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1. Lifestyle changes in middle age and risk of cancer: evidence from the European Prospective Investigation into Cancer and Nutrition

Author

Botteri, E, Peveri, G, Berstad, P, Bagnardi, V, Hoff, G, Heath, A, Cross, A, Vineis, P, Dossus, L, Johansson, M, Freisling, H, Matta, K, Huybrechts, I, Chen, S, B. Borch, K, Sandanger, T, H. Nost, T, Dahm, C, Antoniussen, C, Tin Tin, S, Fournier, A, Marques, C, Artaud, F, Sanchez, M, Guevara, M, Santiuste, C, Agudo, A, Bajracharya, R, Katzke, V, Ricceri, F, Agnoli, C, Bergmann, M, Schulze, M, Panico, S, Masala, G, Tjonneland, A, Olsen, A, Stocks, T, Manjer, J, Aizpurua-Atxega, A, Weiderpass, E, Riboli, E, Gunter, M, Ferrari, P, Botteri E., Peveri G., Berstad P., Bagnardi V., Hoff G., Heath A. K., Cross A. J., Vineis P., Dossus L., Johansson M., Freisling H., Matta K., Huybrechts I., Chen S. L. F., B. Borch K., Sandanger T. M., H. Nost T., Dahm C. C., Antoniussen C. S., Tin Tin S., Fournier A., Marques C., Artaud F., Sanchez M. -J., Guevara M., Santiuste C., Agudo A., Bajracharya R., Katzke V., Ricceri F., Agnoli C., Bergmann M. M., Schulze M. B., Panico S., Masala G., Tjonneland A., Olsen A., Stocks T., Manjer J., Aizpurua-Atxega A., Weiderpass E., Riboli E., Gunter M. J., Ferrari P., Botteri, E, Peveri, G, Berstad, P, Bagnardi, V, Hoff, G, Heath, A, Cross, A, Vineis, P, Dossus, L, Johansson, M, Freisling, H, Matta, K, Huybrechts, I, Chen, S, B. Borch, K, Sandanger, T, H. Nost, T, Dahm, C, Antoniussen, C, Tin Tin, S, Fournier, A, Marques, C, Artaud, F, Sanchez, M, Guevara, M, Santiuste, C, Agudo, A, Bajracharya, R, Katzke, V, Ricceri, F, Agnoli, C, Bergmann, M, Schulze, M, Panico, S, Masala, G, Tjonneland, A, Olsen, A, Stocks, T, Manjer, J, Aizpurua-Atxega, A, Weiderpass, E, Riboli, E, Gunter, M, Ferrari, P, Botteri E., Peveri G., Berstad P., Bagnardi V., Hoff G., Heath A. K., Cross A. J., Vineis P., Dossus L., Johansson M., Freisling H., Matta K., Huybrechts I., Chen S. L. F., B. Borch K., Sandanger T. M., H. Nost T., Dahm C. C., Antoniussen C. S., Tin Tin S., Fournier A., Marques C., Artaud F., Sanchez M. -J., Guevara M., Santiuste C., Agudo A., Bajracharya R., Katzke V., Ricceri F., Agnoli C., Bergmann M. M., Schulze M. B., Panico S., Masala G., Tjonneland A., Olsen A., Stocks T., Manjer J., Aizpurua-Atxega A., Weiderpass E., Riboli E., Gunter M. J., and Ferrari P.

Abstract

In this study, we aimed to provide novel evidence on the impact of changing lifestyle habits on cancer risk. In the EPIC cohort, 295,865 middle-aged participants returned a lifestyle questionnaire at baseline and during follow-up. At both timepoints, we calculated a healthy lifestyle index (HLI) score based on cigarette smoking, alcohol consumption, body mass index and physical activity. HLI ranged from 0 (most unfavourable) to 16 (most favourable). We estimated the association between HLI change and risk of lifestyle-related cancers—including cancer of the breast, lung, colorectum, stomach, liver, cervix, oesophagus, bladder, and others—using Cox regression models. We reported hazard ratios (HR) with 95% confidence intervals (CI). Median time between the two questionnaires was 5.7 years, median age at follow-up questionnaire was 59 years. After the follow-up questionnaire, we observed 14,933 lifestyle-related cancers over a median follow-up of 7.8 years. Each unit increase in the HLI score was associated with 4% lower risk of lifestyle-related cancers (HR 0.96; 95%CI 0.95–0.97). Among participants in the top HLI third at baseline (HLI > 11), those in the bottom third at follow-up (HLI ≤ 9) had 21% higher risk of lifestyle-related cancers (HR 1.21; 95%CI 1.07–1.37) than those remaining in the top third. Among participants in the bottom HLI third at baseline, those in the top third at follow-up had 25% lower risk of lifestyle-related cancers (HR 0.75; 95%CI 0.65–0.86) than those remaining in the bottom third. These results indicate that lifestyle changes in middle age may have a significant impact on cancer risk.

Published
2024

3. Dietary intake of advanced glycation end products (AGEs) and changes in body weight in European adults

Author

Cordova, R., Knaze, V., Viallon, V., Rust, P., Schalkwijk, C. G., Weiderpass, E., Wagner, K-H., Mayen-Chacon, A-L., Aglago, E. K., Dahm, C. C., Overvad, K., Tjønneland, A., Halkjær, J., Mancini, F. R., Boutron-Ruault, M-C., Fagherazzi, G., Katzke, V., Kühn, T., Schulze, M. B., Boeing, H., Trichopoulou, A., Karakatsani, A., Thriskos, P., Masala, G., Krogh, V., Panico, S., Tumino, R., Ricceri, F., Spijkerman, A., Boer, J., Skeie, G., Rylander, C., Borch, K. B., Quirós, J. R., Agudo, A., Redondo-Sánchez, D., Amiano, P., Gómez-Gómez, J-H., Barricarte, A., Ramne, S., Sonestedt, E., Johansson, I., Esberg, A., Tong, T., Aune, D., Tsilidis, K. K., Gunter, M. J., Jenab, M., and Freisling, Heinz

Published
2020
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4. Changes in Lifestyle and Risk of Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition

Author

Botteri, E, Peveri, G, Berstad, P, Bagnardi, V, Chen, S, Sandanger, T, Hoff, G, Dahm, C, Antoniussen, C, Tjonneland, A, Eriksen, A, Skeie, G, Perez-Cornago, A, Huerta, J, Jakszyn, P, Harlid, S, Sundstrom, B, Barricarte, A, Monninkhof, E, Derksen, J, Schulze, M, Bueno-De-Mesquita, B, Sanchez, M, Cross, A, Tsilidis, K, De Magistris, M, Kaaks, R, Katzke, V, Rothwell, J, Laouali, N, Severi, G, Amiano, P, Contiero, P, Sacerdote, C, Goldberg, M, Touvier, M, Freisling, H, Viallon, V, Weiderpass, E, Riboli, E, Gunter, M, Jenab, M, Ferrari, P, Botteri E., Peveri G., Berstad P., Bagnardi V., Chen S. L. F., Sandanger T. M., Hoff G., Dahm C. C., Antoniussen C. S., Tjonneland A., Eriksen A. K., Skeie G., Perez-Cornago A., Huerta J. M., Jakszyn P., Harlid S., Sundstrom B., Barricarte A., Monninkhof E. M., Derksen J. W. G., Schulze M. B., Bueno-De-Mesquita B., Sanchez M. -J., Cross A. J., Tsilidis K. K., De Magistris M. S., Kaaks R., Katzke V., Rothwell J. A., Laouali N., Severi G., Amiano P., Contiero P., Sacerdote C., Goldberg M., Touvier M., Freisling H., Viallon V., Weiderpass E., Riboli E., Gunter M. J., Jenab M., Ferrari P., Botteri, E, Peveri, G, Berstad, P, Bagnardi, V, Chen, S, Sandanger, T, Hoff, G, Dahm, C, Antoniussen, C, Tjonneland, A, Eriksen, A, Skeie, G, Perez-Cornago, A, Huerta, J, Jakszyn, P, Harlid, S, Sundstrom, B, Barricarte, A, Monninkhof, E, Derksen, J, Schulze, M, Bueno-De-Mesquita, B, Sanchez, M, Cross, A, Tsilidis, K, De Magistris, M, Kaaks, R, Katzke, V, Rothwell, J, Laouali, N, Severi, G, Amiano, P, Contiero, P, Sacerdote, C, Goldberg, M, Touvier, M, Freisling, H, Viallon, V, Weiderpass, E, Riboli, E, Gunter, M, Jenab, M, Ferrari, P, Botteri E., Peveri G., Berstad P., Bagnardi V., Chen S. L. F., Sandanger T. M., Hoff G., Dahm C. C., Antoniussen C. S., Tjonneland A., Eriksen A. K., Skeie G., Perez-Cornago A., Huerta J. M., Jakszyn P., Harlid S., Sundstrom B., Barricarte A., Monninkhof E. M., Derksen J. W. G., Schulze M. B., Bueno-De-Mesquita B., Sanchez M. -J., Cross A. J., Tsilidis K. K., De Magistris M. S., Kaaks R., Katzke V., Rothwell J. A., Laouali N., Severi G., Amiano P., Contiero P., Sacerdote C., Goldberg M., Touvier M., Freisling H., Viallon V., Weiderpass E., Riboli E., Gunter M. J., Jenab M., and Ferrari P.

