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1. Association between dietary meat consumption and incident type 2 diabetes: the EPIC-InterAct study

Author

Benedinelli, B, Palli, D, Masala, G, Sharp, Sj, Schulz, Mb, Guevara, M, van der AD, Sera, F, Amiano, P, Balkau, B, Barricarte, A, Boeing, H, Crowe, Fl, Dahm, Cc, Dalmeijer, G, de Lauzon Guillain, B, Egeberg, R, Fagherazzi, G, Franks, Pw, Krogh, V, Huerta, Jm, Jakszyn, P, Khaw, Kt, Li, K, Mattiello, A, Nilsson, Pm, Overvad, K, Ricceri, Fulvio, Rolandsson, O, Sánchez, Mj, Slimani, N, Sluijs, I, Spijkerman, Am, Teucher, B, Tjonneland, A, Tumino, R, van den Berg SW, Forouhi, Ng, Langeberg, C, Feskens, Ej, Riboli, E, Wareham, Nj, and Interact, Consortium

Subjects
Adult, Male, Risk, Meat, Nutrition and Disease, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, Cohort Studies, Young Adult, Voeding en Ziekte, Diabetes mellitus, Internal Medicine, Humans, Medicine, Prospective Studies, Prospective cohort study, Aged, Aged, 80 and over, Sex Characteristics, business.industry, Incidence, Case-control study, Middle Aged, medicine.disease, Diet, European Prospective Investigation into Cancer and Nutrition, Europe, Meat Products, Cross-Sectional Studies, Case-cohort study, Diabetes Mellitus, Type 2, Case-Control Studies, Red meat, Female, business, Iron, Dietary, Follow-Up Studies, Demography, Cohort study
Abstract

Aims/hypothesis: A diet rich in meat has been reported to contribute to the risk of type 2 diabetes. The present study aims to investigate the association between meat consumption and incident type 2 diabetes in the EPIC-InterAct study, a large prospective case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: During 11.7 years of follow-up, 12,403 incident cases of type 2 diabetes were identified among 340,234 adults from eight European countries. A centre-stratified random subsample of 16,835 individuals was selected in order to perform a case-cohort design. Prentice-weighted Cox regression analyses were used to estimate HR and 95% CI for incident diabetes according to meat consumption. Results: Overall, multivariate analyses showed significant positive associations with incident type 2 diabetes for increasing consumption of total meat (50 g increments: HR 1.08; 95% CI 1.05, 1.12), red meat (HR 1.08; 95% CI 1.03, 1.13) and processed meat (HR 1.12; 95% CI 1.05, 1.19), and a borderline positive association with meat iron intake. Effect modifications by sex and class of BMI were observed. In men, the results of the overall analyses were confirmed. In women, the association with total and red meat persisted, although attenuated, while an association with poultry consumption also emerged (HR 1.20; 95% CI 1.07, 1.34). These associations were not evident among obese participants. Conclusions/interpretation: This prospective study confirms a positive association between high consumption of total and red meat and incident type 2 diabetes in a large cohort of European adults.

Published
2012
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2. Meat consumption and mortality--results from the European Prospective Investigation into Cancer and Nutrition

