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1. Fruit and vegetable consumption and mortality: European prospective investigation into cancer and nutrition

Author

Leenders, M, Sluijs, I, Ros, M, Boshuizen, H, Siersema, P, Ferrari, P, Weikert, C, Tjønneland, A, Olsen, A, Boutron-Ruault, M, Clavel-Chapelon, F, Nailler, L, Teucher, B, Li, K, Boeing, H, Bergmann, M, Trichopoulou, A, Lagiou, P, Trichopoulos, D, Palli, D, Pala, V, Panico, S, Tumino, R, Sacerdote, C, and Peeters, P

Abstract

In this study, the relation between fruit and vegetable consumption and mortality was investigated within the European Prospective Investigation Into Cancer and Nutrition. Survival analyses were performed, including 451,151 participants from 10 European countries, recruited between 1992 and 2000 and followed until 2010. Hazard ratios, rate advancement periods, and preventable proportions to respectively compare risk of death between quartiles of consumption, to estimate the period by which the risk of death was postponed among high consumers, and to estimate proportions of deaths that could be prevented if all participants would shift their consumption 1 quartile upward. Consumption of fruits and vegetables was inversely associated with all-cause mortality (for the highest quartile, hazard ratio = 0.90, 95% confidence interval (CI): 0.86, 0.94), with a rate advancement period of 1.12 years (95% CI: 0.70, 1.54), and with a preventable proportion of 2.95%. This association was driven mainly by cardiovascular disease mortality (for the highest quartile, hazard ratio = 0.85, 95% CI: 0.77, 0.93). Stronger inverse associations were observed for participants with high alcohol consumption or high body mass index and suggested in smokers. Inverse associations were stronger for raw than for cooked vegetable consumption. These results support the evidence that fruit and vegetable consumption is associated with a lower risk of death.

Published
2016

2. Fruit and vegetable consumption and mortality: European prospective investigation into cancer and nutrition

Author

Leenders, M., van der Sluijs, I., Ros, M.M., Boshuizen, H.C., Siersema, P.D., Ferrari, P., Weikert, C., Tjonneland, A., Olsen, A., Boutron-Ruault, M.C., Clavel-Chapelon, F., Nailler, L., Teucher, B., Li, K.R., Boeing, H., Bergmann, M.M., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Palli, D., Pala, V., Panico, S., Tumino, R., Sacerdote, C., Peeters, P.H.M., van Gils, C.H., Lund, E., Engeset, D., Redondo, M.L., Agudo, A., Sanchez, M.J., Navarro, C., Ardanaz, E., Sonestedt, E., Ericson, U., Nilsson, L.M., Khaw, K.T., Warcham, N.J., Key, T.J., Crowe, F.L., Romieu, I., Gunter, M.J., Gallo, V., Overvad, K., Riboli, E., Bueno-de-Mesquita, H.B., Leenders, M, Sluijs, I, Ros, Mm, Boshuizen, Hc, Siersema, Pd, Ferrari, P, Weikert, C, Tj?nneland, A, Olsen, A, Boutron Ruault, Mc, Clavel Chapelon, F, Nailler, L, Teucher, B, Li, K, Boeing, H, Bergmann, Mm, Trichopoulou, A, Lagiou, P, Trichopoulos, D, Palli, D, Pala, V, Panico, Salvatore, Tumino, R, Sacerdote, C, Peeters, Ph, van Gils, Ch, Lund, E, Engeset, D, Redondo, Ml, Agudo, A, S?nchez, Mj, Navarro, C, Ardanaz, E, Sonestedt, E, Ericson, U, Nilsson, Lm, Khaw, Kt, Wareham, Nj, Key, Tj, Crowe, Fl, Romieu, I, Gunter, Mj, Gallo, V, Overvad, K, Riboli, E, and Bueno de Mesquita, Hb

Subjects
Adult, Male, Nutrition and Disease, cardiovascular-disease, men, population, Diet Surveys, Wiskundige en Statistische Methoden - Biometris, Cause of Death, Neoplasms, Voeding en Ziekte, Vegetables, Humans, oxidative stress, Prospective Studies, Mathematical and Statistical Methods - Biometris, Aged, Proportional Hazards Models, risk, Molecular epidemiology Aetiology, screening and detection [NCEBP 1], dietary assessment, health, Middle Aged, PE&RC, calibration, Survival Analysis, heart-disease, Europe, Fruit, impact, Female
Abstract