Abstract

Introduction: We investigated the impact of changes in lifestyle habits on colorectal cancer (CRC) risk in a multicountry European cohort. Methods: We used baseline and follow-up questionnaire data from the European Prospective Investigation into Cancer cohort to assess changes in lifestyle habits and their associations with CRC development. We calculated a healthy lifestyle index (HLI) score based on smoking status, alcohol consumption, body mass index, and physical activity collected at the 2 time points. HLI ranged from 0 (most unfavorable) to 16 (most favorable). We estimated the association between HLI changes and CRC risk using Cox regression models and reported hazard ratios (HR) with 95% confidence intervals (CI). Results: Among 295,865 participants, 2,799 CRC cases were observed over a median of 7.8 years. The median time between questionnaires was 5.7 years. Each unit increase in HLI from the baseline to the follow-up assessment was associated with a statistically significant 3% lower CRC risk. Among participants in the top tertile at baseline (HLI > 11), those in the bottom tertile at follow-up (HLI ≤ 9) had a higher CRC risk (HR 1.34; 95% CI 1.02-1.75) than those remaining in the top tertile. Among individuals in the bottom tertile at baseline, those in the top tertile at follow-up had a lower risk (HR 0.77; 95% CI 0.59-1.00) than those remaining in the bottom tertile. Discussion: Improving adherence to a healthy lifestyle was inversely associated with CRC risk, while worsening adherence was positively associated with CRC risk. These results justify and support recommendations for healthy lifestyle changes and healthy lifestyle maintenance for CRC prevention.

Published
2023

8. Standards for Ecologically Successful River Restoration

Author

Palmer, M. A., Bernhardt, E. S., Allan, J. D., Lake, P. S., Alexander, G., Brooks, S., Carr, J., Clayton, S., Dahm, C. N., Shah, J. Follstad, Galat, D. L., Loss, S. G., Goodwin, P., Hart, D. D., Hassett, B., Jenkinson, R., Kondolf, G. M., Lave, R., Meyer, J. L., O'Donnell, T. K., Pagano, L., and Sudduth, E.

Published
2005

11. Adherence to a healthy Nordic food index and risk of myocardial infarction in middle-aged Danes: the diet, cancer and health cohort study

Author

Gunge, V B, Andersen, I, Kyrø, C, Hansen, C P, Dahm, C C, Christensen, J, and Tjønneland, A

Subjects
Scandinavia -- Health aspects, Heart attack -- Prevention, Middle aged persons -- Food and nutrition -- Health aspects, Diet -- Health aspects, Food/cooking/nutrition, Health
Abstract

Background/objectives: For decades, the Mediterranean diet has been in focus regarding healthy eating as it has been associated with reduced risk of non-communicable diseases. Less interest has been given to health benefits of other regional diets. The aim of the present study was to assess whether adherence to a healthy Nordic food index was associated with lower risk of myocardial infarction (MI) among middle-aged Danes. Subjects/methods: Data were obtained from the Danish Diet, Cancer and Health cohort study of 57 053 men and women aged 50-64 years recruited between 1993 and 1997. The healthy Nordic food index comprised healthy Nordic food items selected a priori (fish, cabbage, rye bread, oatmeal, apple and pears and root vegetables). Information on incident MI was ascertained through linkage with national registries. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated from sex-specific Cox proportional hazard models. Results: In total, 1669 men and 653 women developed MI during follow-up (13.6 median years). In adjusted models, those with an index score of 5-6 points (highest scores) had significantly lower MI risk (men: HR=0.77, 95% CI=0.62, 0.97; women: HR=0.55, 95% CI=0.37, 0.82) relative to those scoring 0 points in the index (lowest score). A significantly lower MI risk was found per 1-point increment in the index in both men (HR=0.95, 95% CI=0.92, 0.99) and women (HR=0.93, 95% CI=0.88, 0.98). Conclusions: A healthy Nordic diet is associated with lower MI risk among middle-aged Danes, suggesting that Nordic diets should be considered in recommendations for dietary changes in the promotion of coronary health., Author(s): V B Gunge [sup.1] , I Andersen [sup.2] , C Kyrø [sup.1] , C P Hansen [sup.3] , C C Dahm [sup.3] , J Christensen [sup.4] , A Tjønneland [...]

Published
2017
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13. Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases: A multinational cohort study

Author

Freisling, H, Viallon, V, Lennon, H, Bagnardi, V, Ricci, C, Butterworth, A, Sweeting, M, Muller, D, Romieu, I, Bazelle, P, Kvaskoff, M, Arveux, P, Severi, G, Bamia, C, Kuhn, T, Kaaks, R, Bergmann, M, Boeing, H, Tjonneland, A, Olsen, A, Overvad, K, Dahm, C, Menendez, V, Agudo, A, Sanchez, M, Amiano, P, Santiuste, C, Gurrea, A, Tong, T, Schmidt, J, Tzoulaki, I, Tsilidis, K, Ward, H, Palli, D, Agnoli, C, Tumino, R, Ricceri, F, Panico, S, Picavet, H, Bakker, M, Monninkhof, E, Nilsson, P, Manjer, J, Rolandsson, O, Thysell, E, Weiderpass, E, Jenab, M, Riboli, E, Vineis, P, Danesh, J, Wareham, N, Gunter, M, Ferrari, P, Freisling H., Viallon V., Lennon H., Bagnardi V., Ricci C., Butterworth A. S., Sweeting M., Muller D., Romieu I., Bazelle P., Kvaskoff M., Arveux P., Severi G., Bamia C., Kuhn T., Kaaks R., Bergmann M., Boeing H., Tjonneland A., Olsen A., Overvad K., Dahm C. C., Menendez V., Agudo A., Sanchez M. -J., Amiano P., Santiuste C., Gurrea A. B., Tong T. Y. N., Schmidt J. A., Tzoulaki I., Tsilidis K. K., Ward H., Palli D., Agnoli C., Tumino R., Ricceri F., Panico S., Picavet H. S. J., Bakker M., Monninkhof E., Nilsson P., Manjer J., Rolandsson O., Thysell E., Weiderpass E., Jenab M., Riboli E., Vineis P., Danesh J., Wareham N. J., Gunter M. J., Ferrari P., Freisling, H, Viallon, V, Lennon, H, Bagnardi, V, Ricci, C, Butterworth, A, Sweeting, M, Muller, D, Romieu, I, Bazelle, P, Kvaskoff, M, Arveux, P, Severi, G, Bamia, C, Kuhn, T, Kaaks, R, Bergmann, M, Boeing, H, Tjonneland, A, Olsen, A, Overvad, K, Dahm, C, Menendez, V, Agudo, A, Sanchez, M, Amiano, P, Santiuste, C, Gurrea, A, Tong, T, Schmidt, J, Tzoulaki, I, Tsilidis, K, Ward, H, Palli, D, Agnoli, C, Tumino, R, Ricceri, F, Panico, S, Picavet, H, Bakker, M, Monninkhof, E, Nilsson, P, Manjer, J, Rolandsson, O, Thysell, E, Weiderpass, E, Jenab, M, Riboli, E, Vineis, P, Danesh, J, Wareham, N, Gunter, M, Ferrari, P, Freisling H., Viallon V., Lennon H., Bagnardi V., Ricci C., Butterworth A. S., Sweeting M., Muller D., Romieu I., Bazelle P., Kvaskoff M., Arveux P., Severi G., Bamia C., Kuhn T., Kaaks R., Bergmann M., Boeing H., Tjonneland A., Olsen A., Overvad K., Dahm C. C., Menendez V., Agudo A., Sanchez M. -J., Amiano P., Santiuste C., Gurrea A. B., Tong T. Y. N., Schmidt J. A., Tzoulaki I., Tsilidis K. K., Ward H., Palli D., Agnoli C., Tumino R., Ricceri F., Panico S., Picavet H. S. J., Bakker M., Monninkhof E., Nilsson P., Manjer J., Rolandsson O., Thysell E., Weiderpass E., Jenab M., Riboli E., Vineis P., Danesh J., Wareham N. J., Gunter M. J., and Ferrari P.

