciences, Public Health Surveillance, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Food Analysis [Medical Subject Headings], RISK, 2. Zero hunger, Nutrition and Dietetics, Multidisciplinary, Nutritional Deficiencies, Factores socioeconómicos, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Habits::Food Habits [Medical Subject Headings], Middle Aged, European Prospective Investigation into Cancer and Nutrition, PRINCIPAL COMPONENTS, Europe, Hábitos alimenticios, Principal component analysis, Investigación, Epidemiological Methods and Statistics, Female, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Health Surveys::Nutrition Surveys::Diet Surveys [Medical Subject Headings], Europa, Cancer Epidemiology, Research Article, Adult, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings], Context (language use), Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], Biology, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Nutrition Assessment [Medical Subject Headings], Environmental health, Confidence Intervals, Vigilancia en salud pública, vigilancia en salud pública, Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Nutrition, Nutrients, Feeding Behavior, Diet, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Onkologi: 762, Nutrition Assessment, Socioeconomic Factors, GASTRIC-CANCER
Abstract: Background: Compared to food patterns, nutrient patterns have been rarely used particularly at international level. We studied, in the context of a multi-center study with heterogeneous data, the methodological challenges regarding pattern analyses. Methodology/Principal Findings: We identified nutrient patterns from food frequency questionnaires (FFQ) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study and used 24-hour dietary recall (24-HDR) data to validate and describe the nutrient patterns and their related food sources. Associations between lifestyle factors and the nutrient patterns were also examined. Principal component analysis (PCA) was applied on 23 nutrients derived from country-specific FFQ combining data from all EPIC centers (N = 477,312). Harmonized 24-HDRs available for a representative sample of the EPIC populations (N = 34,436) provided accurate mean group estimates of nutrients and foods by quintiles of pattern scores, presented graphically. An overall PCA combining all data captured a good proportion of the variance explained in each EPIC center. Four nutrient patterns were identified explaining 67% of the total variance: Principle component (PC) 1 was characterized by a high contribution of nutrients from plant food sources and a low contribution of nutrients from animal food sources; PC2 by a high contribution of micro-nutrients and proteins; PC3 was characterized by polyunsaturated fatty acids and vitamin D; PC4 was characterized by calcium, proteins, riboflavin, and phosphorus. The nutrients with high loadings on a particular pattern as derived from country-specific FFQ also showed high deviations in their mean EPIC intakes by quintiles of pattern scores when estimated from 24-HDR. Center and energy intake explained most of the variability in pattern scores. Conclusion/Significance: The use of 24-HDR enabled internal validation and facilitated the interpretation of the nutrient patterns derived from FFQs in term of food sources. These outcomes open research opportunities and perspectives of using nutrient patterns in future studies particularly at international level., The coordination of EPIC is supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Generale de l'Education Nationale, Institut National de la Sante et de la Recherche Medicale (INSERM) (France); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); Hellenic Health Foundation (Greece); Italian Association for Research on Cancer (AIRC) and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); [ERC-2009-AdG 232997] and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health. (Norway); Health Research Fund (FIS) of the Spanish Ministry of Health, Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia [no. 6236] and Navarra and the Catalan Institute of Oncology, ISCIII RETIC [RD06/0020] (Spain); Swedish Cancer Society, Swedish Scientific Council and Regional Government of Skane and Vasterbotten (Sweden); Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, and Wellcome Trust (United Kingdom). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Published: 2014
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27. Biomarker patterns of inflammatory and metabolic pathways are associated with risk of colorectal cancer: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)

Author: Anne Tjønneland, Christina Bamia, Aurelio Barricarte, Laure Dossus, Petra H.M. Peeters, Marc J. Gunter, Sabine Westhpal, Antonia Trichopoulou, Sabina Rinaldi, Ruth C. Travis, Veronika Fedirko, Fränzel J.B. Van Duijnhoven, J. Ramón Quirós, Kay-Tee Khaw, Philippos Orfanos, Rudolf Kaaks, Krasimira Aleksandrova, Richard Palmqvist, Neil Murphy, Esther Molina-Montes, Eric J. Duell, Eugene Jansen, Jytte Halkjær, Nicholas J. Wareham, Tobias Pischon, Mazda Jenab, Antoine Racine, María Dolores Chirlaque, Domenico Palli, Claudia Agnoli, Miren Dorronsoro, Pietro Ferrari, Heiner Boeing, Kim Overvad, Rosario Tumino, Elio Riboli, Ingrid Ljuslinder, Marie-Christine Boutron-Ruault, Salvatore Panico, Annekatrin Lukanova, H. Bas Bueno-de-Mesquita, Isabelle Romieu, Paolo Vineis, Aleksandrova, K, Jenab, M, Bueno de Mesquita, Hb, Fedirko, V, Kaaks, R, Lukanova, A, van Duijnhoven, Fj, Jansen, E, Rinaldi, S, Romieu, I, Ferrari, P, Murphy, N, Gunter, Mj, Riboli, E, Westhpal, S, Overvad, K, Tj?nneland, A, Halkj?r, J, Boutron Ruault, Mc, Dossus, L, Racine, A, Trichopoulou, A, Bamia, C, Orfanos, P, Agnoli, C, Palli, D, Panico, Salvatore, Tumino, R, Vineis, P, Peeters, Ph, Duell, Ej, Molina Montes, E, Quir?s, Jr, Dorronsoro, M, Chirlaque, Md, Barricarte, A, Ljuslinder, I, Palmqvist, R, Travis, Rc, Khaw, Kt, Wareham, N, Pischon, T, and Boeing, H.
Subjects: Oncology, Male, Nutrition and Disease, multiple imputation, Epidemiology, hdl-cholesterol, Rate ratio, adipose-tissue, Body Mass Index, chemistry.chemical_compound, c-reactive protein, Risk Factors, Voeding en Ziekte, plasma adiponectin, oxidative stress, Prospective Studies, Prospective cohort study, Incidence, density-lipoprotein cholesterol, Middle Aged, Prognosis, European Prospective Investigation into Cancer and Nutrition, Europe, C-Reactive Protein, Biomarker (medicine), Female, Colorectal Neoplasms, Metabolic Networks and Pathways, medicine.medical_specialty, binding-proteins, insulin-resistance, soluble leptin receptor, Adipokines, Internal medicine, medicine, Biomarkers, Tumor, Humans, Triglycerides, VLAG, Aged, Glycated Hemoglobin, Inflammation, Leptin receptor, Adiponectin, business.industry, Case-control study, Endocrinology, Logistic Models, chemistry, Socioeconomic Factors, Case-Control Studies, Glycated hemoglobin, business
Abstract: A number of biomarkers of inflammatory and metabolic pathways are individually related to higher risk of colorectal cancer (CRC); however, the association between biomarker patterns and CRC incidence has not been previously evaluated. Our study investigates the association of biomarker patterns with CRC in a prospective nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC). During median follow-up time of 7.0 (3.7-9.4) years, 1,260 incident CRC cases occurred and were matched to 1,260 controls using risk-set sampling. Pre-diagnostic measurements of C-peptide, glycated hemoglobin, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP), reactive oxygen metabolites (ROM), insulin-like growth factor 1, adiponectin, leptin and soluble leptin receptor (sOB-R) were used to derive biomarker patterns from principal component analysis (PCA). The relation with CRC incidence was assessed using conditional logistic regression models. We identified four biomarker patterns 'HDL-C/Adiponectin fractions', 'ROM/CRP', 'TG/C-peptide' and 'leptin/sOB-R' to explain 60% of the overall biomarker variance. In multi-variable-adjusted logistic regression, the 'HDL-C/Adiponectin fractions', 'ROM/CRP' and 'leptin/sOB-R' patterns were associated with CRC risk [for the highest quartile vs the lowest, incidence rate ratio (IRR) = 0.69, 95% CI 0.51-0.93, P-trend = 0.01; IRR = 1.70, 95% CI 1.30-2.23, P-trend = 0.002; and IRR = 0.79, 95% CI 0.58-1.07; P-trend = 0.05, respectively]. In contrast, the 'TG/C-peptide' pattern was not associated with CRC risk (IRR = 0.75, 95% CI 0.56-1.00, P-trend = 0.24). After cases within the first 2 follow-up years were excluded, the 'ROM/CRP' pattern was no longer associated with CRC risk, suggesting potential influence of preclinical disease on these associations. By application of PCA, the study identified 'HDL-C/Adiponectin fractions', 'ROM/CRP' and 'leptin/sOB-R' as biomarker patterns representing potentially important pathways for CRC development. © Springer Science+Business Media 2014.
Published: 2013
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28. Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study1,4