In this study, the relation between fruit and vegetable consumption and mortality was investigated within the European Prospective Investigation Into Cancer and Nutrition. Survival analyses were performed, including 451,151 participants from 10 European countries, recruited between 1992 and 2000 and followed until 2010. Hazard ratios, rate advancement periods, and preventable proportions to respectively compare risk of death between quartiles of consumption, to estimate the period by which the risk of death was postponed among high consumers, and to estimate proportions of deaths that could be prevented if all participants would shift their consumption 1 quartile upward. Consumption of fruits and vegetables was inversely associated with all-cause mortality (for the highest quartile, hazard ratio = 0.90, 95% confidence interval (CI): 0.86, 0.94), with a rate advancement period of 1.12 years (95% CI: 0.70, 1.54), and with a preventable proportion of 2.95%. This association was driven mainly by cardiovascular disease mortality (for the highest quartile, hazard ratio = 0.85, 95% CI: 0.77, 0.93). Stronger inverse associations were observed for participants with high alcohol consumption or high body mass index and suggested in smokers. Inverse associations were stronger for raw than for cooked vegetable consumption. These results support the evidence that fruit and vegetable consumption is associated with a lower risk of death. In this study, the relation between fruit and vegetable consumption and mortality was investigated within the European Prospective Investigation Into Cancer and Nutrition. Survival analyses were performed, including 451,151 participants from 10 European countries, recruited between 1992 and 2000 and followed until 2010. Hazard ratios, rate advancement periods, and preventable proportions to respectively compare risk of death between quartiles of consumption, to estimate the period by which the risk of death was postponed among high consumers, and to estimate proportions of deaths that could be prevented if all participants would shift their consumption 1 quartile upward. Consumption of fruits and vegetables was inversely associated with all-cause mortality (for the highest quartile, hazard ratio = 0.90, 95% confidence interval (CI): 0.86, 0.94), with a rate advancement period of 1.12 years (95% CI: 0.70, 1.54), and with a preventable proportion of 2.95%. This association was driven mainly by cardiovascular disease mortality (for the highest quartile, hazard ratio = 0.85, 95% CI: 0.77, 0.93). Stronger inverse associations were observed for participants with high alcohol consumption or high body mass index and suggested in smokers. Inverse associations were stronger for raw than for cooked vegetable consumption. These results support the evidence that fruit and vegetable consumption is associated with a lower risk of death.

Published
2013

3. Dietary acrylamide intake of adults in the European Prospective Investigation into Cancer and Nutrition differs greatly according to geographical region

Author

Freisling, H. Moskal, A. Ferrari, P. Nicolas, G. Knaze, V. Clavel-Chapelon, F. Boutron-Ruault, M.-C. Nailler, L. Teucher, B. Grote, V.A. Boeing, H. Clemens, M. Tjønneland, A. Olsen, A. Overvad, K. Quirós, J.R. Duell, E.J. Sánchez, M.-J. Amiano, P. Chirlaque, M.-D. Barricarte, A. Khaw, K.-T. Wareham, N.J. Crowe, F.L. Gallo, V. Oikonomou, E. Naska, A. Trichopoulou, A. Palli, D. Agnoli, C. Tumino, R. Polidoro, S. Mattiello, A. Bueno-De-Mesquita, H.B. Ocké, M.C. Peeters, P.H.M. Wirfält, E. Ericson, U. Bergdahl, I.A. Johansson, I. Hjartåker, A. Engeset, D. Skeie, G. Riboli, E. Slimani, N.

Abstract

Purpose: Methodological differences in assessing dietary acrylamide (AA) often hamper comparisons of intake across populations. Our aim was to describe the mean dietary AA intake in 27 centers of 10 European countries according to selected lifestyle characteristics and its contributing food sources in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: In this cross-sectional analysis, 36 994 men and women, aged 35-74 years completed a single, standardized 24-hour dietary recall using EPIC-Soft. Food consumption data were matched to a harmonized AA database. Intake was computed by gender and center, and across categories of habitual alcohol consumption, smoking status, physical activity, education, and body mass index (BMI). Adjustment was made for participants' age, height, weight, and energy intake using linear regression models. Results: Adjusted mean AA intake across centers ranged from 13 to 47 μg/day in men and from 12 to 39 μg/day in women; intakes were higher in northern European centers. In most centers, intake in women was significantly higher among alcohol drinkers compared with abstainers. There were no associations between AA intake and physical activity, BMI, or education. At least 50 % of AA intake across centers came from two food groups "bread, crisp bread, rusks" and "coffee." The third main contributing food group was "potatoes". Conclusions: Dietary AA intake differs greatly among European adults residing in different geographical regions. This observed heterogeneity in AA intake deserves consideration in the design and interpretation of population-based studies of dietary AA intake and health outcomes. © 2012 Springer-Verlag.