Abstract

Background: Although lifestyle factors have been studied in relation to individual non-communicable diseases (NCDs), their association with development of a subsequent NCD, defined as multimorbidity, has been scarcely investigated. The aim of this study was to investigate associations between five lifestyle factors and incident multimorbidity of cancer and cardiometabolic diseases. Methods: In this prospective cohort study, 291,778 participants (64% women) from seven European countries, mostly aged 43 to 58 years and free of cancer, cardiovascular disease (CVD), and type 2 diabetes (T2D) at recruitment, were included. Incident multimorbidity of cancer and cardiometabolic diseases was defined as developing subsequently two diseases including first cancer at any site, CVD, and T2D in an individual. Multi-state modelling based on Cox regression was used to compute hazard ratios (HR) and 95% confidence intervals (95% CI) of developing cancer, CVD, or T2D, and subsequent transitions to multimorbidity, in relation to body mass index (BMI), smoking status, alcohol intake, physical activity, adherence to the Mediterranean diet, and their combination as a healthy lifestyle index (HLI) score. Cumulative incidence functions (CIFs) were estimated to compute 10-year absolute risks for transitions from healthy to cancer at any site, CVD (both fatal and non-fatal), or T2D, and to subsequent multimorbidity after each of the three NCDs. Results: During a median follow-up of 11 years, 1910 men and 1334 women developed multimorbidity of cancer and cardiometabolic diseases. A higher HLI, reflecting healthy lifestyles, was strongly inversely associated with multimorbidity, with hazard ratios per 3-unit increment of 0.75 (95% CI, 0.71 to 0.81), 0.84 (0.79 to 0.90), and 0.82 (0.77 to 0.88) after cancer, CVD, and T2D, respectively. After T2D, the 10-year absolute risks of multimorbidity were 40% and 25% for men and women, respectively, with unhealthy lifestyle, and 30% and 18% for men and

Published
2020

14. A longitudinal evaluation of alcohol intake throughout adulthood and colorectal cancer risk

Author

Mayen, A, Viallon, V, Botteri, E, Proust-Lima, C, Bagnardi, V, Batista, V, Cross, A, Laouali, N, Macdonald, C, Severi, G, Katzke, V, Bergmann, M, Schulze, M, Tjonneland, A, Eriksen, A, Dahm, C, Antoniussen, C, Jakszyn, P, Sanchez, M, Amiano, P, Colorado-Yohar, S, Ardanaz, E, Travis, R, Palli, D, Sabina, S, Tumino, R, Ricceri, F, Panico, S, Bueno-de-Mesquita, B, Derksen, J, Sonestedt, E, Winkvist, A, Harlid, S, Braaten, T, Gram, I, Lukic, M, Jenab, M, Riboli, E, Freisling, H, Weiderpass, E, Gunter, M, Ferrari, P, Mayen, A, Viallon, V, Botteri, E, Proust-Lima, C, Bagnardi, V, Batista, V, Cross, A, Laouali, N, Macdonald, C, Severi, G, Katzke, V, Bergmann, M, Schulze, M, Tjonneland, A, Eriksen, A, Dahm, C, Antoniussen, C, Jakszyn, P, Sanchez, M, Amiano, P, Colorado-Yohar, S, Ardanaz, E, Travis, R, Palli, D, Sabina, S, Tumino, R, Ricceri, F, Panico, S, Bueno-de-Mesquita, B, Derksen, J, Sonestedt, E, Winkvist, A, Harlid, S, Braaten, T, Gram, I, Lukic, M, Jenab, M, Riboli, E, Freisling, H, Weiderpass, E, Gunter, M, and Ferrari, P

Abstract

Background: Alcohol intake is an established risk factor for colorectal cancer (CRC); however, there is limited knowledge on whether changing alcohol drinking habits during adulthood modifies CRC risk. Objective: Leveraging longitudinal exposure assessments on alcohol intake at different ages, we examined the relationship between change in alcohol intake and subsequent CRC risk. Methods: Within the European Prospective Investigation into Cancer and Nutrition, changes in alcohol intake comparing follow-up with baseline assessments were investigated in relation to CRC risk. The analysis included 191,180, participants and 1530 incident CRC cases, with exclusion of the first three years of follow-up to minimize reverse causation. Trajectory profiles of alcohol intake, assessed at ages 20, 30, 40, 50 years, at baseline and during follow-up, were estimated using latent class mixed models and related to CRC risk, including 407,605 participants and 5,008 incident CRC cases. Results: Mean age at baseline was 50.2 years and the follow-up assessment occurred on average 7.1 years later. Compared to stable intake, a 12 g/day increase in alcohol intake during follow-up was positively associated with CRC risk (HR = 1.15, 95%CI 1.04, 1.25), while a 12 g/day reduction was inversely associated with CRC risk (HR = 0.86, 95%CI 0.78, 0.95). Trajectory analysis showed that compared to low alcohol intake, men who increased their alcohol intake from early- to mid- and late-adulthood by up to 30 g/day on average had significantly increased CRC risk (HR = 1.24; 95%CI 1.08, 1.42), while no associations were observed in women. Results were consistent by anatomical subsite. Conclusions: Increasing alcohol intake during mid-to-late adulthood raised CRC risk, while reduction lowered risk.

Published
2022

15. Milk intake and incident stroke and CHD in populations of European descent: A Mendelian randomisation study

Author

Cardiovasculaire Epi Team 1, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Circulatory Health, Public Health Practice, Public Health Epidemiologie, Vissers, L. E.T., Sluijs, I., Burgess, S., Forouhi, N. G., Freisling, H., Imamura, F., Nilsson, T. K., Renström, F., Weiderpass, E., Aleksandrova, K., Dahm, C. C., Perez-Cornago, A., Schulze, M. B., Tong, T. Y.N., Aune, D., Bonet, C., Boeing, H., Chirlaque, M. D., Conchi, M. I., Imaz, L., Jäger, S., Krogh, V., Kyrø, C., Masala, G., Melander, O., Overvad, K., Panico, S., Sánches, M. J., Sonestedt, E., Tjønneland, A., Tzoulaki, I., Verschuren, W. M.M., Riboli, E., Wareham, N. J., Danesh, J., Butterworth, A. S., Van Der Schouw, Y. T., Cardiovasculaire Epi Team 1, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Circulatory Health, Public Health Practice, Public Health Epidemiologie, Vissers, L. E.T., Sluijs, I., Burgess, S., Forouhi, N. G., Freisling, H., Imamura, F., Nilsson, T. K., Renström, F., Weiderpass, E., Aleksandrova, K., Dahm, C. C., Perez-Cornago, A., Schulze, M. B., Tong, T. Y.N., Aune, D., Bonet, C., Boeing, H., Chirlaque, M. D., Conchi, M. I., Imaz, L., Jäger, S., Krogh, V., Kyrø, C., Masala, G., Melander, O., Overvad, K., Panico, S., Sánches, M. J., Sonestedt, E., Tjønneland, A., Tzoulaki, I., Verschuren, W. M.M., Riboli, E., Wareham, N. J., Danesh, J., Butterworth, A. S., and Van Der Schouw, Y. T.

Published
2022

22. Milk intake and incident stroke and CHD in populations of European descent: a Mendelian randomisation study

Author

Vissers, L. E. T., primary, Sluijs, I., additional, Burgess, S., additional, Forouhi, N. G., additional, Freisling, H., additional, Imamura, F., additional, Nilsson, T. K., additional, Renström, F., additional, Weiderpass, E., additional, Aleksandrova, K., additional, Dahm, C. C., additional, Perez-Cornago, A., additional, Schulze, M. B., additional, Tong, T. Y. N., additional, Aune, D., additional, Bonet, C., additional, Boer, J. M. A., additional, Boeing, H., additional, Chirlaque, M. D., additional, Conchi, M. I., additional, Imaz, L., additional, Jäger, S., additional, Krogh, V., additional, Kyrø, C., additional, Masala, G., additional, Melander, O., additional, Overvad, K., additional, Panico, S., additional, Sánches, M. J., additional, Sonestedt, E., additional, Tjønneland, A., additional, Tzoulaki, I., additional, Verschuren, W. M. M., additional, Riboli, E., additional, Wareham, N. J., additional, Danesh, J., additional, Butterworth, A. S., additional, and van der Schouw, Y. T., additional

Published
2021
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23. Milk intake and incident stroke and CHD in populations of European descent: a Mendelian randomisation study.

Author

Vissers, L. E. T., Sluijs, I., Burgess, S., Forouhi, N. G., Freisling, H., Imamura, F., Nilsson, T. K., Renström, F., Weiderpass, E., Aleksandrova, K., Dahm, C. C., Perez-Cornago, A., Schulze, M. B., Tong, T. Y. N., Aune, D., Bonet, C., Boer, J. M. A., Boeing, H., Chirlaque, M. D., and Conchi, M. I.

Subjects
CORONARY heart disease risk factors, STROKE risk factors, CARDIOVASCULAR diseases risk factors, RELATIVE medical risk, GENETICS, CONFIDENCE intervals, MILK, ALLELES, DAIRY products, RISK assessment, DESCRIPTIVE statistics, ODDS ratio, DATA analysis software, PROPORTIONAL hazards models
Abstract

Higher milk intake has been associated with a lower stroke risk, but not with risk of CHD. Residual confounding or reverse causation cannot be excluded. Therefore, we estimated the causal association of milk consumption with stroke and CHD risk through instrumental variable (IV) and gene-outcome analyses. IV analysis included 29 328 participants (4611 stroke; 9828 CHD) of the European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD (eight European countries) and European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) case-cohort studies. rs4988235, a lactase persistence (LP) SNP which enables digestion of lactose in adulthood was used as genetic instrument. Intake of milk was first regressed on rs4988235 in a linear regression model. Next, associations of genetically predicted milk consumption with stroke and CHD were estimated using Prentice-weighted Cox regression. Gene-outcome analysis included 777 024 participants (50 804 cases) from MEGASTROKE (including EPIC-CVD), UK Biobank and EPIC-NL for stroke, and 483 966 participants (61 612 cases) from CARDIoGRAM, UK Biobank, EPIC-CVD and EPIC-NL for CHD. In IV analyses, each additional LP allele was associated with a higher intake of milk in EPIC-CVD (β = 13·7 g/d; 95 % CI 8·4, 19·1) and EPIC-NL (36·8 g/d; 95 % CI 20·0, 53·5). Genetically predicted milk intake was not associated with stroke (HR per 25 g/d 1·05; 95 % CI 0·94, 1·16) or CHD (1·02; 95 % CI 0·96, 1·08). In gene-outcome analyses, there was no association of rs4988235 with risk of stroke (OR 1·02; 95 % CI 0·99, 1·05) or CHD (OR 0·99; 95 % CI 0·95, 1·03). Current Mendelian randomisation analysis does not provide evidence for a causal inverse relationship between milk consumption and stroke or CHD risk. [ABSTRACT FROM AUTHOR]