Author: Vergnaud, Anne-Claire, Romaguera, Dora, Peeters, Petra H, van Gils, Carla H, Chan, Doris S M, Romieu, Isabelle, Freisling, Heinz, Ferrari, Pietro, Clavel-Chapelon, Françoise, Fagherazzi, Guy, Dartois, Laureen, Li, Kuanrong, Tikk, Kaja, Bergmann, Manuela M, Boeing, Heiner, Tjønneland, Anne, Olsen, Anja, Overvad, Kim, Dahm, Christina Catherine, Redondo, Maria Luisa, Agudo, Antonio, Sánchez, María-José, Amiano, Pilar, Chirlaque, María-Dolores, Ardanaz, Eva, Khaw, Kay-Tee, Wareham, Nick J, Crowe, Francesca, Trichopoulou, Antonia, Orfanos, Philippos, Trichopoulos, Dimitrios, Masala, Giovanna, Sieri, Sabina, Tumino, Rosario, Vineis, Paolo, Panico, Salvatore, Bueno-de-Mesquita, H Bas, Ros, Martine M, May, Anne, Wirfält, Elisabet, Sonestedt, Emily, Johansson, Ingegerd, Hallmans, Göran, Lund, Eiliv, Weiderpass, Elisabete, Parr, Christine L, Riboli, Elio, Norat, Teresa, Vergnaud, Ac, Romaguera, D, Peeters, Ph, van Gils, Ch, Chan, D, Romieu, I, Freisling, H, Ferrari, P, Clavel Chapelon, F, Fagherazzi, G, Dartois, L, Li, K, Tikk, K, Bergmann, Mm, Boeing, H, Tj?nneland, A, Olsen, A, Overvad, K, Dahm, Cc, Redondo, Ml, Agudo, A, S?nchez, Mj, Amiano, P, Chirlaque, Md, Ardanaz, E, Khaw, Kt, Wareham, Nj, Crowe, F, Trichopoulou, A, Orfanos, P, Trichopoulos, D, Masala, G, Sieri, S, Tumino, R, Vineis, P, Panico, Salvatore, Bueno de Mesquita, Hb, Ros, Mm, May, A, Wirf?lt, E, Sonestedt, E, Johansson, I, Hallmans, G, Lund, E, Weiderpass, E, Parr, Cl, Riboli, E, and Norat, T.
Subjects: Adult, Male, Questionnaires, European Continental Ancestry Group, Guidelines as Topic, Middle Aged, Motor Activity, Nutrition Surveys, Diet, Cohort Studies, Europe, Risk Factors, Neoplasms, Humans, Patient Compliance, Female, Prospective Studies, Energy Intake, Life Style, Aged, Follow-Up Studies, Proportional Hazards Models, Molecular epidemiology Aetiology, screening and detection [NCEBP 1]
Abstract: Item does not contain fulltext BACKGROUND: In 2007, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) issued recommendations on diet, physical activity, and weight management for cancer prevention on the basis of the most comprehensive collection of available evidence. OBJECTIVE: We investigated whether concordance with WCRF/AICR recommendations is related to risk of death. DESIGN: The current study included 378,864 participants from 9 European countries enrolled in the European Prospective Investigation into Cancer and Nutrition study. At recruitment (1992-1998), dietary, anthropometric, and lifestyle information was collected. A WCRF/AICR score, which incorporated 6 of the WCRF/AICR recommendations for men [regarding body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, and alcoholic drinks (score range: 0-6)] and 7 WCRF/AICR recommendations for women [plus breastfeeding (score range: 0-7)], was constructed. Higher scores indicated greater concordance with WCRF/AICR recommendations. Associations between the WCRF/AICR score and risks of total and cause-specific death were estimated by using Cox regression analysis. RESULTS: After a median follow-up time of 12.8 y, 23,828 deaths were identified. Participants within the highest category of the WCRF/AICR score (5-6 points in men; 6-7 points in women) had a 34% lower hazard of death (95% CI: 0.59, 0.75) compared with participants within the lowest category of the WCRF/AICR score (0-2 points in men; 0-3 points in women). Significant inverse associations were observed in all countries. The WCRF/AICR score was also significantly associated with a lower hazard of dying from cancer, circulatory disease, and respiratory disease. CONCLUSION: Results of this study suggest that following WCRF/AICR recommendations could significantly increase longevity.
Published: 2013
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29. Combined Impact of Lifestyle Factors on Prospective Change in Body Weight and Waist Circumference in Participants of the EPIC-PANACEA Study

Author: Salvatore Panico, Marianne Uhre Jakobsen, Carlos González, Noémie Travier, Emily Sonestedt, Dora Romaguera, Rosario Tumino, Kim Overvad, Rudolf Kaaks, Isabel Drake, Petra H.M. Peeters, Sabina Rinaldi, Domenico Palli, María José Sánchez, Jytte Halkjær, Marie-Christine Boutron-Ruault, Antonio Agudo, Isabelle Romieu, Francesca L. Crowe, Anne M. May, Paolo Vineis, J. Ramón Quirós, Nadia Slimani, Claudia Agnoli, Eva Ardanaz, Philippos Orfanos, José María Huerta, Pilar Amiano, H. Bas Bueno-de-Mesquita, Antonia Trichopoulou, Elio Riboli, Heiner Boeing, Teresa Norat, Manuela M. Bergmann, Tonje Braaten, Monique Verschuren, Androniki Naska, Birgit Teucher, Ulf Ekelund, Guy Fagherazzi, Annika Steffen, Anne Tjønneland, Laureen Dartois, Nicholas J. Wareham, May, Am, Romaguera, D, Travier, N, Ekelund, U, Bergmann, Mm, Kaaks, R, Teucher, B, Steffen, A, Boeing, H, Halkjaer, J, Tjonneland, A, Jakobsen, Mu, Overvad, K, Dartois, L, Fagherazzi, G, Boutron Ruault, Mc, Quir?s, Jr, Agudo, A, Gonzalez, C, S?nchez, Mj, Amiano, P, Huerta, Jm, Ardanaz, E, Wareham, Nj, Crowe, Fl, Naska, A, Orfanos, P, Trichopoulou, A, Palli, D, Agnoli, C, Tumino, R, Vineis, P, Panico, Salvatore, Bueno de Mesquita, Hb, Verschuren, M, Drake, I, Sonestedt, E, Braaten, T, Rinaldi, S, Romieu, I, Slimani, N, Norat, T, Riboli, E, and Peeters, Ph
Subjects: Gerontology, Male, Mediterranean diet, Non-Clinical Medicine, Epidemiology, Health Behavior, lcsh:Medicine, 0302 clinical medicine, Modiried Mediterranean diet, Mass index, 030212 general & internal medicine, Prospective Studies, lcsh:Science, Cancer, 2. Zero hunger, Multidisciplinary, Nutrition and Dietetics, VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Smoking, Abdominal adiposity, Middle Aged, Circumference, Socioeconomic Aspects of Health, Europe, Multidisciplinary Sciences, Health Education and Awareness, Medicine, Science & Technology - Other Topics, Female, Public Health, medicine.symptom, Waist Circumference, Behavioral and Social Aspects of Health, Research Article, Adult, Waist, 030209 endocrinology & metabolism, Motor Activity, Alcohol-consumption, 03 medical and health sciences, Health behaviours, medicine, Humans, Obesity, Life Style, Aged, Nutrition, Randomized controlled-trail, Health Care Policy, Science & Technology, business.industry, Body Weight, lcsh:R, Health Risk Analysis, Anthropometry, Prospective cohort, medicine.disease, Diet, lcsh:Q, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, business, Weight gain, Body mass index, Demography
Abstract: Background: The evidence that individual dietary and lifestyle factors influence a person's weight and waist circumference is well established; however their combined impact is less well documented. Therefore, we investigated the combined effect of physical activity, nutrition and smoking status on prospective gain in body weight and waist circumference. Methods: We used data of the prospective EPIC-PANACEA study. Between 1992 and 2000, 325,537 participants (94,445 men and 231,092 women, aged between 25-70) were recruited from nine European countries. Participants were categorised into two groups (positive or negative health behaviours) for each of the following being physically active, adherent to a healthy (Mediterranean not including alcohol) diet, and never-smoking for a total score ranging from zero to three. Anthropometric measures were taken at baseline and were mainly self-reported after a medium follow-up time of 5 years. Results: Mixed-effects linear regression models adjusted for age, educational level, alcohol consumption, baseline body mass index and follow-up time showed that men and women who reported to be physically active, never-smoking and adherent to the Mediterranean diet gained over a 5-year period 537 (95% CI -706, -368) and 200 (-478, -87) gram less weight and 0.95 (-1.27, -0.639) and 0.99 (-1.29, -0.69) cm less waist circumference, respectively, compared to participants with zero healthy behaviours. Conclusion: The combination of positive health behaviours was associated with significantly lower weight and waist circumference gain.
Published: 2012
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30. Determinants of non- response to a second assessment of lifestyle factors and body weight in the EPIC-PANACEA study