Author

Pietro Ferrari, Dagrun Engeset, Timothy J. Key, Kuanrong Li, Anne Tjønneland, Kim Overvad, José María Huerta, H. Bas Bueno-de-Mesquita, Christine L. Parr, Guri Skeie, Pilar Amiano, Kay-Tee Khaw, Teresa Norat, Göran Hallmans, Anne C. Vergnaud, Isabelle Romieux, Fulvio Ricceri, M. Luisa Redondo, Dimitirios Trichopoulos, Rosario Tumino, Veronika Fedirko, Françoise Clavel-Chapelon, Elio Riboli, Androniki Naska, Rikke Egeberg, Nicholas J. Wareham, Marianne Uhre Jakobsen, Emily Sonestedt, Heiner Boeing, Aurelio Barricarte, Salvatore Panico, Max Leenders, Manuela M. Bergmann, Laura Nailler, Isabel Drake, Paula Jakszyn, Marie-Christine Boutron-Ruault, Domenico Palli, Sabine Rohrmann, Vittorio Krogh, Antonia Trichopoulou, María José Sánchez, Jakob Linseisen, Petra H.M. Peeters, Ingegerd Johansson, Francesca L. Crowe, Rudolf Kaaks, Khaw, Kay-Tee [0000-0002-8802-2903], Wareham, Nicholas [0000-0003-1422-2993], Apollo - University of Cambridge Repository, University of Zurich, Rohrmann, Sabine, [Rohrmann,S] Division of Cancer Epidemiology and Prevention, Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland. [Rohrmann,S., Li,K, Kaaks,R, Linseisen,J] Division of Cancer Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany. [Overvad,K, Jakobsen,MU] Section of Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark. [Bueno-de-Mesquita,HB] National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.[Bueno-de-Mesquita, HB, Leenders,M] Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. [Egeberg,R, Tjønneland,A] Danish Cancer Society Research Center, Copenhagen, Denmark. [Nailler,L, Boutron-Ruault,MC, Clavel-Chapelon,F] Inserm, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Villejuif, France. [Nailler,L, Clavel-Chapelon,F] Paris South University, UMRS, Villejuif, France. [Krogh,V] Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. [Palli,D] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy. [Panico,S] Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, 'Civile - M.P.Arezzo' Hospital, Ragusa, Italy. [Ricceri,F] HuGeF - Human Genetics Foundation - Torino, Torino, Italy. [Bergmann,MM, Boeing,H] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany. [Khaw,KT] Department of Public Health and Primary Care, University of Cambridge, Cambridge UK. [Wareham,NJ] Medical Research Council (MRC) Epidemiology Unit, Cambridge UK. [Crowe,FL, Key,TJ] Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK. [Naska,A, Trichopoulou,A] WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Trichopoulou,A, Trichopoulos,D] Hellenic Health Foundation, Athens, Greece. [Trichopoulos,D] Department of Epidemiology, Harvard School of Public Health, Boston MA, USA.Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece. [Peeters,PHM] Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands. [Peeters,PHM, Norat,T, Vergnaud,AC, Riboli,E] School of Public Health, Imperial College, London, UK. [Engeset,D, Skeie,G] Department of Community Medicine, University of Tromsø, Tromsø, Norway. [Parr,CL] Department of Biostatistics, Faculty of Medicine, University of Oslo, Oslo, Norway. [Jakszyn,P] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Barcelona, Spain. [Sánchez,MJ, Huerta,JM] Andalusian School of Public Health, Granada, Spain. [Sánchez,MJ, Barricarte,A, Amiano,P] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Spain. [Huerta,JM] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. [Redondo,ML] Public Health Directorate Asturias, Oviedo, Spain. [Barricarte,A] Navarre Public Health Institute, Pamplona, Spain. [Amiano,P] Public Health Division of Gipuzkoa, BIODonostia Research Institute, Department of Health of the Regional Government of the Basque Country, San Sebastian, Spain. [Drake,I, Sonestedt,E] Department of Clinical Sciences, Lund University, Malmö, Sweden. [Hallmans,G] Department of Public Health and Clinical Medicine, Nutrition Research, Umeå University, Umeå, Sweden. [Johansson,I] Department of Odontology, Cariology, Umeå University, Umeå, Sweden. [Fedirko,V, Romieux,I, Ferrari,P] International Agency for Research on Cancer (IARC), Lyon, France. [Linseisen,J] Institute of Epidemiology, Helmholtz Centre Munich, Neuherberg, Germany., Europe Against Cancer Program of the European Commission (SANCO), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum, German Federal Ministry of Education and Research, Danish Cancer Society, Health Research Fund (FIS) of the Spanish Ministry of Health, Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra, ISCIII RCESP exp. C03/09, Spain, Cancer Research UK, Medical Research Council, United Kingdom, Stroke Association, United Kingdom, British Heart Foundation, Department of Health, United Kingdom, Food Standards Agency, United Kingdom, Wellcome Trust, United Kingdom, the Hellenic Health Foundation and the Stavros Niarchos Foundation, Italian Association for Research on Cancer (AIRC), Italian National Research Council, Fondazione-Istituto Banco Napoli, 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), Swedish Cancer Society, Swedish Scientific Council, Regional Government of Skåne, Sweden, Nordforsk the Norwegian Cancer Society, French League against Cancer (LNCC), National Institute for Health and Medical Research (INSERM), France, Mutuelle Générale de l’Education Nationale (MGEN), France, 3M Co, France, Gustave Roussy Institute (IGR), France, and General Councils of France, BMC, Ed., Division of Cancer Epidemiology and Prevention, Universität Zürich [Zürich] = University of Zurich (UZH)-Institute of Social and Preventive Medicine, Division of Cancer Epidemiology, Deutsches Krebsforschungszentrum, Section of Epidemiology, Aarhus University [Aarhus], Department of Gastroenterology and Hepatology, University Medical Centre, National Institute for Public Health and the Environment [Bilthoven] (RIVM), Danish Cancer Society Research Center, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori - National Cancer Institute [Milan], Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Department of Clinical and Experimental Medicine, University of Naples Federico II = Università degli studi di Napoli Federico II, Cancer Registry and Histopathology Unit, Civile - M.P.Arezzo Hospital, HuGeF - Human Genetics Foundation - Torino, Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE), Department of Public Health and Primary Care, University of Cambridge [UK] (CAM), Epidemiology Unit, Medical Research Council, Cancer Epidemiology Unit, University of Oxford, WHO Collaborating Center for Food and Nutrition Policies, University of Athens Medical School [Athens], Hellenic Health Foundation, Harvard School of Public Health, Bureau of Epidemiologic Research, Academy of Athens, Julius Center, University Medical Center [Utrecht], School of Public Health, Imperial College London, Department of Community Medicine, University of Tromsø (UiT), Department of Biostatistics [Oslo], Institute of Basic Medical Sciences [Oslo], Faculty of Medicine [Oslo], University of Oslo (UiO)-University of Oslo (UiO)-Faculty of Medicine [Oslo], University of Oslo (UiO)-University of Oslo (UiO), Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO), Andalusian School of Public Health [Granada], Consortium for Biomedical Research in Epidemiology and Public Health, CIBER de Epidemiología y Salud Pública (CIBERESP), Murcia Regional Health Council, Public Health Directorate Asturias, Navarre Public Health Institute, Public Health Division of Gipuzkoa, BIODonostia Research Institute, Department of Clinical Sciences, Lund University [Lund], Department of Public Health and Clinical Medicine, Umeå University, Department of Odontology, Cariology, International Agency for Cancer Research (IACR), Institute of Epidemiology, Helmholtz Centre Munich, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Università degli studi di Napoli Federico II, University of Oxford [Oxford], Rohrmann, S, Overvad, K, Bueno de Mesquita, Hb, Jakobsen, Mu, Egeberg, R, Tj?nneland, A, Nailler, L, Boutron Ruault, Mc, Clavel Chapelon, F, Krogh, V, Palli, D, Panico, Salvatore, Tumino, R, Ricceri, F, Bergmann, Mm, Boeing, H, Li, K, Kaaks, R, Khaw, Kt, Wareham, Nj, Crowe, Fl, Key, Tj, Naska, A, Trichopoulou, A, Trichopoulos, D, Leenders, M, Peeters, Ph, Engeset, D, Parr, Cl, Skeie, G, Jakszyn, P, S?nchez, Mj, Huerta, Jm, Redondo, Ml, Barricarte, A, Amiano, P, Drake, I, Sonestedt, E, Hallmans, G, Johansson, I, Fedirko, V, Romieux, I, Ferrari, P, Norat, T, Vergnaud, Ac, Riboli, E, and Linseisen, J.