Published
2013

4. 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

5. Nutrient Patterns and Their Food Sources in an International Study Setting: Report from the EPIC Study

Author

Andrea Wendt, Joline W.J. Beulens, H. Bas Bueno-de-Mesquita, Pilar Amiano, Stephanie E. Chiuve, Elio Riboli, Anette Hjartåker, Domenico Palli, Isabel Drake, Pietro Ferrari, Anne Tjønneland, Maria Santucci de Magistris, Esther Molina-Montes, Heinz Freisling, Timothy J. Key, Aurelio Barricarte Gurrea, Aurelie Moskal, Jytte Halkjær, Brian Buijsse, Carlotta Sacerdote, Valeria Pala, Philippos Orfanos, Pedro T. Pisa, Tilman Kühn, Heiner Boeing, Antonia Trichopoulou, José María Huerta Castaño, José Ramón Quirós, Ulrika Ericson, Lena Maria Nilsson, Elisabete Weiderpass, Anna Winkvist, Genevieve Buckland, Nadia Slimani, Laura Nailler, Marleen A. H. Lentjes, Anne-Claire Vergnaud, Marie-Christine Boutron-Ruault, Graham Byrnes, Kay-Tee Khaw, Christina C. Dahm, Christina Bamia, Claire Cadeau, Marga C. Ocké, Dora Romaguera, Rosario Tumino, Epidemiology and Data Science, ACS - Diabetes & metabolism, ACS - Heart failure & arrhythmias, APH - Health Behaviors & Chronic Diseases, [Moskal,A, Pisa,PT, Freisling,H, Slimani,N] Dietary Exposure Assessment Group, International Agency for Research on Cancer, Lyon, France. [Ferrari,P] Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon, France. [Byrnes,G] Biostatistics Group, International Agency for Research on Cancer, Lyon, France. [Boutron-Ruault,M, Cadeau,C, Nailler,L] Center for research in Epidemiology and Population Health, Nutrition, Hormones and Women’s Health, INSERM, Villejuif, France. Université Paris Sud, Villejuif, France. Institut Gustave-Roussy, Villejuif, France. [Wendt,A, Kühn,T] Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany. [Boeing,H, Buijsse,B] Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany. [Tjønneland,A, Halkjær,J] Danish Cancer Society Research Center, Diet, Genes and Environment, Copenhagen, Denmark. [Dahm,CC] Section for Epidemiology, Institute of Public Health, Aarhus University, Aarhus, Denmark. [Chiuve,SE] Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America. Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America. [Quirós,JR] Public Health and Health Planning Directorate, Asturias, Spain. [Buckland,G] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain. [Molina-Montes,E] Andalusian School of Public Health, Granada, Spain. [Amiano,P, Huerta,JM, Barricarte,A] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain. [Amiano,P] Public Health Division of Gipuzkoa, BIODonostia Research Institute, San Sebastian, Spain. [Barricarte,A] Navarre Public Health Institute, Pamplona, Spain. [Huerta,JM] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. [Khaw,K, Lentjes,MA] Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. [Key,TJ] Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom. [Romaguera,D, Vergnaud,A, Riboli,E] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. [Romaguera,D] CIBER Fisiopatología de la Obesidad y Nutrición, Madrid, Spain. [Trichopoulou,A, Bamia,C, Orfanos,P] WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of AthensMedical School, Athens, Greece. Hellenic Health Foundation, Athens, Greece. [Palli,D] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute ISPO, Florence, Italy. [Pala,V] Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, ‘‘Civile - M.P. Arezzo’’ Hospital, Ragusa, Italy. [Sacerdote,C] HuGeF Foundation and Center for Cancer Prevention CPOPiemonte, Torino, Italy. [Magistris,MS] Department of Clinical and ExperimentalMedicine, Federico II University, Naples, Italy. [Bueno-de-Mesquita,HB, Ocké,MC] The National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. [Bueno-de-Mesquita,HB] Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, The Netherlands. [Beulens,JWJ] Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. [Ericson,U] Diabetes and cardiovascular Disease, Genetic Epidemiology, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden. [Drake,I] Department of Clinical Sciences in Malmö, Research Group in Nutritional Epidemiology, Lund University, Malmö, Sweden. [Nilsson,LM] Department of Public Health and Clinical Medicine, Nutrition Research, Umea University, Umea, Sweden. [Winkvist,A] Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden. [Weiderpass,E] Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway. Department of Research, Cancer Registry of Norway, Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Samfundet Folkhälsan, Helsinki, Finland. [Hjartaker,A] Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway., Funding: The coordination of EPIC is supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Ge´ne´ rale de l’Education Nationale, Institut National de la Sante´ et de la Recherche Me´dicale (INSERM) (France), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany), Hellenic Health Foundation (Greece), Italian Association for Research on Cancer (AIRC) and National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands), [ERC-2009-AdG 232997] and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health. (Norway), Health Research Fund (FIS) of the Spanish Ministry of Health, Spanish Regional Governments of Andalucı´a, Asturias, Basque Country, Murcia [no. 6236] and Navarra and the Catalan Institute of Oncology, ISCIII RETIC [RD06/0020] (Spain), Swedish Cancer Society, Swedish Scientific Council and Regional Government of Ska°ne and Va¨sterbotten (Sweden), Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, and Wellcome Trust (United Kingdom)., and 16491, Cancer Research UK, United Kingdom