Published
2022
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24. Foreign families and schools Innovative strategies for improving the family-school relationship. English version

Author

Macià Bordalba, Mònica, Burriel Manzanares, Francesca, Roig del Amor, Enric, Casanovas Jové, Ricard, Lafuente, Maite, Vidal, Victoria, Lamo, Jaime de, Brújula, Emma, Pardina, Maite, Baró, Maite, Llenas, Lluïsa, Guzmán, Maite, Alonso, Toni, Gálvez, Jordi, Sorribes, Mª Luz, Jiménez, Maika, Seguro, Núria, Prieto, Pilar, Colombo, Maddalena, Santagati, Mariagrazia, Gheza, Bianca, Prandelli, Lidia, Hurka, Paola, Alessandrini, Elisa, Lancini, Alessandra, Biatta, Anna, Cirimbelli, Cinzia, Palmira Ferrari, Maria, Filippini, Micaela, Albini, Alessandra, Costa, Giuliana, Paterini, Mina, Forlani, Dario, Belotti, Chiara, Pederzani, Giovanna, Sferruzza, Letizia, Poli, Giampietro, Piotti, Claudia, Poncelet, D., Bodson, M., Dahm, C., Mirkes, D., Calvi, N., Kerger, S., Macià Bordalba, Mònica, and Burriel Manzanares, Francesca

Subjects
Psicologia social, Educació inclusiva, Psicologia pedagògica, Educació, Multiculturalisme, Emigració i immigració -- Educació, Família i escola, Educació intercultural
Published
2021

25. SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe

Author

Achenbach, S, Aleksandrova, K, Amiano, P, San Sebastian, D, Amouyel, P, Andersson, J, Bakker, S, Da Providencia Costa, R, Beulens, J, Blaha, M, Bobak, M, Boer, J, Bonet, C, Bonnet, F, Boutron-Ruault, M, Braaten, T, Brenner, H, Brunner, F, Brunner, E, Brunström, M, Buring, J, Butterworth, A, Capkova, N, Cesana, G, Chrysohoou, C, Colorado-Yohar, S, Cook, N, Cooper, C, Dahm, C, Davidson, K, Dennison, E, Di Castelnuovo, A, Donfrancesco, C, Dörr, M, Doryńska, A, Eliasson, M, Engström, G, Ferrari, P, Ferrario, M, Ford, I, Fu, M, Gansevoort, R, Giampaoli, S, Gillum, R, Gómez de la Cámara, A, Grassi, G, Hansson, P, Huculeci, R, Hveem, K, Iacoviello, L, Ikram, M, Jørgensen, T, Joseph, B, Jousilahti, P, Wouter Jukema, J, Kaaks, R, Katzke, V, Kavousi, M, Kiechl, S, Klotsche, J, König, W, Kronmal, R, Kubinova, R, Kucharska-Newton, A, Läll, K, Lehmann, N, Leistner, D, Linneberg, A, Pablos, D, Lorenz, T, Lu, W, Luksiene, D, Lyngbakken, M, Magnussen, C, Malyutina, S, Ibañez, A, Masala, G, Mathiesen, E, Matsushita, K, Meade, T, Melander, O, Meyer, H, Moons, K, Moreno-Iribas, C, Muller, D, Münzel, T, Nikitin, Y, Nordestgaard, B, Omland, T, Onland, C, Overvad, K, Packard, C, Pająk, A, Palmieri, L, Panagiotakos, D, Panico, S, Perez-Cornago, A, Peters, A, Pietilä, A, Pikhart, H, Psaty, B, Quarti-Trevano, F, Garcia, J, Riboli, E, Ridker, P, Rodriguez, B, Rodriguez-Barranco, M, Rosengren, A, Roussel, R, Sacerdote, C, S, S, Sattar, N, Schiborn, C, Schmidt, B, Schöttker, B, Schulze, M, Schwartz, J, Selmer, R, Shea, S, Shipley, M, Sieri, S, Söderberg, S, Sofat, R, Tamosiunas, A, Thorand, B, Tillmann, T, Tjønneland, A, Tong, T, Trichopoulou, A, Tumino, R, Tunstall-Pedoe, H, Tybjaerg-Hansen, A, Tzoulaki, J, van der Heijden, A, van der Schouw, Y, Verschuren, W, Völzke, H, Waldeyer, C, Wareham, N, Weiderpass, E, Weidinger, F, Wild, P, Willeit, J, Willeit, P, Wilsgaard, T, Woodward, M, Zeller, T, Zhang, D, Zhou, B, Bakker, SJL, Da Providencia Costa, RB, Beulens, JWJ, Boer, JMA, Boutron-Ruault, MC, Brunner, EJ, Butterworth, AS, Cook, NR, Dahm, CC, Gansevoort, RT, Gillum, RF, Hansson, PO, Ikram, MK, Kronmal, RA, Pablos, DL, Malyutina, So, Ibañez, AM, Mathiesen, EB, Meade, TW, Meyer, HE, Moons, KGM, Nordestgaard, BG, Psaty, BM, Garcia, JRQ, Ridker, PM, C Sans, Schwartz, JE, Selmer, RM, Shipley, MJ, Tong, TYN, van der Schouw, YT, Verschuren, WMM, Wareham, NJ, Achenbach, S, Aleksandrova, K, Amiano, P, San Sebastian, D, Amouyel, P, Andersson, J, Bakker, S, Da Providencia Costa, R, Beulens, J, Blaha, M, Bobak, M, Boer, J, Bonet, C, Bonnet, F, Boutron-Ruault, M, Braaten, T, Brenner, H, Brunner, F, Brunner, E, Brunström, M, Buring, J, Butterworth, A, Capkova, N, Cesana, G, Chrysohoou, C, Colorado-Yohar, S, Cook, N, Cooper, C, Dahm, C, Davidson, K, Dennison, E, Di Castelnuovo, A, Donfrancesco, C, Dörr, M, Doryńska, A, Eliasson, M, Engström, G, Ferrari, P, Ferrario, M, Ford, I, Fu, M, Gansevoort, R, Giampaoli, S, Gillum, R, Gómez de la Cámara, A, Grassi, G, Hansson, P, Huculeci, R, Hveem, K, Iacoviello, L, Ikram, M, Jørgensen, T, Joseph, B, Jousilahti, P, Wouter Jukema, J, Kaaks, R, Katzke, V, Kavousi, M, Kiechl, S, Klotsche, J, König, W, Kronmal, R, Kubinova, R, Kucharska-Newton, A, Läll, K, Lehmann, N, Leistner, D, Linneberg, A, Pablos, D, Lorenz, T, Lu, W, Luksiene, D, Lyngbakken, M, Magnussen, C, Malyutina, S, Ibañez, A, Masala, G, Mathiesen, E, Matsushita, K, Meade, T, Melander, O, Meyer, H, Moons, K, Moreno-Iribas, C, Muller, D, Münzel, T, Nikitin, Y, Nordestgaard, B, Omland, T, Onland, C, Overvad, K, Packard, C, Pająk, A, Palmieri, L, Panagiotakos, D, Panico, S, Perez-Cornago, A, Peters, A, Pietilä, A, Pikhart, H, Psaty, B, Quarti-Trevano, F, Garcia, J, Riboli, E, Ridker, P, Rodriguez, B, Rodriguez-Barranco, M, Rosengren, A, Roussel, R, Sacerdote, C, S, S, Sattar, N, Schiborn, C, Schmidt, B, Schöttker, B, Schulze, M, Schwartz, J, Selmer, R, Shea, S, Shipley, M, Sieri, S, Söderberg, S, Sofat, R, Tamosiunas, A, Thorand, B, Tillmann, T, Tjønneland, A, Tong, T, Trichopoulou, A, Tumino, R, Tunstall-Pedoe, H, Tybjaerg-Hansen, A, Tzoulaki, J, van der Heijden, A, van der Schouw, Y, Verschuren, W, Völzke, H, Waldeyer, C, Wareham, N, Weiderpass, E, Weidinger, F, Wild, P, Willeit, J, Willeit, P, Wilsgaard, T, Woodward, M, Zeller, T, Zhang, D, Zhou, B, Bakker, SJL, Da Providencia Costa, RB, Beulens, JWJ, Boer, JMA, Boutron-Ruault, MC, Brunner, EJ, Butterworth, AS, Cook, NR, Dahm, CC, Gansevoort, RT, Gillum, RF, Hansson, PO, Ikram, MK, Kronmal, RA, Pablos, DL, Malyutina, So, Ibañez, AM, Mathiesen, EB, Meade, TW, Meyer, HE, Moons, KGM, Nordestgaard, BG, Psaty, BM, Garcia, JRQ, Ridker, PM, C Sans, Schwartz, JE, Selmer, RM, Shipley, MJ, Tong, TYN, van der Schouw, YT, Verschuren, WMM, and Wareham, NJ