Subjects
Male, 030309 nutrition & dietetics, Colorectal cancer, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Survival Analysis [Medical Subject Headings], Review, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], 2700 General Medicine, DISEASE, COLORECTAL-CANCER, VDP::Medical disciplines: 700::Health sciences: 800::Nutrition: 811, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Cohort Studies, Diet, Meat, Mortality, Cohort, Europe, Cardiovascular, Cancer, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Health Surveys::Nutrition Surveys [Medical Subject Headings], 0302 clinical medicine, Neoplasms, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Medicine(all), RISK, CALIBRATION, 2. Zero hunger, 0303 health sciences, Nutrition and Dietetics, cardiovascular, Diabetes, Hazard ratio, food and beverages, cohort, General Medicine, Diseases::Neoplasms [Medical Subject Headings], Middle Aged, Nutrition Surveys, Neoplasias, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Näringslära, Cardiovascular Diseases, Red meat, [SDV.BBM.GTP] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Female, Enfermedades cardiovasculares, Life Sciences & Biomedicine, Geographicals::Geographic Locations::Americas::North America::United States [Medical Subject Headings], CERTIFICATES, Research Article, Cohort study, Technology, Industry, Agriculture::Food and Beverages::Food::Meat [Medical Subject Headings], Adult, medicine.medical_specialty, 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], Processed meat, Estudios de cohortes, Check Tags::Male [Medical Subject Headings], 610 Medicine & health, Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Feeding Behavior [Medical Subject Headings], VDP::Medisinske Fag: 700::Helsefag: 800::Ernæring: 811, VEGETARIANS, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], medicine, cancer, Humans, ddc:610, Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Diseases::Cardiovascular Diseases [Medical Subject Headings], Aged, Science & Technology, business.industry, VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Oncology: 762, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), Feeding Behavior, medicine.disease, mortality, Survival Analysis, United States, Surgery, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Onkologi: 762, RED MEAT, Check Tags::Female [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], Commentary, 21-YEAR FOLLOW-UP, business, Body mass index, Demography
Abstract