Author: Dora Romaguera, Rosario Tumino, Françoise Clavel-Chapelon, Heiner Boeing, Carlos González, Elizabeth A Spencer, Silke Hermann, Kim Overvad, Androniki Naska, Veronica Hellstrom, Antonio Agudo, Anne Tjønneland, Jytte Halkjær, Anne-Claire Vergnaud, Miren Dorronsoro, Tonje Braaten, Jonas Manjer, José María Huerta, Bo Hedblad, Nadia Slimani, H. Bas Bueno-de-Mesquita, Amalia Mattiello, Marianne Uhre Jakobsen, Traci Mouw, Petra H.M. Peeters, Teresa Norat, Daphne L. van der A, Aurelio Barricarte, Nicholas J. Wareham, Timothy J. Key, Domenico Palli, Valeria Pala, Eiliv Lund, Elio Riboli, Anne M. May, Marie-Christine Boutron-Ruault, Laudina Rodríguez, Lotte E. Adema, Maria J. Sánchez, Philippos Orfanos, Ulf Ekelund, Antonia Trichopoulou, Annika Steffen, Sabine Rohrmann, Manuela M. Bergmann, Sabina Rinaldi, Julius Centre for Health Sciences and Primary Care, University Medical Center [Utrecht], National Institute for Public Health and the Environment [Bilthoven] (RIVM), Department of Epidemiology and Public Health, Imperial College London, Unit of Nutrition, Environment and Cancer, Institut d'Investigació Biomèdica de Bellvitge [Barcelone] (IDIBELL), Epidemiology Unit, Medical Research Council, German Institute of Human Nutrition Potsdam-Rehbrücke, German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE), Hellenic Health Foundation, Department of Hygiene, Epidemiology and Medical Statistics, International Agency for Cancer Research (IACR), Division of Clinical Epidemiology, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Department of Epidemiology, Aarhus University [Aarhus], Department of Cardiology, Aarhus University Hospital, Danish Cancer Society, Institute of Cancer Epidemiology, Cancer Research UK Epidemiology Unit, University of Oxford, Department of Public Health and Clinical Medicine, Umeå University, Department of Surgery, Lund University [Lund]-Malmø University Hospital, Department of Clinical Science, Institute of Community Medicine, University of Tromsø (UiT), Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Public Health and Participation Directorate, Health and Health Care Services Council, Andalusian School of Public Health [Granada], Epidemiology and Health Information, Public Health Department of Gipuzkoa, Public Health Institute of Navarra, Epidemiology Department, CIBER de Epidemiología y Salud Pública (CIBERESP)-Council of Health and Consumer Affairs, Molecular and Nutritional Epidemiology Unit, ISPO-Cancer Research and Prevention Institute, Nutritional Epidemiology Unit, National Cancer Institute [Bethesda] (NCI-NIH), National Institutes of Health [Bethesda] (NIH)-National Institutes of Health [Bethesda] (NIH)-IRCCS Foundation, Dipartimento di Medicina Clinica e Sperimentale, Universita di Napoli, Cancer Registry, Civile - M.P.Arezzo Hospital, This work was supported by the European Union, in the framework of the Public Health Programme (project number: 2005328). The work was further financially supported by the European Commission: Public Health and Consumer Protection Directorate 1993-2004, Research Directorate-General 2005-.', Ligue contre le Cancer, Societé 3 M, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), German Cancer Aid, German Cancer Research Center, Federal Ministry of Education and Research (Germany), Danish Cancer Society (Denmark), Health Research Fund (FIS) of the Spanish Ministry of Health, The participating regional governments and institutions and the ISCIII of the Spanish Ministry of Health (RETICC DR06/0020) (Spain), Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, the Wellcome Trust (United Kingdom), Greek Ministry of Health and Social Solidarity, Hellenic Health Foundation and Stavros Niarchos Foundation (Greece), Italian Association for Research on Cancer, National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports, Dutch Ministry of Health, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF) (the The Netherlands), Swedish Cancer Society, Swedish Scientific Council, Regional Government of Skane (Sweden), Norwegian Cancer Society (Norway)., BMC, Ed., [May,AM, Adema,LE, Peeters,PHM] Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University,Utrecht, The Netherlands. [May,AM, van der Daphne,A, Bueno-de-Mesquita,HB] National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. [Romaguera,D, Vergnaud,AC, Mouw,T, Norat,T, Riboli,E, Peeters,PHM] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. [Agudo,A, Gonzalez,C] Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology, IDIBELL, Barcelona, Spain. [Ekelund,U, Wareham,NJ] Medical Research Council, Epidemiology Unit, Cambridge, United Kingdom. [Steffen,A, Boeing,H, Bergmann,MM] German Institute of Human Nutrition Potsdam Rehbrücke, Heidelberg, Germany. [Orfanos,P, Naska,A, Trichopoulou,A] Hellenic Health Foundation, Athens, Greece AND Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece. [Slimani,N, Rinaldi,S] International Agency for Research on Cancer (IARC-WHO), Lyon, France. [Rohrmann,S, Hermann,S] Division of Clinical Epidemiology, German Cancer Research Center, Heidelberg, Germany. [Jakobsen,MU, Overvad,K] Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark. [Overvad,K] Department of Cardiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark. [Tjonneland,A, Halkjaer,J] Danish Cancer Society, Institute of Cancer Epidemiology, Copenhagen, Denmark. [Key,TJ, Spencer,EA] Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, United Kingdom. [Hellstrom,V] Department of Public Health and Clinical Medicine,Nutritional Research, Umea University, Umea, Sweden. [Manjer,J] Department of Surgery, Malmø University Hospital, Lund University, Malmø, Sweden. [Hedblad,B] Department of Clinical Science, Malmø University Hospital, Lund University, Malmø, Sweden. [Lund,E, Braaten,T] Institute of Community Medicine, University of Tromsø, Tromsø, Norway. [Clavel-Chapelon,F, Boutron-Ruault,MC] Institut National de la Santé et de la Recherche Médicale(INSERM), Villejuif, France. [Clavel-Chapelon,F, Boutron-Ruault,MC] Institut Gustave Roussy, Villejuif, France. [Rodriguez,L] Public Health and Participation Directorate, Health and Health Care Services Council, Asturias, Spain. [Sanchez,MJ] Andalusian School of Public Health, Granada, and CIBER de Epidemiology and Public Health (CIBERESP), Granada, Spain. [Dorronsoro,M] Public Health Department of Gipuzkoa, San Sebastian, Spain. [Barricarte,A] Public Health Institute of Navarra, Pamplona, Spain. [Huerta,JM] Epidemiology Department, Council of Health and Consumer Affairs, Murcia & CIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain. [Palli,D] Molecular and Nutritional Epidemiology Unit, ISPO-Cancer Research and Prevention Institute, Florence, Italy.[Pala,V] Nutritional Epidemiology Unit, IRCCS Foundation, National Cancer Institute, Milan, Italy. [Mattiello,A] Dipartimento di Medicina Clinica e Sperimentale, Università di Napoli, Naples, Italy.[Tumino,R] Cancer Registry, Azienda Ospedaliera 'Civile M.P.Arezzo', Ragusa, Italy., This work was supported by the European Union, in the framework of the Public Health Programme (project number: 2005328). The work was further financially supported by the European Commission: Public Health and Consumer Protection Directorate 1993–2004, Ligue contre le Cancer, Societé 3 M, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), University of Oxford [Oxford], Wareham, Nicholas [0000-0003-1422-2993], Apollo - University of Cambridge Repository, University of Zurich, and May, Anne M
Subjects: Gerontology, Male, Restaurants, Epidemiology, Cross-sectional study, VDP::Medisinske Fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803, Lost-to-follow-up, Weight Gain, Non-participation, Body Mass Index, Eating, 0302 clinical medicine, Risk Factors, Medicine, 030212 general & internal medicine, Prospective Studies, PREDICTORS, Prospective cohort study, Workplace, Nonresponse bias, POPULATION, 2718 Health Informatics, lcsh:R5-920, education.field_of_study, Nutrition and Dietetics, Anthropometry, Follow-up, Participation, Public Health, Global Health, Social Medicine and Epidemiology, HEALTH SURVEY, cohort, Middle Aged, Health survey, HEALTH CARE SCIENCES & SERVICES, 3. Good health, Näringslära, Europe, VDP::Medical disciplines: 700::Health sciences: 800::Epidemiology medical and dental statistics: 803, Cohort, Female, lcsh:Medicine (General), Life Sciences & Biomedicine, Estilo de Vida, Cohort study, Research Article, Adult, Estils de vida, representativeness, Non-response, PARTICIPATION, Population, Lifestyles, Pes corporal, 610 Medicine & health, 030209 endocrinology & metabolism, Health Informatics, 03 medical and health sciences, Sex Factors, Attrition, Humans, COHORT, Obesity, education, REPRESENTATIVENESS, Aged, Selection bias, SELECTION BIAS, Science & Technology, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Health Surveys [Medical Subject Headings], business.industry, Predictors, Body Weight, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Life Style [Medical Subject Headings], 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), Odds ratio, Health Care Service and Management, Health Policy and Services and Health Economy, Encuestas epidemiológicas, Body weight, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Cross-Sectional Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, NONRESPONSE BIAS, ATTRITION, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, FOLLOW-UP, business, Energy Intake, Body mass index, 2713 Epidemiology
Abstract: Background This paper discusses whether baseline demographic, socio-economic, health variables, length of follow-up and method of contacting the participants predict non-response to the invitation for a second assessment of lifestyle factors and body weight in the European multi-center EPIC-PANACEA study. Methods Over 500.000 participants from several centers in ten European countries recruited between 1992 and 2000 were contacted 2–11 years later to update data on lifestyle and body weight. Length of follow-up as well as the method of approaching differed between the collaborating study centers. Non-responders were compared with responders using multivariate logistic regression analyses. Results Overall response for the second assessment was high (81.6%). Compared to postal surveys, centers where the participants completed the questionnaire by phone attained a higher response. Response was also high in centers with a short follow-up period. Non-response was higher in participants who were male (odds ratio 1.09 (confidence interval 1.07; 1.11), aged under 40 years (1.96 (1.90; 2.02), living alone (1.40 (1.37; 1.43), less educated (1.35 (1.12; 1.19), of poorer health (1.33 (1.27; 1.39), reporting an unhealthy lifestyle and who had either a low (25, 1.08 (1.06; 1.10); especially ≥30 kg/m2, 1.26 (1.23; 1.29)). Conclusions Cohort studies may enhance cohort maintenance by paying particular attention to the subgroups that are most unlikely to respond and by an active recruitment strategy using telephone interviews.
Published: 2012
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31. Fluid intake and the risk of urothelial cell carcinomas in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Author: Miren Dorronsoro, Antonia Trichopoulou, Laudina Rodríguez, Françoise Clavel-Chapelon, Nadia Slimani, Jonas Manjer, Lars Egevad, Georgia Stasinopulou, Elio Riboli, Esther Molina, Nina Roswall, Philippos Orfanos, Inger T. Gram, Maria Dolores Chirlaque, Petra H.M. Peeters, Kim Overvad, Vittorio Krogh, Naomi E. Allen, Martine M. Ros, Ellen Kampman, Amalia Mattiello, Börje Ljungberg, Rosario Tumino, Fränzel J.B. Van Duijnhoven, Frederike L. Büchner, Paolo Boffetta, Nicholas J. Wareham, Anne Tjønneland, Lambertus A. Kiemeney, Steffen Weikert, Heiner Boeing, Katja K.H. Aben, Paolo Vineis, Aurelio Barricarte, Kay-Tee Khaw, Calogero Saieva, Jenny Chang-Claude, Carlos González, Dominique S. Michaud, Eiliv Lund, Roy Ehrnström, H. Bas Bueno-de-Mesquita, Rudolf Kaaks, Andrew W. Roddam, Ros, M.M., Bas Bueno-De-Mesquita, H.B., Büchner, F.L., Aben, K.K.H., Kampman, E., Egevad, L., Overvad, K., Tjãnneland, A., Roswall, N., Clavel-Chapelon, F., Kaaks, R., Chang-Claude, J., Boeing, H., Weikert, S., Trichopoulou, A., Orfanos, P., Stasinopulou, G., Saieva, C., Krogh, V., Vineis, P., Tumino, R., Mattiello, A., Peeters, P.H.M., Van Duijnhoven, F.J.B., Lund, E., Gram, I.T., Chirlaque, M.D., Barricarte, A., Rodríguez, L., Molina, E., Gonzalez, C., Dorronsoro, M., Manjer, J., Ehrnström, R., Ljungberg, B., Allen, N.E., Roddam, A.W., Khaw, K.-T., Wareham, N., Boffetta, P., Slimani, N., Michaud, D.S., Kiemeney, L.A.L.M., and Riboli, E.
Subjects: Male, Cancer Research, Nutrition and Disease, urothelial, food frequency questionnaire, Aetiology, screening and detection [ONCOL 5], carcinoma, Cohort Studies, 0302 clinical medicine, Risk Factors, Voeding en Ziekte, Epidemiology, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, risk, Cancer, disinfection by-products, Hazard ratio, Middle Aged, Prognosis, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, Prospective, Oncology, 030220 oncology & carcinogenesis, Female, epidemiology, Fluid, bladder-cancer, intake, Cohort study, Adult, medicine.medical_specialty, life-style, coffee, drinking-water, Drinking, European, Beverages, lower urinary-tract, Molecular epidemiology [NCEBP 1], 03 medical and health sciences, Internal medicine, medicine, Humans, consumption, Risk factor, Aged, VLAG, Molecular epidemiology Aetiology, screening and detection [NCEBP 1], Nutrition, Gynecology, Investigation, business.industry, Proportional hazards model, Feeding Behavior, relative validity, Urinary Bladder Neoplasms, Fluid Therapy, business, EPIC, Relative validity, Follow-Up Studies
Abstract: Contains fulltext : 97923.pdf (Publisher’s version ) (Closed access) Results from previous studies investigating the association between fluid intake and urothelial cell carcinomas (UCC) are inconsistent. We evaluated this association among 233,236 subjects in the European Prospective Investigation into Cancer and Nutrition (EPIC), who had adequate baseline information on water and total fluid intake. During a mean follow-up of 9.3 years, 513 first primary UCC occurred. At recruitment, habitual fluid intake was assessed by a food frequency questionnaire. Multivariable hazard ratios were estimated using Cox regression stratified by age, sex and center and adjusted for energy intake, smoking status, duration of smoking and lifetime intensity of smoking. When using the lowest tertile of intake as reference, total fluid intake was not associated with risk of all UCC (HR 1.12; 95%CI 0.86-1.45, p-trend = 0.42) or with risk of prognostically high-risk UCC (HR 1.28; 95%CI 0.85-1.93, p-trend = 0.27) or prognostically low-risk UCC (HR 0.93; 95%CI 0.65-1.33, p-trend = 0.74). No associations were observed between risk of UCC and intake of water, coffee, tea and herbal tea and milk and other dairy beverages. For prognostically low-risk UCC suggestions of an inverse association with alcoholic beverages and of a positive association with soft drinks were seen. Increased risks were found for all UCC and prognostically low-risk UCC with higher intake of fruit and vegetable juices. In conclusion, total usual fluid intake is not associated with UCC risk in EPIC. The relationships observed for some fluids may be due to chance, but further investigation of the role of all types of fluid is warranted.
Published: 2011
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32. The association of education with body mass index and waist circumference in the EPIC-PANACEA study