Subjects
Male, Epidemiology, EXPLORATORY FACTOR-ANALYSIS, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], VDP::Medical disciplines: 700::Health sciences: 800::Nutrition: 811, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 0302 clinical medicine, Surveys and Questionnaires, estudios prospectivos, Estudios prospectivos, Public and Occupational Health, Food science, Prospective Studies, Cuestionarios, lcsh:Science, mediana edad, Evaluación nutricional, Disciplines and Occupations::Natural Science Disciplines::Science::Research [Medical Subject Headings], 0303 health sciences, anciano, dieta, Geographicals::Geographic Locations::Europe [Medical Subject Headings], Vitamins, adulto, Explained variation, Food Analysis, 3. Good health, DIETARY PATTERNS, Näringslära, Micronutrient Deficiencies, 030220 oncology & carcinogenesis, estilo de vida, Physical Sciences, Science & Technology - Other Topics, evaluación nutricional, Statistics (Mathematics), Check Tags::Male [Medical Subject Headings], factores socioeconómicos, Biostatistics, Endocrinology and Diabetes, Technology, Industry, Agriculture::Food and Beverages::Food [Medical Subject Headings], Estilo de vida, VDP::Medisinske Fag: 700::Helsefag: 800::Ernæring: 811, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], BREAST-CANCER, Humans, Statistical Methods, Life Style, Aged, conducta alimentaria, Science & Technology, MULTIDISCIPLINARY SCIENCES, VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Oncology: 762, lcsh:R, OLDER EUROPEANS, Biology and Life Sciences, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Life Style [Medical Subject Headings], Food Patterns, LARYNGEAL-CANCER, Check Tags::Female [Medical Subject Headings], Food, lcsh:Q, EUROPEAN COUNTRIES, Mathematics, análisis de alimentos, 030309 nutrition & dietetics, Animal food, humanos, lcsh:Medicine, COLORECTAL-CANCER, Nutrient, Alimentos, Medicine and Health Sciences, Public Health Surveillance, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Food Analysis [Medical Subject Headings], RISK, 2. Zero hunger, Nutrition and Dietetics, Multidisciplinary, Nutritional Deficiencies, Factores socioeconómicos, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Habits::Food Habits [Medical Subject Headings], Middle Aged, European Prospective Investigation into Cancer and Nutrition, PRINCIPAL COMPONENTS, Europe, Hábitos alimenticios, Principal component analysis, Investigación, Epidemiological Methods and Statistics, Female, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Health Surveys::Nutrition Surveys::Diet Surveys [Medical Subject Headings], Europa, Cancer Epidemiology, Research Article, Adult, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings], Context (language use), Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], Biology, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Nutrition Assessment [Medical Subject Headings], Environmental health, Confidence Intervals, Vigilancia en salud pública, vigilancia en salud pública, Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Nutrition, Nutrients, Feeding Behavior, Diet, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Onkologi: 762, Nutrition Assessment, Socioeconomic Factors, GASTRIC-CANCER
Abstract