Abstract

Aims: The aim of this study was to develop, validate, and illustrate an updated prediction model (SCORE2) to estimate 10-year fatal and non-fatal cardiovascular disease (CVD) risk in individuals without previous CVD or diabetes aged 40-69 years in Europe. Methods and results : We derived risk prediction models using individual-participant data from 45 cohorts in 13 countries (677 684 individuals, 30 121 CVD events). We used sex-specific and competing risk-adjusted models, including age, smoking status, systolic blood pressure, and total- and HDL-cholesterol. We defined four risk regions in Europe according to country-specific CVD mortality, recalibrating models to each region using expected incidences and risk factor distributions. Region-specific incidence was estimated using CVD mortality and incidence data on 10 776 466 individuals. For external validation, we analysed data from 25 additional cohorts in 15 European countries (1 133 181 individuals, 43 492 CVD events). After applying the derived risk prediction models to external validation cohorts, C-indices ranged from 0.67 (0.65-0.68) to 0.81 (0.76-0.86). Predicted CVD risk varied several-fold across European regions. For example, the estimated 10-year CVD risk for a 50-year-old smoker, with a systolic blood pressure of 140 mmHg, total cholesterol of 5.5 mmol/L, and HDL-cholesterol of 1.3 mmol/L, ranged from 5.9% for men in low-risk countries to 14.0% for men in very high-risk countries, and from 4.2% for women in low-risk countries to 13.7% for women in very high-risk countries. Conclusion : SCORE2-a new algorithm derived, calibrated, and validated to predict 10-year risk of first-onset CVD in European populations-enhances the identification of individuals at higher risk of developing CVD across Europe.

Published
2021

26. Fruit and vegetable intake and type 2 diabetes: EPIC-InterAct prospective study and meta-analysis

Author

Cooper, A J, Forouhi, N G, Ye, Z, Buijsse, B, Arriola, L, Balkau, B, Barricarte, A, Beulens, J W J, Boeing, H, Büchner, F L, Dahm, C C, de Lauzon-Guillain, B, Fagherazzi, G, Franks, P W, Gonzalez, C, Grioni, S, Kaaks, R, Key, T J, Masala, G, Navarro, C, Nilsson, P, Overvad, K, Panico, S, Ramón Quirós, J, Rolandsson, O, Roswall, N, Sacerdote, C, Sánchez, M-J, Slimani, N, Sluijs, I, Spijkerman, A M W, Teucher, B, Tjonneland, A, Tumino, R, Sharp, S J, Langenberg, C, Feskens, E J M, Riboli, E, and Wareham, N J

Published
2012
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29. Inflammatory potential of the diet and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Author

Jakszyn, P, Cayssials, V, Buckland, G, Perez-Cornago, A, Weiderpass, E, Boeing, H, Bergmann, M M, Vulcan, A, Ohlsson, B, Masala, G, Cross, A J, Riboli, E, Ricceri, F, Dahm, C, Nyvang, D, Katzke, V A, Kühns, T, Kyrø, C, Tjønneland, A, Ward, H A, Tsilidis, K K, Skeie, G, Sieri, S, Sanchez, M J, Huerta, J M, Amiano, P, Lasheras, C, Ardanaz, E, Mahamat-Saleh, Y, Boutron-Ruault, M C, Carbonnel, F, Panico, S, Peppa, E, Trichopoulou, A, Karakatsani, A, Tumino, R, Vermeulen, R, Jenab, M, Gunter, M, Agudo, A, Jakszyn, P, Cayssials, V, Buckland, G, Perez-Cornago, A, Weiderpass, E, Boeing, H, Bergmann, M M, Vulcan, A, Ohlsson, B, Masala, G, Cross, A J, Riboli, E, Ricceri, F, Dahm, C, Nyvang, D, Katzke, V A, Kühns, T, Kyrø, C, Tjønneland, A, Ward, H A, Tsilidis, K K, Skeie, G, Sieri, S, Sanchez, M J, Huerta, J M, Amiano, P, Lasheras, C, Ardanaz, E, Mahamat-Saleh, Y, Boutron-Ruault, M C, Carbonnel, F, Panico, S, Peppa, E, Trichopoulou, A, Karakatsani, A, Tumino, R, Vermeulen, R, Jenab, M, Gunter, M, and Agudo, A

Abstract

Pro-inflammatory diets are associated with risk of developing colorectal cancer (CRC), however inconsistencies exist in subsite- and sex-specific associations. The relationship between CRC and combined lifestyle-related factors that contribute towards a low-grade inflammatory profile has not yet been explored. We examined the association between the dietary inflammatory potential and an inflammatory profile and CRC risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. This cohort included 476,160 participants followed-up of 14 years and 5,991 incident CRC cases (3,897 colon and 2,094 rectal tumours). Dietary inflammatory potential was estimated using an Inflammatory Score of the Diet (ISD). An Inflammatory Profile Score (IPS) was constructed, incorporating the ISD, physical activity level and abdominal obesity. The associations between the ISD and CRC and IPS and CRC were assessed using multivariable regression models. More pro- inflammatory diets were related to a higher CRC risk, particularly for colon cancer; Hazar Ratio (HR) for highest versus lowest ISD quartile was 1.15 (95% confidence interval (CI) 1.04-1.27) for CRC, 1.24 (95% CI 1.09-1.41) for colon cancer and 0.99 (95% CI 0.83-1.17) for rectal cancer. Associations were more pronounced in men and not significant in women. The IPS was associated with CRC risk, particularly colon cancer among men; HRs for the highest versus lowest IPS were 1.62 (95% CI 1.31- 2.01) for colon cancer overall and 2.11 (95% CI 1.50-2.97) for colon cancer in men. This study shows that more pro-inflammatory diets and a more inflammatory profile are associated with higher risk of CRC, principally colon cancer and in men. This article is protected by copyright. All rights reserved.

Published
2020

30. Inflammatory potential of the diet and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Author

One Health Chemisch, dIRAS RA-2, Jakszyn, P, Cayssials, V, Buckland, G, Perez-Cornago, A, Weiderpass, E, Boeing, H, Bergmann, M M, Vulcan, A, Ohlsson, B, Masala, G, Cross, A J, Riboli, E, Ricceri, F, Dahm, C, Nyvang, D, Katzke, V A, Kühns, T, Kyrø, C, Tjønneland, A, Ward, H A, Tsilidis, K K, Skeie, G, Sieri, S, Sanchez, M J, Huerta, J M, Amiano, P, Lasheras, C, Ardanaz, E, Mahamat-Saleh, Y, Boutron-Ruault, M C, Carbonnel, F, Panico, S, Peppa, E, Trichopoulou, A, Karakatsani, A, Tumino, R, Vermeulen, R, Jenab, M, Gunter, M, Agudo, A, One Health Chemisch, dIRAS RA-2, Jakszyn, P, Cayssials, V, Buckland, G, Perez-Cornago, A, Weiderpass, E, Boeing, H, Bergmann, M M, Vulcan, A, Ohlsson, B, Masala, G, Cross, A J, Riboli, E, Ricceri, F, Dahm, C, Nyvang, D, Katzke, V A, Kühns, T, Kyrø, C, Tjønneland, A, Ward, H A, Tsilidis, K K, Skeie, G, Sieri, S, Sanchez, M J, Huerta, J M, Amiano, P, Lasheras, C, Ardanaz, E, Mahamat-Saleh, Y, Boutron-Ruault, M C, Carbonnel, F, Panico, S, Peppa, E, Trichopoulou, A, Karakatsani, A, Tumino, R, Vermeulen, R, Jenab, M, Gunter, M, and Agudo, A

Published
2020

31. Adherence to the mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study

Author

Buckland, G., Travier, N., Cottet, V., González, C. A., Luján-Barroso, L., Agudo, A., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Peeters, P. H., May, A., Bueno-de-Mesquita, H. B., Bvan Duijnhoven, F. J., Key, T. J., Allen, N., Khaw, K. T., Wareham, N., Romieu, I., McCormack, V., Boutron-Ruault, M., Clavel-Chapelon, F., Panico, S., Agnoli, C., Palli, D., Tumino, R., Vineis, P., Amiano, P., Barricarte, A., Rodríguez, L., Sanchez, M. J., Chirlaque, M. D., Kaaks, R., Teucher, B., Boeing, H., Bergmann, M. M., Overvad, K., Dahm, C. C., Tjnneland, A., Olsen, A., Manjer, J., Wirfält, E., Hallmans, G., Johansson, I., Lund, E., Hjartåker, A., Skeie, G., Vergnaud, A. C., Norat, T., Romaguera, D., and Riboli, E.

Published
2013
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32. Variety in vegetable and fruit consumption and the risk of gastric and esophageal cancer in the European prospective investigation into cancer and nutrition

Author

Jeurnink, S. M., Büchner, F. L., Bueno-de-Mesquita, H. B., Siersema, P. D., Boshuizen, H. C., Numans, M. E., Dahm, C. C., Overvad, K., Tjnneland, A., Roswall, N., Clavel-Chapelon, F., Boutron-Ruault, M. C., Morois, S., Kaaks, R., Teucher, B., Boeing, H., Buijsse, B., Trichopoulou, A., Benetou, V., Zylis, D., Palli, D., Sieri, S., Vineis, P., Tumino, R., Panico, S., Ocké, M. C., Peeters, P. H.M., Skeie, G., Brustad, M., Lund, E., Sánchez-Cantalejo, E., Navarro, C., Amiano, P., Ardanaz, E., Ramón Quirós, J., Hallmans, G., Johansson, I., Lindkvist, B., Regnér, S., Khaw, K. T., Wareham, N., Key, T. J., Slimani, N., Norat, T., Vergnaud, A. C., Romaguera, D., and Gonzalez, C. A.