Author: Amalia Mattiello, Marianne Uhre Jakobsen, Noémie Travier, Dora Romaguera, Rosario Tumino, Jakob Linseisen, Kim Overvad, Giovanna Masala, Rudolf Kaaks, Aurelio Barricarte, Petra H.M. Peeters, Sabina Rinaldi, Silke Hermann, Petra G. Van Boeckel, Jytte Halkjær, Miren Dorronsoro, Bethany Van Guelpen, Esther Molina, Ingegerd Johansson, Francesca L. Crowe, Anne M. May, Paolo Vineis, Anton E. Kunst, Nadia Slimani, Claudia Agnoli, Signe Borgquist, Philippos Orfanos, H. Bas Bueno-de-Mesquita, Traci Mouw, Antonia Trichopoulou, Françoise Clavel-Chapelon, Elio Riboli, Teresa Norat, Manuela M. Bergmann, Kay-Tee Khaw, Tonje Braaten, Androniki Naska, Laudina Rodríguez, Sabine Rohrmann, Hervé Besson, Guy Fagherazzi, Annika Steffen, Anne Tjønneland, María José Tormo, Jonas Manjer, Nicholas J. Wareham, Division of Cancer Epidemiology, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Social and Preventive Medicine Institute, Universität Zürich [Zürich] = University of Zurich (UZH), Institute of Epidemiology, Helmholtz Centre Munich, Julius Centre for Health Sciences and Primary Care, University Medical Center [Utrecht], National Institute for Public Health and the Environment [Bilthoven] (RIVM), Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA), Medical Research Council, Institute of Metabolic Science-Epidemiology Unit, Department of Epidemiology & Public Health, Imperial College London, Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology-Environment and Cancer, Epidemiology Service, Murcia Health Council, Preventive Medicine and Public Health Unit, Murcia Medical School, CIBER Epidemiología y Salud Pública (CIBERESP), CIBER de Epidemiología y Salud Pública (CIBERESP), Andalusian School of Public Health [Granada], Public Health Department of Gipuzkoa, Public Health Institute of Navarra, Public Health and Participation Directorate, Health and Health Care Services Council, Cancer Epidemiology Unit, University of Oxford, Department of Public Health and Primary Care, University of Cambridge [UK] (CAM), Department of Cardiology, Aarhus University Hospital, Department of Clinical Epidemiology, Danish Cancer Society, Institute of Cancer Epidemiology, Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Clinical and Experimental Medicine, University of Naples Federico II = Università degli studi di Napoli Federico II, Cancer Registry and Histopathology Unit, Department of Oncology-Civile - M.P.Arezzo Hospital, Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), ISI Foundation Institute for Scientific Interchange, Environmental Epidemiology, Department of Hygiene and Epidemiology, University of Athens Medical School [Athens], Hellenic Health Foundation, Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke (DifE), Leibniz Association, Department of Medical Biosciences and Pathology, Umeå University, Department of Odontology, Department of Oncology, Lund University Hospital, Department of Surgery, Malmö University Hospital, Institute of Community Medicine, University of Tromsø (UiT), Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), The work was further financially supported by the European Commission: Public Health and Consumer Protection Directorate 1993-2004, Research Directorate-General 2005-.', Ligue contre le Cancer, Societé 3M, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), German Cancer Aid, German Cancer Research Center, Federal Ministry of Education and Research (Germany), Danish Cancer Society (Denmark), Health Research Fund (FIS) of the Spanish Ministry of Health, The participating regional governments and institutions (Spain), Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, the Wellcome Trust (United Kingdom), Greek Ministry of Health and Social Solidarity, Hellenic Health Foundation and Stavros Niarchos Foundation (Greece), Italian Association for Research on Cancer, National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports, Dutch Ministry of Health, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF) (the Netherlands), Swedish Cancer Society, Swedish Scientific Council, Regional Government of Skane (Sweden), Norwegian Cancer Society (Norway)., BMC, Ed., University of Zurich, Rohrmann, S, University of Oxford [Oxford], Università degli studi di Napoli Federico II, [Hermann,S, Rohrmann,S, Linseisen,J, Kaaks,R] German Canc Res Ctr, Div Canc Epidemiol, D-6900 Heidelberg, Germany. [Linseisen,J] Helmholtz Ctr Munich, Inst Epidemiol, Neuherberg, Germany. [May,AM., Besson,H, Peeters,PH.M.] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands. [May,AM., van Boeckel,PG.A., Bueno-de-Mesquita,H.B] Natl Inst Publ Hlth & Environm RIVM, Bilthoven, Netherlands. [Kunst,A] Univ Amsterdam, Acad Med Ctr, Amsterdam, Netherlands. [Besson,H, Wareham,NJ.] MRC, Inst Metab Sci, Epidemiol Unit, Cambridge, England. [Romaguera,D, Mouw,T, Norat,T, Riboli,E] Univ London Imperial Coll Sci Technol & Med, Dept Epidemiol & Publ Hlth, London, England. [Travier,N] IDIBELL, Catalan Inst Oncol, Unit Nutr Environm & Canc, Barcelona, Spain. [Tormo,MJ] Murcia Hlth Council, Epidemiol Serv, Murcia, Spain. [Tormo,MJ] Murcia Med Sch, Prevent Med & Publ Hlth Unit, Murcia, Spain. [Molina,E] Andalusian Sch Publ Hlth, Granada, Spain. [Dorronsoro,M] Publ Hlth Dept Gipuzkoa, San Sebastian, Spain. [Barricarte,A] Publ Hlth Inst Navarra, Pamplona, Spain. [Rodriguez,L] Hlth & Hlth Care Serv Council, Publ Hlth & Participat Directorate, Asturias, Spain. [Crowe,FL.] Univ Oxford, Canc Epidemiol Unit, Oxford, England. [Khaw,K-T] Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge, England. [Overvad,K] Aarhus Univ Hosp, Aalborg Hosp, Dept Cardiol, Aalborg, Denmark. [Overvad,K, Jakobsen,MU] Aarhus Univ Hosp, Dept Clin Epidemiol, Aalborg, Denmark. [Tjonneland,A, Halkjaer,J] Danish Canc Soc, Inst Canc Epidemiol, Copenhagen, Denmark. [Agnoli,C] Fdn IRCCS Ist Nazl Tumori, Nutr Epidemiol Unit, Milan, Italy. [Mattiello,A] Univ Naples Federico 2, Dept Clin & Expt Med, Naples, Italy. [Tumino,R] Civile MP Arezzo Hosp, Dept Oncol, Canc Registry & Histopathol Unit, Ragusa, Italy. [Masala,G] Canc Res & Prevent Inst ISPO, Mol & Nutr Epidemiol Unit, Florence, Italy. [Vineis,P] ISI Fdn, Turin, Italy. [Naska,A, Orfanos,P, Trichopoulou,A] Univ Athens, Sch Med, Dept Hyg & Epidemiol, Athens, Greece. [Bergmann,MM., Steffen,A] German Inst Human Nutr Potsdam Rehbrucke, Nuthetal, Germany. [Van Guelpen,B] Umea Univ, Dept Med Biosci, Umea, Sweden. [Johansson,I] Umea Univ, Dept Odontol, Umea, Sweden. [Borgquist,S] Univ Lund Hosp, Dept Oncol, Lund, Sweden. [Manjer,J] Malmo Univ Hosp, Dept Surg, Malmo, Sweden. [Braaten,T] Univ Tromso, Inst Community Med, Tromso, Norway. [Fagherazzi,G, Clavel-Chapelon,F] Paris S Univ, Inst Gustave Roussy, Villejuif, France. [Fagherazzi,G, Clavel-Chapelon,F] INSERM, ERI20, Villejuif, France. [Besson,H, Rinaldi,S, Slimani,N] Int Agcy Res Canc, Lyon, France. [Rohrmann,S] Univ Zurich, Inst Social & Prevent Med, Zurich, Switzerland, European Commission: Grant no DG Sanco, project number: 2005328. The work was further financially supported by the European Commission: Public Health and Consumer Protection Directorate 1993-2004, Khaw, Kay-Tee [0000-0002-8802-2903], Wareham, Nicholas [0000-0003-1422-2993], Apollo - University of Cambridge Repository, Faculteit der Geneeskunde, APH - Amsterdam Public Health, and Public and occupational health
Subjects: Male, Epidemiology, Body Mass Index, VDP::Medical disciplines: 700::Health sciences: 800::Nutrition: 811, 0302 clinical medicine, Prospective Studies, Public, Environmental & Occupational Health, MESH: Middle Aged, 3. Good health, MESH: Health Status Disparities, MESH: Waist Circumference, Socioeconomic status, Waist circumference, Public Health, Waist Circumference, Cohort study, VDP::Medisinske Fag: 700::Helsefag: 800::Medisinsk/odontologisk etikk, atferdsfag, historie: 805, Waist, Pes corporal, Education, MESH: Body Mass Index, VDP::Medisinske Fag: 700::Helsefag: 800::Ernæring: 811, 03 medical and health sciences, MESH: Sex Factors, cohort study, Humans, Aged, Science & Technology, MESH: Humans, Prevention, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, MESH: Adult, Body weight, medicine.disease, Obesity, Health Care::Environment and Public Health::Public Health::Epidemiologic Measurements::Biometry::Anthropometry::Body Mass Index [Medical Subject Headings], Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Prospective Studies [Medical Subject Headings], ENERGY-INTAKE, OXFORD PARTICIPANTS, PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH, SCI, Educació, MESH: Educational Status, Body mass index, MESH: Female, Demography, Gerontology, Overweight, SOCIOECONOMIC-STATUS, 030212 general & internal medicine, 2. Zero hunger, MESH: Aged, education, Bmi, Cohort Study, Epic, Socioeconomic Status, lcsh:Public aspects of medicine, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, Circumference, CANCER, PREVALENCE, European Prospective Investigation into Cancer and Nutrition, Europe, OBESITY, Educational Status, Female, medicine.symptom, Life Sciences & Biomedicine, Research Article, Adult, VDP::Medical disciplines: 700::Health sciences: 800::Medical/dental ethics, behavioural sciences, history: 805, 030209 endocrinology & metabolism, 610 Medicine & health, socioeconomic status, BMI, Sex Factors, Eating disorders and obesity, Phenomena and Processes::Physiological Phenomena::Body Constitution::Body Weights and Measures::Body Size::Waist Circumference [Medical Subject Headings], medicine, ddc:610, Nutrition, OVERWEIGHT, business.industry, Health Care::Environment and Public Health::Public Health::Epidemiologic Measurements::Demography::Health Status::Health Status Disparities [Medical Subject Headings], Health Status Disparities, ADULTS, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), 2739 Public Health, Environmental and Occupational Health, MESH: Prospective Studies, MESH: Male, PHYSICAL-ACTIVITY, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, WEIGHT STATUS, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Europe, EPIC, business
Abstract: Background To examine the association of education with body mass index (BMI) and waist circumference (WC) in the European Prospective Investigation into Cancer and Nutrition (EPIC). Method This study included 141,230 male and 336,637 female EPIC-participants, who were recruited between 1992 and 2000. Education, which was assessed by questionnaire, was classified into four categories; BMI and WC, measured by trained personnel in most participating centers, were modeled as continuous dependent variables. Associations were estimated using multilevel mixed effects linear regression models. Results Compared with the lowest education level, BMI and WC were significantly lower for all three higher education categories, which was consistent for all countries. Women with university degree had a 2.1 kg/m2 lower BMI compared with women with lowest education level. For men, a statistically significant, but less pronounced difference was observed (1.3 kg/m2). The association between WC and education level was also of greater magnitude for women: compared with the lowest education level, average WC of women was lower by 5.2 cm for women in the highest category. For men the difference was 2.9 cm. Conclusion In this European cohort, there is an inverse association between higher BMI as well as higher WC and lower education level. Public Health Programs that aim to reduce overweight and obesity should primarily focus on the lower educated population.
Published: 2011
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33. Anthropometry, physical activity and hip fractures in the elderly