Background Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods Included in the analysis were 448,568 men and women without prevalent cancer, stroke, or myocardial infarction, and with complete information on diet, smoking, physical activity and body mass index, who were between 35 and 69 years old at baseline. Cox proportional hazards regression was used to examine the association of meat consumption with all-cause and cause-specific mortality. Results As of June 2009, 26,344 deaths were observed. After multivariate adjustment, a high consumption of red meat was related to higher all-cause mortality (hazard ratio (HR) = 1.14, 95% confidence interval (CI) 1.01 to 1.28, 160+ versus 10 to 19.9 g/day), and the association was stronger for processed meat (HR = 1.44, 95% CI 1.24 to 1.66, 160+ versus 10 to 19.9 g/day). After correction for measurement error, higher all-cause mortality remained significant only for processed meat (HR = 1.18, 95% CI 1.11 to 1.25, per 50 g/d). We estimated that 3.3% (95% CI 1.5% to 5.0%) of deaths could be prevented if all participants had a processed meat consumption of less than 20 g/day. Significant associations with processed meat intake were observed for cardiovascular diseases, cancer, and 'other causes of death'. The consumption of poultry was not related to all-cause mortality. Conclusions The results of our analysis support a moderate positive association between processed meat consumption and mortality, in particular due to cardiovascular diseases, but also to cancer.

Published
2013
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3. 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

4. Meat and heme iron intake and risk of squamous cell carcinoma of the upper aero-digestive tract in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Author