Published
2012
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33. Synthesizing U.S. River Restoration Efforts

Author

Bernhardt, E. S., Palmer, M. A., Allan, J. D., Alexander, G., Barnas, K., Brooks, S., Carr, J., Clayton, S., Dahm, C., Follstad-Shah, J., Galat, D., Gloss, S., Goodwin, P., Hart, D., Hassett, B., Jenkinson, R., Katz, S., Kondolf, G. M., Lake, P. S., Lave, R., Meyer, J. L., O'Donnell, T. K., Pagano, L., Powell, B., and Sudduth, E.

Published
2005

36. Dietary intake of advanced glycation end products (AGEs) and changes in body weight in European adults

Author

Cordova, R., primary, Knaze, V., additional, Viallon, V., additional, Rust, P., additional, Schalkwijk, C. G., additional, Weiderpass, E., additional, Wagner, K-H., additional, Mayen-Chacon, A-L., additional, Aglago, E. K., additional, Dahm, C. C., additional, Overvad, K., additional, Tjønneland, A., additional, Halkjær, J., additional, Mancini, F. R., additional, Boutron-Ruault, M-C., additional, Fagherazzi, G., additional, Katzke, V., additional, Kühn, T., additional, Schulze, M. B., additional, Boeing, H., additional, Trichopoulou, A., additional, Karakatsani, A., additional, Thriskos, P., additional, Masala, G., additional, Krogh, V., additional, Panico, S., additional, Tumino, R., additional, Ricceri, F., additional, Spijkerman, A., additional, Boer, J., additional, Skeie, G., additional, Rylander, C., additional, Borch, K. B., additional, Quirós, J. R., additional, Agudo, A., additional, Redondo-Sánchez, D., additional, Amiano, P., additional, Gómez-Gómez, J-H., additional, Barricarte, A., additional, Ramne, S., additional, Sonestedt, E., additional, Johansson, I., additional, Esberg, A., additional, Tong, T., additional, Aune, D., additional, Tsilidis, K. K., additional, Gunter, M. J., additional, Jenab, M., additional, and Freisling, Heinz, additional

Published
2019
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37. Risk thresholds for alcohol consumption:combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies

Author

Wood, A. M. (Angela M.), Kaptoge, S. (Stephen), Butterworth, A. S. (Adam S.), Willeit, P. (Peter), Warnakula, S. (Samantha), Bolton, T. (Thomas), Paige, E. (Ellie), Paul, D. S. (Dirk S.), Sweeting, M. (Michael), Burgess, S. (Stephen), Bell, S. (Steven), Astle, W. (William), Stevens, D. (David), Koulman, A. (Albert), Selmer, R. M. (Randi M.), Verschuren, W. M. (W. M. Monique), Sato, S. (Shinichi), Njolstad, I. (Inger), Woodward, M. (Mark), Salomaa, V. (Veikko), Nordestgaard, B. G. (Borge G.), Yeap, B. B. (Bu B.), Fletcher, A. (Astrid), Melander, O. (Olle), Kuller, L. H. (Lewis H.), Balkau, B. (Beverley), Marmot, M. (Michael), Koenig, W. (Wolfgang), Casiglia, E. (Edoardo), Cooper, C. (Cyrus), Arndt, V. (Volker), Franco, O. H. (Oscar H.), Wennberg, P. (Patrik), Gallacher, J. (John), de la Camara, A. G. (Agustin Gomez), Volzke, H. (Henry), Dahm, C. C. (Christina C.), Dale, C. E. (Caroline E.), Bergmann, M. M. (Manuela M.), Crespo, C. J. (Carlos J.), van der Schouw, Y. T. (Yvonne T.), Kaaks, R. (Rudolf), Simons, L. A. (Leon A.), Lagiou, P. (Pagona), Schoufour, J. D. (Josje D.), Boer, J. M. (Jolanda M. A.), Key, T. J. (Timothy J.), Rodriguez, B. (Beatriz), Moreno-Iribas, C. (Conchi), Davidson, K. W. (Karina W.), Taylor, J. O. (James O.), Sacerdote, C. (Carlotta), Wallace, R. B. (Robert B.), Quiros, J. R. (J. Ramon), Tumino, R. (Rosario), Blazer, D. G. (Dan G., II), Linneberg, A. (Allan), Daimon, M. (Makoto), Panico, S. (Salvatore), Howard, B. (Barbara), Skeie, G. (Guri), Strandberg, T. (Timo), Weiderpass, E. (Elisabete), Nietert, P. J. (Paul J.), Psaty, B. M. (Bruce M.), Kromhout, D. (Daan), Salamanca-Fernandez, E. (Elena), Kiechl, S. (Stefan), Krumholz, H. M. (Harlan M.), Grioni, S. (Sara), Palli, D. (Domenico), Huerta, J. M. (Jose M.), Price, J. (Jackie), Sundstrom, J. (Johan), Arriola, L. (Larraitz), Arima, H. (Hisatomi), Travis, R. C. (Ruth C.), Panagiotakos, D. B. (Demosthenes B.), Karakatsani, A. (Anna), Trichopoulou, A. (Antonia), Kuhn, T. (Tilman), Grobbee, D. E. (Diederick E.), Barrett-Connor, E. (Elizabeth), van Schoor, N. (Natasja), Boeing, H. (Heiner), Overvad, K. (Kim), Kauhanen, J. (Jussi), Wareham, N. (Nick), Langenberg, C. (Claudia), Forouhi, N. (Nita), Wennberg, M. (Maria), Despres, J.-P. (Jean-Pierre), Cushman, M. (Mary), Cooper, J. A. (Jackie A.), Rodriguez, C. J. (Carlos J.), Sakurai, M. (Masaru), Shaw, J. E. (Jonathan E.), Knuiman, M. (Matthew), Voortman, T. (Trudy), Meisinger, C. (Christa), Tjonneland, A. (Anne), Brenner, H. (Hermann), Palmieri, L. (Luigi), Dallongeville, J. (Jean), Brunner, E. J. (Eric J.), Assmann, G. (Gerd), Trevisan, M. (Maurizio), Gillum, R. F. (Richard F.), Ford, I. (Ian), Sattar, N. (Naveed), Lazo, M. (Mariana), Thompson, S. G. (Simon G.), Ferrari, P. (Pietro), Leon, D. A. (David A.), Smith, G. D. (George Davey), Peto, R. (Richard), Jackson, R. (Rod), Banks, E. (Emily), Di Angelantonio, E. (Emanuele), Danesh, J. (John), Wood, A. M. (Angela M.), Kaptoge, S. (Stephen), Butterworth, A. S. (Adam S.), Willeit, P. (Peter), Warnakula, S. (Samantha), Bolton, T. (Thomas), Paige, E. (Ellie), Paul, D. S. (Dirk S.), Sweeting, M. (Michael), Burgess, S. (Stephen), Bell, S. (Steven), Astle, W. (William), Stevens, D. (David), Koulman, A. (Albert), Selmer, R. M. (Randi M.), Verschuren, W. M. (W. M. Monique), Sato, S. (Shinichi), Njolstad, I. (Inger), Woodward, M. (Mark), Salomaa, V. (Veikko), Nordestgaard, B. G. (Borge G.), Yeap, B. B. (Bu B.), Fletcher, A. (Astrid), Melander, O. (Olle), Kuller, L. H. (Lewis H.), Balkau, B. (Beverley), Marmot, M. (Michael), Koenig, W. (Wolfgang), Casiglia, E. (Edoardo), Cooper, C. (Cyrus), Arndt, V. (Volker), Franco, O. H. (Oscar H.), Wennberg, P. (Patrik), Gallacher, J. (John), de la Camara, A. G. (Agustin Gomez), Volzke, H. (Henry), Dahm, C. C. (Christina C.), Dale, C. E. (Caroline E.), Bergmann, M. M. (Manuela M.), Crespo, C. J. (Carlos J.), van der Schouw, Y. T. (Yvonne T.), Kaaks, R. (Rudolf), Simons, L. A. (Leon A.), Lagiou, P. (Pagona), Schoufour, J. D. (Josje D.), Boer, J. M. (Jolanda M. A.), Key, T. J. (Timothy J.), Rodriguez, B. (Beatriz), Moreno-Iribas, C. (Conchi), Davidson, K. W. (Karina W.), Taylor, J. O. (James O.), Sacerdote, C. (Carlotta), Wallace, R. B. (Robert B.), Quiros, J. R. (J. Ramon), Tumino, R. (Rosario), Blazer, D. G. (Dan G., II), Linneberg, A. (Allan), Daimon, M. (Makoto), Panico, S. (Salvatore), Howard, B. (Barbara), Skeie, G. (Guri), Strandberg, T. (Timo), Weiderpass, E. (Elisabete), Nietert, P. J. (Paul J.), Psaty, B. M. (Bruce M.), Kromhout, D. (Daan), Salamanca-Fernandez, E. (Elena), Kiechl, S. (Stefan), Krumholz, H. M. (Harlan M.), Grioni, S. (Sara), Palli, D. (Domenico), Huerta, J. M. (Jose M.), Price, J. (Jackie), Sundstrom, J. (Johan), Arriola, L. (Larraitz), Arima, H. (Hisatomi), Travis, R. C. (Ruth C.), Panagiotakos, D. B. (Demosthenes B.), Karakatsani, A. (Anna), Trichopoulou, A. (Antonia), Kuhn, T. (Tilman), Grobbee, D. E. (Diederick E.), Barrett-Connor, E. (Elizabeth), van Schoor, N. (Natasja), Boeing, H. (Heiner), Overvad, K. (Kim), Kauhanen, J. (Jussi), Wareham, N. (Nick), Langenberg, C. (Claudia), Forouhi, N. (Nita), Wennberg, M. (Maria), Despres, J.-P. (Jean-Pierre), Cushman, M. (Mary), Cooper, J. A. (Jackie A.), Rodriguez, C. J. (Carlos J.), Sakurai, M. (Masaru), Shaw, J. E. (Jonathan E.), Knuiman, M. (Matthew), Voortman, T. (Trudy), Meisinger, C. (Christa), Tjonneland, A. (Anne), Brenner, H. (Hermann), Palmieri, L. (Luigi), Dallongeville, J. (Jean), Brunner, E. J. (Eric J.), Assmann, G. (Gerd), Trevisan, M. (Maurizio), Gillum, R. F. (Richard F.), Ford, I. (Ian), Sattar, N. (Naveed), Lazo, M. (Mariana), Thompson, S. G. (Simon G.), Ferrari, P. (Pietro), Leon, D. A. (David A.), Smith, G. D. (George Davey), Peto, R. (Richard), Jackson, R. (Rod), Banks, E. (Emily), Di Angelantonio, E. (Emanuele), and Danesh, J. (John)