Author: Valeria Pala, Yvonne T. van der Schouw, Graziella Frasca, Petra H.M. Peeters, H. Bas Bueno-de-Mesquita, Ioannis S. Benetos, Jone M. Altzibar, Vassiliki Benetou, Alberto Evangelista, Heiner Boeing, Maria Concetta Giurdanella, Ulrika Pettersson, Paolo Boffetta, Bethany Van Guelpen, Sabine Rohrmann, Jakob Linseisen, Cornelia Weikert, Philippos Orfanos, Antonia Trichopoulou, Benetou, V., Orfanos, P., Benetos, I.S., Pala, V., Evangelista, A., Frasca, G., Giurdanella, M.C., Peeters, P.H.M., Van Der Schouw, Y.T., Rohrmann, S., Linseisen, J., Boeing, H., Weikert, C., Pettersson, U., Van Guelpen, B., Bueno-De-Mesquita, H.B., Altzibar, J., Boffetta, P., and Trichopoulou, A.
Subjects: Male, musculoskeletal diseases, medicine.medical_specialty, Poison control, Motor Activity, Hip fracture, Waist–hip ratio, Elderly, Bone Density, Risk Factors, Surveys and Questionnaires, Humans, Medicine, Prospective Studies, Body mass index, Aged, General Environmental Science, Anthropometry, Hip Fractures, Waist-Hip Ratio, business.industry, Physical activity, Incidence, Public health, Waist-to-hip ratio, Human factors and ergonomics, Middle Aged, medicine.disease, Diet, Europe, EPIC study, Body height, Orthopedic surgery, Physical therapy, General Earth and Planetary Sciences, Female, business
Abstract: Introduction: Hip fractures constitute a major and growing public health problem amongst the elderly worldwide. We examined the association of anthropometry and physical activity with hip fracture incidence in a cohort of elderly Europeans, participants in the European Prospective Investigation into Cancer and nutrition (EPIC) study. Materials and methods: The study population consisted of 27 982 volunteers (10 553 men and 17 429 women) aged 60 years and above from five European countries. Information on anthropometry, physical activity, medical history and other characteristics was collected at baseline. During a median follow-up of 8 years, 261 incident hip fractures (203 women and 58 men) were recorded. Data were analysed through Cox proportional hazard regression with adjustment for potential confounders. Results: A higher body mass index (BMI) was associated with lower hip fracture risk (hazard ratio (HR) per increasing sex-specific-quintile: 0.85, 95% confidence interval (95% CI): 0.77-0.94). Body height was associated with increased hip fracture risk (HR per 5 cm: 1.13, 95% CI: 1.01-1.25). Waist-to-hip ratio was not related to hip fracture risk. Increasing levels of leisure-time physical activity were related to lower risk (HR per increasing tertile: 0.84, 95% CI: 0.70-0.99, p for trend: 0.039). Conclusions: In a prospective cohort study of elderly Europeans, we found evidence that high body stature increased and high BMI decreased the incidence of hip fractures. After adjustment for BMI, waist-to-hip ratio was not associated with hip fracture risk. Leisure-time physical activity appears to play a beneficial role in the prevention of hip fractures. © 2010 Elsevier Ltd. All rights reserved.
Published: 2011