Background: Compared to food patterns, nutrient patterns have been rarely used particularly at international level. We studied, in the context of a multi-center study with heterogeneous data, the methodological challenges regarding pattern analyses. Methodology/Principal Findings: We identified nutrient patterns from food frequency questionnaires (FFQ) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study and used 24-hour dietary recall (24-HDR) data to validate and describe the nutrient patterns and their related food sources. Associations between lifestyle factors and the nutrient patterns were also examined. Principal component analysis (PCA) was applied on 23 nutrients derived from country-specific FFQ combining data from all EPIC centers (N = 477,312). Harmonized 24-HDRs available for a representative sample of the EPIC populations (N = 34,436) provided accurate mean group estimates of nutrients and foods by quintiles of pattern scores, presented graphically. An overall PCA combining all data captured a good proportion of the variance explained in each EPIC center. Four nutrient patterns were identified explaining 67% of the total variance: Principle component (PC) 1 was characterized by a high contribution of nutrients from plant food sources and a low contribution of nutrients from animal food sources; PC2 by a high contribution of micro-nutrients and proteins; PC3 was characterized by polyunsaturated fatty acids and vitamin D; PC4 was characterized by calcium, proteins, riboflavin, and phosphorus. The nutrients with high loadings on a particular pattern as derived from country-specific FFQ also showed high deviations in their mean EPIC intakes by quintiles of pattern scores when estimated from 24-HDR. Center and energy intake explained most of the variability in pattern scores. Conclusion/Significance: The use of 24-HDR enabled internal validation and facilitated the interpretation of the nutrient patterns derived from FFQs in term of food sources. These outcomes open research opportunities and perspectives of using nutrient patterns in future studies particularly at international level., The coordination of EPIC is supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Generale de l'Education Nationale, Institut National de la Sante et de la Recherche Medicale (INSERM) (France); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); Hellenic Health Foundation (Greece); Italian Association for Research on Cancer (AIRC) and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); [ERC-2009-AdG 232997] and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health. (Norway); Health Research Fund (FIS) of the Spanish Ministry of Health, Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia [no. 6236] and Navarra and the Catalan Institute of Oncology, ISCIII RETIC [RD06/0020] (Spain); Swedish Cancer Society, Swedish Scientific Council and Regional Government of Skane and Vasterbotten (Sweden); Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, and Wellcome Trust (United Kingdom). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Published
2014

6. Consumption of Dairy Products and Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Author

Salvatore Panico, Eiliv Lund, Petra H.M. Peeters, Marc J. Gunter, Pagona Lagiou, Paolo Vineis, Ingegerd Johansson, Martin Almquist, Veronika Fedirko, Bas Bueno-de-Mesquita, Kay-Tee Khaw, Francesca L. Crowe, Rudolf Kaaks, Pietro Ferrari, Teresa Norat, Carmen Navarro, Neil Murphy, Richard Palmqvist, Timothy J. Key, Rosario Tumino, Guri Skeie, Birgit Teucher, Jonas Manjer, Christina C. Dahm, Marie-Christine Boutron-Ruault, Raul Zamora-Ros, Françoise Clavel-Chapelon, María José Sánchez Pérez, Elio Riboli, Eva Ardanaz, Anja Olsen, Nicholas J. Wareham, Antonia Trichopoulou, Elisabete Weiderpass, Manuela M. Bergmann, Vincent K. Dik, Mazda Jenab, Anne Tjønneland, Dimitrios Trichopoulos, Jose Ramon Quiros Garcia, Kim Overvad, Valeria Pala, Domenico Palli, Laura Nailler, Miren Dorronsoro, Heiner Boeing, Murphy, N, Norat, T, Ferrari, P, Jenab, M, Bueno de Mesquita, B, Skeie, G, Olsen, A, Tj?nneland, A, Dahm, Cc, Overvad, K, Boutron Ruault, Mc, Clavel Chapelon, F, Nailler, L, Kaaks, R, Teucher, B, Boeing, H, Bergmann, Mm, Trichopoulou, A, Lagiou, P, Trichopoulos, D, Palli, D, Pala, V, Tumino, R, Vineis, P, Panico, Salvatore, Peeters, Ph, Dik, Vk, Weiderpass, E, Lund, E, Garcia, Jr, Zamora Ros, R, P?rez, Mj, Dorronsoro, M, Navarro, C, Ardanaz, E, Manjer, J, Almquist, M, Johansson, I, Palmqvist, R, Khaw, Kt, Wareham, N, Key, Tj, Crowe, Fl, Fedirko, V, Gunter, Mj, and Riboli, E.