Abstract

Background: Low-risk limits recommended for alcohol consumption vary substantially across different national guidelines. To define thresholds associated with lowest risk for all-cause mortality and cardiovascular disease, we studied individual-participant data from 599 912 current drinkers without previous cardiovascular disease. Methods: We did a combined analysis of individual-participant data from three large-scale data sources in 19 high-income countries (the Emerging Risk Factors Collaboration, EPIC-CVD, and the UK Biobank). We characterised dose–response associations and calculated hazard ratios (HRs) per 100 g per week of alcohol (12·5 units per week) across 83 prospective studies, adjusting at least for study or centre, age, sex, smoking, and diabetes. To be eligible for the analysis, participants had to have information recorded about their alcohol consumption amount and status (ie, non-drinker vs current drinker), plus age, sex, history of diabetes and smoking status, at least 1 year of follow-up after baseline, and no baseline history of cardiovascular disease. The main analyses focused on current drinkers, whose baseline alcohol consumption was categorised into eight predefined groups according to the amount in grams consumed per week. We assessed alcohol consumption in relation to all-cause mortality, total cardiovascular disease, and several cardiovascular disease subtypes. We corrected HRs for estimated long-term variability in alcohol consumption using 152 640 serial alcohol assessments obtained some years apart (median interval 5·6 years [5th–95th percentile 1·04–13·5]) from 71 011 participants from 37 studies. Findings: In the 599 912 current drinkers included in the analysis, we recorded 40 310 deaths and 39 018 incident cardiovascular disease events during 5·4 million person-years of follow-up. For all-cause mortality, we recorded a positive and curvilinear association with the level of alcohol consumption, with the minimum mortality ris

Published
2018

39. Adherence to a healthy Nordic food index and risk of myocardial infarction in middle-aged Danes:the diet, cancer and health cohort study

Author

Gunge, V. B., Andersen, I., Kyrø, C., Hansen, C. P., Dahm, C. C., Christensen, J., Tjønneland, A., Olsen, A., Gunge, V. B., Andersen, I., Kyrø, C., Hansen, C. P., Dahm, C. C., Christensen, J., Tjønneland, A., and Olsen, A.

Abstract

BACKGROUND/OBJECTIVES: For decades, the Mediterranean diet has been in focus regarding healthy eating as it has been associated with reduced risk of non-communicable diseases. Less interest has been given to health benefits of other regional diets. The aim of the present study was to assess whether adherence to a healthy Nordic food index was associated with lower risk of myocardial infarction (MI) among middle-aged Danes. SUBJECTS/METHODS: Data were obtained from the Danish Diet, Cancer and Health cohort study of 57 053 men and women aged 50 − 64 years recruited between 1993 and 1997. The healthy Nordic food index comprised healthy Nordic food items selected a priori (fish, cabbage, rye bread, oatmeal, apple and pears and root vegetables). Information on incident MI was ascertained through linkage with national registries. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated from sex-specific Cox proportional hazard models. RESULTS: In total, 1669 men and 653 women developed MI during follow-up (13.6 median years). In adjusted models, those with an index score of 5 − 6 points (highest scores) had significantly lower MI risk (men: HR = 0.77, 95% CI = 0.62, 0.97; women: HR = 0.55, 95% CI = 0.37, 0.82) relative to those scoring 0 points in the index (lowest score). A significantly lower MI risk was found per 1-point increment in the index in both men (HR = 0.95, 95% CI = 0.92, 0.99) and women (HR = 0.93, 95% CI = 0.88, 0.98). CONCLUSIONS: A healthy Nordic diet is associated with lower MI risk among middle-aged Danes, suggesting that Nordic diets should be considered in recommendations for dietary changes in the promotion of coronary health.

Published
2017

40. 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, A, Romaguera, D, Peeters, P, Gils, v, Chan, D, Romieu, I, Freisling, H, Ferrari, P, Clavel-Chapelon, F, Fagherazzi, G, Dartois, L, Li, K, Tikk, K, Bergmann, M, Boeing, H, Tjønneland, A, Olsen, A, Overvad, K, Dahm, C, Redondo, M, Agudo, A, Sánchez, M, Amiano, P, Chirlaque, MD, and Ardanaz, E

Abstract

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
2016

42. Healthy Lifestyle and Risk of Cancer in the European Prospective Investigation Into Cancer and Nutrition Cohort Study

Author

McKenzie, F, Biessy, C, Ferrari, P, Freisling, H, Rinaldi, S, Chajès, V, Dahm, C, Overvad, K, Dossus, L, Lagiou, P, Trichopoulos, D, Trichopoulou, A, Bueno-de-Mesquita, H, May, A, Peeters, P, Weiderpass, E, Sanchez, M, Navarro, C, Ardanaz, E, Ericson, U, Wirfält, E, Travis, R, Romieu, I, de Batlle, J, Dartois, L, Krogh, V, Panico, S, Tumino, R, Rosso, S, Buckland, G, Andersson, A, Sund, M, Key, T, Gunter, M, Riboli, E, Vergnaud, A, and Medical Research Council (MRC)

Subjects
Gerontology, Male, Health Status, GUIDELINES, 0302 clinical medicine, Behavior Therapy, Neoplasms, Medicine, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Non-U.S. Gov't, INDEX, Cancer, Medicine(all), education.field_of_study, VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Nutritional Support, Research Support, Non-U.S. Gov't, Hazard ratio, Age Factors, WOMEN, General Medicine, Middle Aged, Nutrition Surveys, Prognosis, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, Multicenter Study, 030220 oncology & carcinogenesis, Cohort, Female, CONCORDANCE, Life Sciences & Biomedicine, RESEARCH FUND/AMERICAN INSTITUTE, Cohort study, Research Article, Adult, Population, Observational Study, Lower risk, Research Support, Risk Assessment, DIET, 03 medical and health sciences, Medicine, General & Internal, Sex Factors, General & Internal Medicine, Journal Article, Humans, CORONARY-HEART-DISEASE, education, Life Style, METAANALYSIS, Science & Technology, Cancer prevention, business.industry, Prevention, 1103 Clinical Sciences, PREVENTION, Arthritis & Rheumatology, Life style, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, business, Demography, Follow-Up Studies, Forecasting
Abstract

It has been estimated that at least a third of the most common cancers are related to lifestyle and as such are preventable. Key modifiable lifestyle factors have been individually associated with cancer risk; however, less is known about the combined effects of these factors. This study generated a healthy lifestyle index score (HLIS) to investigate the joint effect of modifiable factors on the risk of overall cancers, alcohol-related cancers, tobacco-related cancers, obesity-related cancers, and reproductive-related cancers. The study included 391,608 men and women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The HLIS was constructed from 5 factors assessed at baseline (diet, physical activity, smoking, alcohol consumption, and anthropometry) by assigning scores of 0 to 4 to categories of each factor, for which higher values indicate healthier behaviors. Hazard ratios (HR) were estimated by Cox proportional regression and population attributable fractions (PAFs) estimated from the adjusted models. There was a 5% lower risk (adjusted HR 0.952, 95% confidence interval (CI): 0.946, 0.958) of all cancers per point score of the index for men and 4% (adjusted HR 0.961, 95% CI: 0.956, 0.966) for women. The fourth versus the second category of the HLIS was associated with a 28% and 24% lower risk for men and women respectively across all cancers, 41%and 33%for alcohol-related, 49%and 46%for tobacco-related, 41% and 26% for obesity-related, and 21% for female reproductive cancers. Findings suggest simple behavior modifications could have a sizeable impact on cancer prevention, especially for men.