34. Diet and hip fractures among elderly Europeans in the EPIC cohort

Author: Ingegerd Johansson, Antonia Trichopoulou, Dimosthenis Zylis, Paolo Boffetta, H. Boeing, Cornelia Weikert, Maria Concetta Giurdanella, J. Linseisen, Philippos Orfanos, Alexandra Nieters, H. B. Bueno-De-Mesquita, R. Tumino, Miren Dorronsoro, P. H. M. Peeters, Paolo Contiero, Ulrika Pettersson, Sabina Sieri, Vassiliki Benetou, Benetou, V., Orfanos, P., Zylis, D., Sieri, S., Contiero, P., Tumino, R., Giurdanella, M.C., Peeters, P.H.M., Linseisen, J., Nieters, A., Boeing, H., Weikert, C., Pettersson, U., Johansson, I., Bueno-De-Mesquita, H.B., Dorronsoro, M., Boffetta, P., and Trichopoulou, A.
Subjects: Male, medicine.medical_specialty, hip, Medicine (miscellaneous), European, elderly, Risk Factors, Surveys and Questionnaires, Vegetables, medicine, Vitamin D and neurology, Humans, hip fractures, diet, nutrients, risk factors, ddc:610, Prospective Studies, Risk factor, Prospective cohort study, Aged, Proportional Hazards Models, Geriatrics, Aged, 80 and over, Hip fracture, Nutrition and Dietetics, business.industry, Hip Fractures, Incidence (epidemiology), Incidence, cohort, Feeding Behavior, Middle Aged, medicine.disease, Surgery, Diet, Europe, Nutrition Assessment, fracture, Cohort, Fatty Acids, Unsaturated, Female, EPIC, business, Demography, Cohort study
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. © 2011 Macmillan Publishers Limited All rights reserved.
Published: 2010

35. Meat consumption and prospective weight change in participants of the EPIC-PANACEA study

Author: Claudia Agnoli, Eiliv Lund, Jytte Halkjær, Paolo Vineis, Nadia Slimani, Laudina Rodríguez, Ingegerd Johansson, Anne M. May, Pilar Amiano, Bas Bueno-de-Mesquita, José María Huerta, Dagrun Engeset, Anne Tjønneland, Françoise Clavel-Chapelon, Heiner Boeing, Marie-Christine Boutron-Ruault, Dora Romaguera, Rosario Tumino, Traci Mouw, Androniki Naska, Marianne Uhre Jakobsen, Nicholas J. Wareham, Elisabeth Couto, Anne-Claire Vergnaud, Frederike L. Büchner, Teresa Norat, Kim Overvad, Philippos Orfanos, Silke Hermann, Timothy J. Key, Vanessa Cottet, Elisabet Wirfält, Salvatore Panico, Jian'an Luan, Antonia Trichopoulou, Veronica Hellstrom, Aurelio Barricarte, Antonio Agudo, Sabina Rinaldi, Jonas Manjer, Noémie Travier, Andreani D. Odysseos, Domenico Palli, Brian Buijsse, María José Sánchez, Tonje Braaten, Sabine Rohrmann, Petra H.M. Peeters, Elio Riboli, E. A. Spencer, Vergnaud, Ac, Norat, T, Romaguera, D, Mouw, T, May, Am, Travier, N, Luan, J, Wareham, N, Slimani, N, Rinaldi, S, Couto, E, Clavel Chapelon, F, Boutron Ruault, Mc, Cottet, V, Palli, D, Agnoli, C, Panico, Salvatore, Tumino, R, Vineis, P, Agudo, A, Rodriguez, L, Sanchez, Mj, Amiano, P, Barricarte, A, Huerta, Jm, Key, Tj, Spencer, Ea, Bueno de Mesquita, B, Büchner, Fl, Orfanos, P, Naska, A, Trichopoulou, A, Rohrmann, S, Hermann, S, Boeing, H, Buijsse, B, Johansson, I, Hellstrom, V, Manjer, J, Wirfält, E, Jakobsen, Mu, Overvad, K, Tjonneland, A, Halkjaer, J, Lund, E, Braaten, T, Engeset, D, Odysseos, A, Riboli, E, and Peeters, Ph
Subjects: Adult, Male, Calorie, Meat, 030309 nutrition & dietetics, Medicine (miscellaneous), 030209 endocrinology & metabolism, Overweight, Weight Gain, Diet Surveys, Molecular epidemiology [NCEBP 1], 03 medical and health sciences, 0302 clinical medicine, Reference Values, Risk Factors, Environmental health, Surveys and Questionnaires, Weight management, medicine, Humans, Food science, Obesity, Prospective Studies, Prospective cohort study, Aged, 2. Zero hunger, 0303 health sciences, Nutrition and Dietetics, business.industry, Weight change, Smoking, food and beverages, Middle Aged, medicine.disease, 3. Good health, Diet, Red meat, Female, medicine.symptom, business, Energy Intake, Weight gain, Follow-Up Studies
Abstract: Contains fulltext : 87610.pdf (Publisher’s version ) (Closed access) 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 approximately 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. 01 augustus 2010
Published: 2010
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36. A cross-sectional analysis of physical activity and obesity indicators in European participants of the EPIC-PANACEA study

Author: Hervé Besson, Domenico Palli, Ulf Ekelund, Claudia Agnoli, S. Rinaldi, C. A. Gonzalez, Jonas Manjer, Teresa Norat, T Mouw, Nadia Slimani, L. Arriola, Françoise Clavel-Chapelon, Elizabeth A Spencer, Cristina Navarro, J. Luan, L. Rodriguez, Noémie Travier, Philippos Orfanos, Elisabet Wirfält, Stephen J. Sharp, Salvatore Panico, Antonio Agudo, María José Sánchez, Paolo Vineis, Mazda Jenab, Andreani D. Odysseos, Kim Overvad, Heiner Boeing, Timothy J. Key, A. Naska, Elio Riboli, H. B. Bueno-de-Mesquita, S. W. van den Berg, Nicholas J. Wareham, Sabine Rohrmann, N Føns Johnsen, Rosario Tumino, A. M. May, M. Bergmann, Antonia Trichopoulou, P. H. Peeters, Elizabeth Lykholt Andreasen, Aurelio Barricarte, M. C. Boutron-Ruault, Rudolf Kaaks, Jytte Halkjær, Eiliv Lund, Besson, H, Ekelund, U, Luan, J, May, Am, Sharp, S, Travier, N, Agudo, A, Slimani, N, Rinaldi, S, Jenab, M, Norat, T, Mouw, T, Rohrmann, S, Kaaks, R, Bergmann, M, Boeing, H, Clavel Chapelon, F, Boutron Ruault, Mc, Overvad, K, Andreasen, El, Johnsen, Nf, Halkjaer, J, Gonzalez, C, Rodriguez, L, Sanchez, Mj, Arriola, L, Barricarte, A, Navarro, C, Key, Tj, Spencer, Ea, Orfanos, P, Naska, A, Trichopoulou, A, Manjer, J, Wirfält, E, Lund, E, Palli, D, Agnoli, C, Vineis, P, Panico, Salvatore, Tumino, R, Bueno de Mesquita, Hb, van den Berg, Sw, Odysseos, Ad, Riboli, E, Wareham, Nj, and Peeters, Ph
Subjects: Gerontology, Male, Waist, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous), Nutritional Status, 030209 endocrinology & metabolism, Motor Activity, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Medicine, Humans, 030212 general & internal medicine, Obesity, 2. Zero hunger, Nutrition and Dietetics, Anthropometry, business.industry, Health Priorities, Smoking, Middle Aged, Circumference, medicine.disease, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, Cross-Sectional Studies, Cohort, Female, business, Body mass index, Demography
Abstract: Objectives: Cross-sectional data suggest a strong association between low levels of physical activity and obesity. The EPIC-PANACEA (European Prospective Investigation into Cancer-Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating out of home And obesity) project was designed to investigate the associations between physical activity and body mass index (BMI) and waist circumference based on individual data collected across nine European countries. Methods: In the European Prospective Investigation into Cancer and Nutrition (EPIC), 519 931 volunteers were recruited between 1992 and 2000, of whom 405 819 had data on main variables of interest. Height, body weight and waist circumference were measured using standardized procedures. Physical activity was assessed using a validated four-category index reflecting a self-reported usual activity during work and leisure time. The associations between physical activity and BMI and waist circumference were estimated using multilevel mixed effects linear regression models, adjusted for age, total energy intake, smoking status, alcohol consumption and educational level. Results: A total of 125 629 men and 280 190 women with a mean age of 52.9 (s.d. 9.7) and 51.5 (s.d. 10.0) years, respectively were included. The mean BMI was 26.6 kg/m 2 (s.d. 3.6) in men and 25.0 kg/m 2 (s.d. 4.5) in women. Fifty percent of men and 30% of women were categorized as being active or moderately active. A one-category difference in the physical activity index was inversely associated with a difference of 0.18 kg/m 2 in the mean BMI (95% confidence interval, CI, 0.11, 0.24) and 1.04-cm (95% CI 0.82, 1.26) difference in waist circumference in men. The equivalent figures for women were 0.31 kg/m 2 (95% CI 0.23, 0.38) and 0.90 cm (95% CI 0.71, 1.08), respectively. Conclusions: Physical activity is inversely associated with both BMI and waist circumference across nine European countries. Although we cannot interpret the association causally, our results were observed in a large and diverse cohort independently from many potential confounders. © 2009 Macmillan Publishers Limited. All rights reserved.
Published: 2009
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37. Adherence to the Mediterranean diet is associated with lower abdominal adiposity in European men and women