Subjects
Male, Non-Clinical Medicine, Colorectal cancer, Epidemiology, lcsh:Medicine, 0302 clinical medicine, Cheese, Epidemiology of cancer, Gastrointestinal Cancers, Medicine, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, lcsh:Science, 2. Zero hunger, Multidisciplinary, VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Cancer Risk Factors, Hazard ratio, Middle Aged, Metaanalysis, Yogurt, European Prospective Investigation into Cancer and Nutrition, Multidisciplinary Sciences, Milk, Health Education and Awareness, Oncology, Nutritional Correlates of Cancer, 030220 oncology & carcinogenesis, Observational Studies, Science & Technology - Other Topics, Female, Public Health, Colorectal Neoplasms, Cancer Prevention, Dietary calcium, Cancer Epidemiology, Research Article, medicine.medical_specialty, Colon-cancer, food.ingredient, Clinical Research Design, Health Informatics, Gastroenterology and Hepatology, 03 medical and health sciences, food, Internal medicine, Skimmed milk, Animals, Humans, Aged, Nutrition, Gynecology, Cancer och onkologi, Cancer prevention, Health Care Policy, Science & Technology, business.industry, Proportional hazards model, VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Oncology: 762, lcsh:R, Health Risk Analysis, Milk-products, medicine.disease, Calcium, Dietary, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Onkologi: 762, Cancer and Oncology, Vitamin-D, lcsh:Q, Surgery, Dairy Products, Preventive Medicine, Health Statistics, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, Clinical Medicine, business
Abstract

Background: Prospective studies have consistently reported lower colorectal cancer risks associated with higher intakes of total dairy products, total milk and dietary calcium. However, less is known about whether the inverse associations vary for individual dairy products with differing fat contents. Materials and Methods: In the European Prospective Investigation into Cancer and Nutrition (EPIC), we investigated the associations between intakes of total milk and milk subtypes (whole-fat, semi-skimmed and skimmed), yoghurt, cheese, and dietary calcium with colorectal cancer risk amongst 477,122 men and women. Dietary questionnaires were administered at baseline. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusted for relevant confounding variables. Results: During the mean 11 years of follow-up, 4,513 incident cases of colorectal cancer occurred. After multivariable adjustments, total milk consumption was inversely associated with colorectal cancer risk (HR per 200 g/day 0.93, 95% CI: 0.89-0.98). Similar inverse associations were observed for whole-fat (HR per 200 g/day 0.90, 95% CI: 0.82-0.99) and skimmed milk (HR per 200 g/day 0.90, 95% CI: 0.79-1.02) in the multivariable models. Inverse associations were observed for cheese and yoghurt in the categorical models; although in the linear models, these associations were non-significant. Dietary calcium was inversely associated with colorectal cancer risk (HR per 200 mg/day 0.95, 95% CI: 0.91-0.99); this association was limited to dairy sources of calcium only (HR per 200 mg/day 0.95, 95% CI: 0.91-0.99), with no association observed for non-dairy calcium sources (HR per 200 mg/day 1.00, 95% CI: 0.81-1.24). Conclusions: Our results strengthen the evidence for a possible protective role of dairy products on colorectal cancer risk. The inverse associations we observed did not differ by the fat content of the dairy products considered.

Published
2013

7. Time to negative PCR conversion amongst high-risk patients with mild-to-moderate Omicron BA.1 and BA.2 COVID-19 treated with sotrovimab or nirmatrelvir.