Published
2016

44. Dietary patterns and risk of Inflammatory Bowel Disease in Europe : Results from the EPIC study

Author

Racine, A., Carbonnel, F., Chan, S., Hart, A., de Mesquita, B. Bueno, Oldenburg, B., VanSchaik, F., Tjonneland, A., Olsen, A., Dahm, C., Key, T., Luben, R., Kaw, K. -T, Riboli, E., Grip, O., Lindgren, S., Hallmans, Göran, Karling, Pontus, Clavel-Chapelon, F., Bergman, M., Boeing, H., Buijsse, B., Kaaks, R., Katzke, V., Palli, D., Masala, G., Jantchou, P., Ruault, M. C. Boutron, Racine, A., Carbonnel, F., Chan, S., Hart, A., de Mesquita, B. Bueno, Oldenburg, B., VanSchaik, F., Tjonneland, A., Olsen, A., Dahm, C., Key, T., Luben, R., Kaw, K. -T, Riboli, E., Grip, O., Lindgren, S., Hallmans, Göran, Karling, Pontus, Clavel-Chapelon, F., Bergman, M., Boeing, H., Buijsse, B., Kaaks, R., Katzke, V., Palli, D., Masala, G., Jantchou, P., and Ruault, M. C. Boutron

Abstract

Supplement: 1, Meeting Abstract: DOP014

Published
2015

45. Experimental pain processing in individuals with cognitive impairment: Current state of the science

Author

Defrin, R., Amanzio, M., De Tommaso, M., Dimova, V., Filipovic, S.R., Finn, D.P., Gimenez-Llort, L., Invitto, S., Jensen-Dahm, C., Lautenbacher, S., Oosterman, J.M., Petrini, L., Pick, C.G., Pickering, G., Vase, L., Kunz, M., Defrin, R., Amanzio, M., De Tommaso, M., Dimova, V., Filipovic, S.R., Finn, D.P., Gimenez-Llort, L., Invitto, S., Jensen-Dahm, C., Lautenbacher, S., Oosterman, J.M., Petrini, L., Pick, C.G., Pickering, G., Vase, L., and Kunz, M.

Abstract

Item does not contain fulltext, Cognitive impairment (CI) can develop during the course of ageing and is a feature of many neurological and neurodegenerative diseases. Many individuals with CI have substantial, sustained, and complex health care needs, which frequently include pain. However, individuals with CI can have difficulty communicating the features of their pain to others, which in turn presents a significant challenge for effective diagnosis and treatment of their pain. Herein, we review the literature on responsivity of individuals with CI to experimental pain stimuli. We discuss pain responding across a large number of neurological and neurodegenerative disorders in which CI is typically present. Overall, the existing data suggest that pain processing is altered in most individuals with CI compared with cognitively intact matched controls. The precise nature of these alterations varies with the type of CI (or associated clinical condition) and may also depend on the type of pain stimulation used and the type of pain responses assessed. Nevertheless, it is clear that regardless of the etiology of CI, patients do feel noxious stimuli, with more evidence for hypersensitivity than hyposensitivity to these stimuli compared with cognitively unimpaired individuals. Our current understanding of the neurobiological mechanisms underpinning these alterations is limited but may be enhanced through the use of animal models of CI, which also exhibit alterations in nociceptive responding. Further research using additional behavioural indices of pain is warranted. Increased understanding of altered experimental pain processing in CI will facilitate the development of improved diagnostic and therapeutic approaches for pain in individuals with CI.

Published
2015

46. Autonomic dysfunction in Alzheimer's disease

Author

Jensen-Dahm, C., Waldemar, G., Jensen, T., Malmqvist, L., Møller, M. M., Andersen, B. B., Høgh, P., Ballegaard, M., Jensen-Dahm, C., Waldemar, G., Jensen, T., Malmqvist, L., Møller, M. M., Andersen, B. B., Høgh, P., and Ballegaard, M.

Published
2015

47. Adherence to the mediterranean diet and risk of breast cancer in the European prospective investigation into cancer and nutrition cohort study

Author

Buckland, G. Travier, N. Cottet, V. Gonzalez, C. A. and Lujan-Barroso, L. Agudo, A. Trichopoulou, A. Lagiou, P. and Trichopoulos, D. Peeters, P. H. May, A. Bueno-de-Mesquita, H. B. Duijnhoven, F. J. Bvan Key, T. J. Allen, N. Khaw, K. T. Wareham, N. Romieu, I. McCormack, V. and Boutron-Ruault, M. Clavel-Chapelon, F. Panico, S. Agnoli, C. and Palli, D. Tumino, R. Vineis, P. Amiano, P. and Barricarte, A. Rodriguez, L. Sanchez, M. J. Chirlaque, M. D. and Kaaks, R. Teucher, B. Boeing, H. Bergmann, M. M. and Overvad, K. Dahm, C. C. Tjonneland, A. Olsen, A. Manjer, J. Wirfalt, E. Hallmans, G. Johansson, I. Lund, E. and Hjartaker, A. Skeie, G. Vergnaud, A. C. Norat, T. and Romaguera, D. Riboli, E.

Abstract

Epidemiological evidence suggests that the Mediterranean diet (MD) could reduce the risk of breast cancer (BC). As evidence from the prospective studies remains scarce and conflicting, we investigated the association between adherence to the MD and risk of BC among 335,062 women recruited from 1992 to 2000, in ten European countries, and followed for 11 years on average. Adherence to the MD was estimated through an adapted relative Mediterranean diet (arMED) score excluding alcohol. Cox proportional hazards regression models were used while adjusting for BC risk factors. A total of 9,009 postmenopausal and 1,216 premenopausal first primary incident invasive BC were identified (5,862 estrogen or progesterone receptor positive [ER+/PR+] and 1,018 estrogen and progesterone receptor negative [ER/PR]). The arMED was inversely associated with the risk of BC overall and in postmenopausal women (high vs. low arMED score; hazard ratio [HR] = 0.94 [95% confidence interval [CI]: 0.88, 1.00] ptrend = 0.048, and HR = 0.93 [95% CI: 0.87, 0.99] ptrend = 0.037, respectively). The association was more pronounced in ER/PR tumors (HR = 0.80 [95% CI: 0.65, 0.99] ptrend = 0.043). The arMED score was not associated with BC in premenopausal women. Our findings show that adherence to a MD excluding alcohol was related to a modest reduced risk of BC in postmenopausal women, and this association was stronger in receptor-negative tumors. The results support the potential scope for BC prevention through dietary modification.

Published
2013

48. Variety in vegetable and fruit consumption and the risk of gastric and esophageal cancer in the European prospective investigation into cancer and nutrition

Author

Jeurnink, S. M. Buchner, F. L. Bueno-de-Mesquita, H. B. and Siersema, P. D. Boshuizen, H. C. Numans, M. E. Dahm, C. C. and Overvad, K. Tjonneland, A. Roswall, N. Clavel-Chapelon, F. Boutron-Ruault, M. C. Morois, S. Kaaks, R. Teucher, B. Boeing, H. Buijsse, B. Trichopoulou, A. Benetou, V. and Zylis, D. Palli, D. Sieri, S. Vineis, P. Tumino, R. and Panico, S. Ocke, M. C. Peeters, P. H. M. Skeie, G. and Brustad, M. Lund, E. Sanchez-Cantalejo, E. Navarro, C. and Amiano, P. Ardanaz, E. Ramon Quiros, J. Hallmans, G. and Johansson, I. Lindkvist, B. Regner, S. Khaw, K. T. and Wareham, N. Key, T. J. Slimani, N. Norat, T. Vergnaud, A. C. Romaguera, D. Gonzalez, C. A.

Abstract

Diets high in vegetables and fruits have been suggested to be inversely associated with risk of gastric cancer. However, the evidence of the effect of variety of consumption is limited. We therefore investigated whether consumption of a variety of vegetables and fruit is associated with gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition study. Data on food consumption and follow-up on cancer incidence were available for 452,269 participants from 10 European countries. After a mean follow-up of 8.4 years, 475 cases of gastric and esophageal adenocarcinomas (180 noncardia, 185 cardia, gastric esophageal junction and esophagus, 110 not specified) and 98 esophageal squamous cell carcinomas were observed. Diet Diversity Scores were used to quantify the variety in vegetable and fruit consumption. We used multivariable Cox proportional hazard models to calculate risk ratios. Independent from quantity of consumption, variety in the consumption of vegetables and fruit combined and of fruit consumption alone were statistically significantly inversely associated with the risk of esophageal squamous cell carcinoma (continuous hazard ratio per 2 products increment 0.88; 95% CI 0.790.97 and 0.76; 95% CI 0.620.94, respectively) with the latter particularly seen in ever smokers. Variety in vegetable and/or fruit consumption was not associated with risk of gastric and esophageal adenocarcinomas. Independent from quantity of consumption, more variety in vegetable and fruit consumption combined and in fruit consumption alone may decrease the risk of esophageal squamous cell carcinoma. However, residual confounding by lifestyle factors cannot be excluded.

Published
2012

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