Author: Anne M. May, Petra H.M. Peeters, Hervé Besson, Aurelio Barricarte, Vanessa Cottet, Ingegerd Johansson, Françoise Clavel-Chapelon, Kim Overvad, Heiner Boeing, Marianne Uhre Jacobsen, Eiliv Lund, Nadia Slimani, Elisabeth Couto, Dragun Engeset, Paolo Vineis, Pilar Amiano, Claudia Agnoli, Jian'an Luan, Rudolf Kaaks, Christina Bamia, Domenico Palli, Frederike L. Büchner, Jytte Halkjær, Laudina Rodríguez, Nicholas J. Wareham, Anne Tjønneland, Elio Riboli, Toni Braaten, María José Sánchez, E. A. Spencer, Jonas Manjer, Sabine Rohrmann, Veronica Hellstrom, Antonio Agudo, José María Huerta, H. Bas Bueno-de-Mesquita, Traci Mouw, Teresa Norat, Timothy J. Key, Manuela M. Bergmann, Sabina Rinaldi, Noémie Travier, Andreani D. Odysseos, Elisabet Wirfält, Salvatore Panico, Philippos Orfanos, Marie-Christine Boutron-Ruault, Antonia Trichopoulou, Dora Romaguera, Rosario Tumino, Androniki Naska, Romaguera, D, Norat, T, Mouw, T, May, Am, Bamia, C, Slimani, N, Travier, N, Besson, H, Luan, J, Wareham, N, Rinaldi, S, Couto, E, Clavel Chapelon, F, Boutron Ruault, Mc, Cottet, V, Palli, D, Agnoli, C, Panico, Salvatore, Tumino, R, Vineis, P, Agudo, A, Rodriguez, L, Sanchez, Mj, Amiano, P, Barricarte, A, Huerta, Jm, Key, Tj, Spencer, Ea, Bueno de Mesquita, Hb, Büchner, Fl, Orfanos, P, Naska, A, Trichopoulou, A, Rohrmann, S, Kaaks, R, Bergmann, M, Boeing, H, Johansson, I, Hellstrom, V, Manjer, J, Wirfält, E, Uhre Jacobsen, M, Overvad, K, Tjonneland, A, Halkjaer, J, Lund, E, Braaten, T, Engeset, D, Odysseos, A, Riboli, E, and Peeters, P. H.
Subjects: Adult, Male, Waist, Mediterranean diet, 030309 nutrition & dietetics, Cross-sectional study, Abdominal Fat, Medicine (miscellaneous), 030209 endocrinology & metabolism, Aetiology, screening and detection [ONCOL 5], Diet, Mediterranean, Body Mass Index, Cohort Studies, Molecular epidemiology [NCEBP 1], 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Obesity, Prospective Studies, Food science, Prospective cohort study, Adiposity, Aged, 2. Zero hunger, 0303 health sciences, Nutrition and Dietetics, Geography, Confounding, Middle Aged, medicine.disease, Diet, Europe, Cross-Sectional Studies, Linear Models, Female, Waist Circumference, Body mass index, Demography, Cohort study
Abstract: Contains fulltext : 79873.pdf (Publisher’s version ) (Closed access) 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.
Published: 2009
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38. Vegetables and fruits in relation to cancer risk: Evidence from the Greek EPIC cohort study

Author: Antonia Trichopoulou, Philippos Orfanos, Dimitrios Trichopoulos, Paolo Boffetta, Vassiliki Benetou, Pagona Lagiou, Benetou, V., Orfanos, P., Lagiou, P., Trichopoulos, D., Boffetta, P., and Trichopoulou, A.
Subjects: Adult, Male, Risk, medicine.medical_specialty, Epidemiology, Population, Vegetables and fruits in relation to cancer risk, Neoplasms, Vegetables, Medicine, Humans, Prospective Studies, education, Prospective cohort study, Aged, Proportional Hazards Models, education.field_of_study, Cancer prevention, Greece, business.industry, Incidence (epidemiology), Incidence, Hazard ratio, Feeding Behavior, Middle Aged, European Prospective Investigation into Cancer and Nutrition, Surgery, Oncology, Fruit, Cohort, Female, business, Demography, Cohort study
Abstract: Introduction: Vegetables and fruits have long been considered as conducive to cancer prevention, but this view has recently been challenged. We investigated the relation of vegetable and fruit intake with total cancer occurrence in the population-based cohort of the Greek component of the European Prospective Investigation into Cancer and nutrition (EPIC), which is characterized by high consumption of these foods. Materials and Methods: For a median of 7.9 years, 25,623 participants (10,582 men, 15,031 women) were actively followed-up, contributing 188,042 person-years. Cancer at any site was diagnosed in 851 participants (421 men, 430 women). Dietary intakes were ascertained at enrollment through an extensive, validated, interviewer-administered food frequency questionnaire. Data were analyzed through Cox regression, controlling for potential confounders. Results: An inverse association of cancer incidence with vegetables and fruits (mutually adjusted) was noted, reaching statistical significance for vegetables among women. When vegetables and fruits were combined, the inverse association with cancer occurrence was statistically significant for the entire cohort [hazard ratio per increasing quintile, 0.94; 95% confidence interval (95% CI), 0.88-0.99], as well as among women (hazard ratio per increasing quintile, 0.90; 95% CI, 0.83-0.98), but not among men (hazard ratio per increasing quintile, 0.95; 95% CI, 0.87-1.04). Conclusions: In a general population-based Greek cohort, we have found evidence that consumption of vegetables and fruits is inversely associated with incidence of cancer overall, although the associations seem to be weaker than expected on the basis of case-control studies previously undertaken in Greece. (Cancer Epidemiol Biomarkers Prev 2008;17(2):387–92)
Published: 2008

39. Conformity to traditional Mediterranean diet and cancer incidence: The Greek EPIC cohort

Author: Antonia Trichopoulou, Dimitrios Trichopoulos, Vassiliki Benetou, Androniki Naska, Philippos Orfanos, Pagona Lagiou, Paolo Boffetta, Benetou, V., Trichopoulou, A., Orfanos, P., Naska, A., Lagiou, P., Boffetta, P., and Trichopoulos, D.
Subjects: Adult, Male, Cancer Research, medicine.medical_specialty, cancer incidence, Mediterranean diet, Epidemiology, dietary patterns, Diet, Mediterranean, EPIC Study, Neoplasms, Surveys and Questionnaires, cohort study, Humans, Medicine, Aged, Greece, business.industry, Incidence, Incidence (epidemiology), Hazard ratio, Cancer, Middle Aged, medicine.disease, Confidence interval, European Prospective Investigation into Cancer and Nutrition, Surgery, Oncology, Cohort, Female, dietary pattern, business, Demography, Cohort study
Abstract: Adherence to traditional Mediterranean diet (MD) has been reported to be inversely associated with total, as well as cardiovascular, mortality. We have examined the relation between degree of such adherence and incidence of cancer overall in a general population sample of 25 623 participants (10 582 men, 15 041 women) of the Greek segment of the European Prospective Investigation into Cancer and nutrition (EPIC). All subjects completed a validated, interviewer-administered, semi-quantitative food-frequency questionnaire at enrolment. Degree of adherence to the traditional MD was assessed through a 10-point scale (0 minimal; 9 maximal) that incorporated key dietary characteristics. During a median follow-up of 7.9 years and 188 042 total person-years, 851 medically confirmed incident cancer cases (421 men, 430 women) were recorded. Using proportional hazards regression with adjustment for potential confounders, we found that a higher degree of MD adherence was associated with lower overall cancer incidence. A two-point increase in the score corresponded to a 12% reduction in cancer incidence (adjusted hazard ratio, 0.88 (95% confidence interval 0.80, 0.95)). The association was exposure-dependent and stronger among women. This inverse association with MD adherence was considerably stronger than that predicted on the basis of the associations of the individual components of this diet and points to the value of analysing dietary patterns in cancer studies. © 2008 Cancer Research UK.
Published: 2008