Ulrika Ericson, Petra H.M. Peeters, J. Ramón Quirós, Domenico Palli, Alessio Naccarati, Peter D. Siersema, Ingegerd Johansson, María Dolores Chirlaque, Heiner Boeing, Francesca L. Crowe, H. B. Bueno-de-Mesquita, Manuela M. Bergmann, Isabelle Romieu, Anne-Claire Vergnaud, Pietro Ferrari, Signe Borgquist, Göran Hallmanns, Salvatore Panico, Despoina Oikonomidou, Vittorio Krogh, Pilar Amiano, Aurelio Barricarte Gurrea, Kim Overvad, Veronika Fedirko, Kay-Tee Khaw, Traci Mouw, Menelaos Pantzalis, Nicholas J. Wareham, Paula Jakszyn, Verena A. Grote, Teresa Norat, María José Sánchez, Rosario Tumino, Anne Tjønneland, Rikke Egeberg, Guri Skeie, Naomi E. Allen, Annika Steffen, Kuanrong Li, Antonia Trichopoulou, Steffen, A, Bergmann, Mm, S?nchez, Mj, Chirlaque, Md, Jakszyn, P, Amiano, P, Quir?s, Jr, Barricarte Gurrea, A, Ferrari, P, Romieu, I, Fedirko, V, Bueno de Mesquita, Hb, Siersema, Pd, Peeters, Ph, Khaw, Kt, Wareham, N, Allen, Ne, Crowe, Fl, Skeie, G, Hallmanns, G, Johansson, I, Borgquist, S, Ericson, U, Egeberg, R, Tj?nneland, A, Overvad, K, Grote, V, Li, K, Trichopoulou, A, Oikonomidou, D, Pantzalis, M, Tumino, R, Panico, Salvatore, Palli, D, Krogh, V, Naccarati, A, Mouw, T, Vergnaud, Ac, Norat, T, and Boeing, H.

Subjects
Male, Risk, medicine.medical_specialty, Pathology, Meat, Epidemiology, Heme iron, Heme, EPIC, Gastroenterology, Risk Assessment, Article, Cohort Studies, Internal medicine, medicine, Humans, Basal cell, Prospective Studies, Prospective cohort study, Laryngeal Neoplasms, Proportional Hazards Models, business.industry, Feeding Behavior, Middle Aged, European Prospective Investigation into Cancer and Nutrition, Europe, stomatognathic diseases, Oncology, Carcinoma, Squamous Cell, Digestive tract, Female, Risk assessment, business, Iron, Dietary, Cohort study
Abstract

Background: Evidence from prospective studies on intake of meat and fish and risk of squamous cell carcinoma (SCC) of the upper aero-digestive tract (UADT) is scarce. We prospectively investigated the association of meat and fish intake with risk of SCC of the UADT and the possible mechanism via heme iron in the large multicenter European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Multivariable proportional hazards models were used to estimate relative risks (RR) of SCC of the UADT in relation to intake of total meat, as well as subtypes of meat, fish, and heme iron among 348,738 individuals from 7 European countries. Results: During an average follow-up of 11.8 years, a total of 682 incident cases of UADT SCC were accrued. Intake of processed meat was positively associated with risk of SCC of the UADT in the total cohort [highest vs. lowest quintile: RR = 1.41; 95% confidence interval (CI) = 1.03–1.94], however, in stratified analyses, this association was confined to the group of current smokers (highest vs. lowest quintile: RR = 1.89; 95% CI = 1.22–2.93). Red meat, poultry, fish, and heme iron were not consistently related to UADT SCC. Conclusion: Higher intake of processed meat was positively associated with SCC of the UADT among smokers. Although this finding was stable in various sensitivity analyses, we cannot rule out residual confounding by smoking. Confirmation in future studies and identification of biologic mechanisms is warranted. Impact: Smokers may further increase their risk for SCC of the UADT if they additionally consume large amounts of processed meat. Cancer Epidemiol Biomarkers Prev; 21(12); 2138–48. ©2012 AACR.