40. Plasma C-reactive protein and risk of cancer: a prospective study from Greece

Author: Paolo Boffetta, Philippos Orfanos, Antonia Trichopoulou, Dimitrios Trichopoulos, Theodora Psaltopoulou, Trichopoulos, D., Psaltopoulou, T., Orfanos, P., Trichopoulou, A., and Boffetta, P.
Subjects: Adult, Male, Risk, medicine.medical_specialty, Epidemiology, Gastroenterology, Plasma C-reactive protein and risk of cancer, Internal medicine, Neoplasms, Blood plasma, medicine, Biomarkers, Tumor, Humans, Prospective Studies, Risk factor, Prospective cohort study, Aged, Aged, 80 and over, biology, Greece, business.industry, C-reactive protein, Acute-phase protein, Cancer, Odds ratio, Middle Aged, medicine.disease, Confidence interval, C-Reactive Protein, Oncology, Immunology, biology.protein, Female, business
Abstract: Background: Inflammation is an important component of carcinogenesis but little research has been conducted on whether inflammation markers can be predictive of cancer risk in humans. Methods: We analyzed C-reactive protein (CRP), a marker of inflammation, in plasma samples of 496 cases of cancer and 996 controls selected among participants in a prospective study from Greece. Results: Plasma CRP level was higher in cancer cases than controls (odds ratio for increase in CRP level of 3.2 mg/L, 1.20; 95% confidence interval, 1.10-1.32): The corresponding odds ratio after exclusion of the first year of follow-up and of individuals with CRP level above 20 mg/L was 1.32 (95% confidence interval, 1.15-1.52). Although based on small number of cases, the association between elevated plasma CRP level and risk was stronger for cancers of the liver, lung, skin, kidney, and bladder, as well as for lymphoma and leukemia than for other neoplasms. Conclusions: Our results confirm the important role of inflammation in human cancer and suggest that plasma CRP level is a potential marker of increased cancer risk. (Cancer Epidemiol Biomarkers Prev 2006;15(2):381–4)
Published: 2006

41. Comparison of two statistical approaches to predict all-cause mortality by dietary patterns in German elderly subjects

Author: Pietro Ferrari, Paolo Boffetta, Kurt Hoffmann, Heiner Boeing, Christina Bamia, Philippos Orfanos, Gabriele Nagel, Hoffmann, K., Boeing, H., Boffetta, P., Nagel, G., Orfanos, P., Ferrari, P., and Bamia, C.
Subjects: Gerontology, Male, Meat, Saturated fat, Eggs, Medicine (miscellaneous), Risk Assessment, Germany, Dietary Carbohydrates, Medicine, Humans, Dietary patterns, Mortality, Aged, Principal Component Analysis, Nutrition and Dietetics, business.industry, Contrast (statistics), Regression analysis, Bread, Feeding Behavior, Dietary Fats, European Prospective Investigation into Cancer and Nutrition, Diet, Relative risk, Fruit, Principal component analysis, Butter, Regression Analysis, Female, Energy source, business, Energy Metabolism, All cause mortality, Demography
Abstract: Dietary patterns are comprehensive variables of dietary intake appropriate to model the complex exposure in nutritional research. The objectives of this study were to identify dietary patterns by applying two statistical methods, principal component analysis (PCA) and reduced rank regression (RRR), and to assess their ability to predict all-cause mortality. Motivated by previous studies we chose percentages of energy from different macronutrients as response variables in the RRR analysis. We used data from 9356 German elderly subject enrolled in the European Prospective Investigation into Cancer and Nutrition study. The first RRR pattern, subjects which explained 30·8 % of variation in energy sources and especially much variation in intake of saturated fat, monounsaturated fat and carbohydrates was a significant predictor of all-cause mortality. The pattern score had high positive loadings in all types of meat, butter, sauces and eggs, and was inversely associated with bread and fruits. After adjustment for other known risk factors, the relative risks from the lowest to highest quintiles of the first RRR pattern score were 1·0, 1·01, 0·96, 1·32, 1·61 (P for trend: 0·0004). In contrast, the first two PCA patterns explaining 19·7 % of food intake variation but only 7·0 % of variation in energy sources were not related to mortality. These results suggest that variation in macronutrients is meaningful for mortality and that the RRR method is more appropriate than the classic PCA method to identify dietary patterns relevant to mortality.
Published: 2005

42. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study

Author: Françoise Clavel-Chapelon, Elio Riboli, Christina Bamia, Petra H.M. Peeters, Elizabeth A Spencer, Kurt Hoffmann, Vassiliki Benetou, Elisabet Wirfält, Ingegerd Johansson, Anja Olsen, Salvatore Panico, Gabriele Nagel, Heiner Boeing, Sheila Bingham, Teresa Norat, Antonia Trichopoulou, Anne Tjønneland, Rosario Tumino, Pietro Ferrari, Heidi H. Hundborg, Miren Dorronsoro, Yvonne T. van der Schouw, Philippos Orfanos, Nadia Slimani, Carmen Navarro, Marie-Christine Boutron-Ruault, Göran Berglund, Androniki Naska, Timothy J. Key, Bas Bueno-de-Mesquita, Kay-Tee Khaw, Emmanuelle Kesse, Paolo Boffetta, Miguel Rodríguez-Barranco, Marga C. Ocké, Carmen Martinez-Garcia, Dimitrios Trichopoulos, Paolo Vineis, Guillem Pera, Göran Hallmans, Vittorio Krogh, Kim Overvad, Giovanna Masala, and Trichopoulou, A. and Orfanos, P. and Norat, T. and Bueno-de-Mesquita, B. and Ocké, M.C. and Peeters, P.H.M. and van der Schouw, Y.T. and Boeing, H. and Hoffmann, K. and Boffetta, P. and Nagel, G. and Masala, G. and Krogh, V. and Panico, S. and Tumino, R. and Vineis, P. and Bamia, C. and Naska, A. and Benetou, V. and Ferrari, P. and Slimani, N. and Pera, G. and Martinez-Garcia, C. and Navarro, C. and Rodriguez-Barranco, M. and Dorronsoro, M. and Spencer, E.A. and Key, T.J. and Bingham, S. and Khaw, K.-T. and Kesse, E. and Clavel-Chapelon, F. and Boutron-Ruault, M.-C. and Berglund, G. and Wirfalt, E. and Hallmans, G. and Johansson, I. and Tjonneland, A. and Olsen, A. and Overvad, K. and Hundborg, H.H. and Riboli, E. and Trichopoulos, D.
Subjects: Male, Gerontology, Mediterranean diet, Denmark, Diet, Mediterranean, Cohort Studies, cause of death, Germany, middle aged, Medicine, Prospective Studies, Prospective cohort study, General Environmental Science, anthropometry, Greece, Confounding, article, General Engineering, clinical trial, General Medicine, stroke, Europe, aged, female, Italy, priority journal, Papers, Regression Analysis, France, prospective study, Human, Cohort study, lifestyle, cohort analysi, Longevity, Regression Analysi, survival, Aged, Netherland, food composition, Humans, cancer, follow up, Letters, Sex Distribution, Life Style, Survival analysis, Sweden, business.industry, Proportional hazards model, questionnaire, sex ratio, ischemic heart disease, major clinical study, mortality, Survival Analysis, United Kingdom, Confidence interval, Prospective Studie, multicenter study, confidence interval, statistical analysi, Spain, life expectancy, Life expectancy, General Earth and Planetary Sciences, Cohort Studie, dietary intake, business, Demography
Abstract: Objective To examine whether adherence to the modified Mediterranean diet, in which unsaturates were substituted for monounsaturates, is associated with longer life expectancy among elderly Europeans. Design Multicentre, prospective cohort study. Setting Nine European countries (Denmark, France, Germany, Greece, Italy, the Netherlands, Spain, Sweden, United Kingdom). Participants 74 607 men and women, aged 60 or more, without coronary heart disease, stroke, or cancer at enrolment and with complete information about dietary intake and potentially confounding variables. Main outcome measures Extent of adherence to a modified Mediterranean diet using a scoring system on a 10 point scale, and death from any cause by time of occurrence, modelled through Cox regression. Results An increase in the modified Mediterranean diet score was associated with lower overall mortality, a two unit increment corresponding to a statistically significant reduction of 8% (95% confidence interval 3% to 12%). No statistically significant evidence of heterogeneity was found among countries in the association of the score with overall mortality even though the association was stronger in Greece and Spain. When dietary exposures were calibrated across countries, the reduction in mortality was 7% (1% to 12%). Conclusion The Mediterranean diet, modified so as to apply across Europe, was associated with increased survival among older people.
Published: 2005

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