Published
2012
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5. Dietary fibre intake and ischaemic heart disease mortality: the European Prospective Investigation into Cancer and Nutrition-Heart study

Author

Bo Hedblad, Y. T. van der Schouw, Rikke Egeberg, Rudolf Kaaks, Conchi Moreno-Iribas, Timothy J. Key, J. R. Quirós, Pamela Ferrari, M-J Sanchez, S-C Chuang, Sabina Sieri, H. B. Bueno-de-Mesquita, José María Huerta, Anne Tjønneland, V Ouranos, Miren Dorronsoro, Francesca L. Crowe, Teresa Norat, J.M.A. Boer, Elio Riboli, Heiner Boeing, Elisavet Valanou, Giuseppe Matullo, Genevieve Buckland, Nicholas J. Wareham, K-T Khaw, Joline W.J. Beulens, Kim Overvad, Giovanna Masala, B Teucher, A-K Illner, Salvatore Panico, John Danesh, Erik Berg Schmidt, Rosario Tumino, P N Appleby, J. H. Jansson, Patrik Wennberg, Antonia Trichopoulou, Cornelia Weikert, Crowe, Fl, Key, Tj, Appleby, Pn, Overvad, K, Schmidt, Eb, Egeberg, R, Tj?nneland, A, Kaaks, R, Teucher, B, Boeing, H, Weikert, C, Trichopoulou, A, Ouranos, V, Valanou, E, Masala, G, Sieri, S, Panico, Salvatore, Tumino, R, Matullo, G, Bueno de Mesquita, Hb, Boer, Jm, Beulens, Jw, van der Schouw, Yt, Quir?s, Jr, Buckland, G, S?nchez, Mj, Dorronsoro, M, Huerta, Jm, Moreno Iribas, C, Hedblad, B, Jansson, Jh, Wennberg, P, Khaw, Kt, Wareham, N, Ferrari, P, Illner, Ak, Chuang, Sc, Norat, T, Danesh, J, Riboli, E., Epidemiology and Data Science, ACS - Diabetes & metabolism, ACS - Heart failure & arrhythmias, and APH - Health Behaviors & Chronic Diseases

Subjects
Dietary Fiber, Male, medicine.medical_specialty, Myocardial Ischemia, Medicine (miscellaneous), Nutritional Status, Disease, prospective cohort studies, Lower risk, Body Mass Index, ischaemic heart disease, Risk Factors, Internal medicine, Neoplasms, Surveys and Questionnaires, Vegetables, medicine, Humans, cardiovascular diseases, Prospective Studies, Prospective cohort study, Life Style, Nutrition and Dietetics, business.industry, dietary fibre, Dietary fibre, Middle Aged, Confidence interval, European Prospective Investigation into Cancer and Nutrition, Surgery, Diet, Europe, Relative risk, Fruit, Regression Analysis, Female, business, Edible Grain, Body mass index, Follow-Up Studies
Abstract

Background/objectives:Evidence from prospective studies is consistent in showing an inverse association between dietary fibre intake and risk of ischaemic heart disease (IHD), but whether dietary fibre from various food sources differ in their effect on IHD risk is less clear. The objective of this study was to assess the associations of total and food sources of dietary fibre with IHD mortality in the European Prospective Investigation into Cancer and Nutrition-Heart study.Subjects/methods:Participants were 306 331 men and women from eight European countries. Dietary fibre intake was assessed using centre or country-specific diet questionnaires and calibrated using a 24-h diet recall.Results:After an average follow-up of 11.5 years, there were 2381 IHD deaths among participants without cardiovascular disease at baseline. The calibrated intake of dietary fibre was inversely related with IHD mortality; each 10 g/day was associated with a 15% lower risk (relative risk (RR) 0.85; 95% confidence interval (CI): 0.73-0.99, P=0.031). There was no difference in the associations of the individual food sources of dietary fibre with the risk of IHD mortality; RR for each 5 g/day higher cereal fibre intake was 0.91 (CI: 0.82-1.01), RR for each 2.5 g/day fruit fibre intake was 0.94 (CI: 0.88-1.01) and RR for each 2.5 g/day vegetable fibre intake was 0.90 (95% CI: 0.76-1.07).Conclusion:A higher consumption of dietary fibre is associated with a lower risk of fatal IHD with no clear difference in the association with IHD for fibre from cereals, fruits or vegetables.European Journal of Clinical Nutrition advance online publication, 23 May 2012; doi:10.1038/ejcn.2012.51.

Published
2012
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