Author

Martin-Blondel G, Marcelin AG, Soulié C, Kaisaridi S, Lusivika-Nzinga C, Zafilaza K, Dorival C, Nailler L, Boston A, Ronchetti AM, Melenotte C, Cabié A, Choquet C, Trinh-Duc A, Lacombe K, Gaube G, Coustillères F, Pourcher V, Martellosio JP, Peiffer-Smadja N, Chauveau M, Housset P, Piroth L, Devaux M, Pialoux G, Martin A, Dubee V, Frey J, Le Bot A, Cazanave C, Petua P, Liblau R, Carrat F, and Yordanov Y

Subjects
Humans, Cohort Studies, Prospective Studies, SARS-CoV-2 genetics, Polymerase Chain Reaction, Lactams, Leucine, Nitriles, COVID-19 Testing, COVID-19
Abstract

Objectives: Our aim was to compare the clinical and virological outcomes in Omicron BA.1- and BA.2-infected patients who received sotrovimab with those in patients who received nirmatrelvir for the prevention of severe COVID-19., Methods: In this multi-centric, prospective ANRS 0003S CoCoPrev cohort study, patients at a high risk of progression of mild-to-moderate BA.1 or BA.2 COVID-19 who received sotrovimab or nirmatrelvir were included. The proportion of patients with progression to severe COVID-19, time between the start of treatment to negative PCR conversion, SARS-CoV-2 viral decay, and characterization of resistance variants were determined. A multi-variable Cox proportional hazard model was used to determine the time to negative PCR conversion and a mixed-effect model for the dynamics of viral decay., Results: Amongst 255 included patients, 199 (80%) received ≥3 vaccine doses, 195 (76%) received sotrovimab, and 60 (24%) received nirmatrelvir. On day 28, new COVID-19-related hospitalization occurred in 4 of 193 (2%; 95% CI, 1-5%) sotrovimab-treated patients and 0 of 55 nirmatrelvir-treated patients (p 0.24). One out of the 55 nirmatrelvir-treated patients died (2%; 95% CI, 0-10%). The median time to negative PCR conversion was 11.5 days (95% CI, 10.5-13) in the sotrovimab-treated patients vs. 4 days (95% CI, 4-9) in the nirmatrelvir-treated patients (p < 0.001). Viral decay was faster in the patients who received nirmatrelvir (p < 0.001). In the multi-variable analysis, nirmatrelvir and nasopharyngeal PCR cycle threshold values were independently associated with faster conversion to negative PCR (hazard ratio, 2.35; 95% CI, 1.56-3.56; p < 0.0001 and hazard ratio, 1.05; 95% CI, 1.01-1.08; p 0.01, respectively)., Conclusions: Early administration of nirmatrelvir in high-risk patients compared with that of sotrovimab was associated with faster viral clearance. This may participate to decrease transmission and prevent viral resistance., (Copyright © 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Published
2023
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8. Brief Report: Frailty in Aging People Living With HIV: A Matched Controlled Study.

Author

Lellouche L, Gutierrez LA, Leclercq P, Zaegel-Faucher O, Bernard L, Vassallo M, Barbuat C, Ozguler A, Zins M, Nailler L, Reynes J, Berr C, and Makinson A

Subjects
Activities of Daily Living, Aged, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Case-Control Studies, Comorbidity, Cross-Sectional Studies, Depression epidemiology, Female, HIV Infections complications, HIV Infections epidemiology, HIV Infections psychology, Humans, Male, Middle Aged, Prevalence, Aging, Frailty epidemiology, HIV Infections drug therapy
Abstract

Background: We compared the prevalence of frailty among aging people living with HIV (PLHIV) with people without HIV from the ANS EP58 HAND 55-70 Study., Methods: Cross-sectional multicentric study which consecutively included 200 PLHIV and 1000 people without HIV from the French national CONSTANCES cohort, matched on age, sex, and education level. PLHIV were aged 55-70 years, with a HIV viral load < 50 copies/mL and a lymphocyte T-CD4 level > 200 cells/µL for the last 24 and 12 months, respectively. We measured frailty (>2 items) and prefrailty (one or 2 items) using a proxy of the 5-item Fried score. Multivariate logistic regression was performed to assess the association between HIV and frailty/prefrailty, adjusting for demographic, social, behavioral, and comorbidity confounders., Results: Outcome measures were available for 192 PLHIV and 822 people without HIV. The median age was 62 years, and 84.9% were men. Among PLHIV, the median CD4 cell count was 645.5 cells/µL. Prevalence of frailty/prefrailty was 5.73%/57.3% in PLHIV vs. 1.73%/52.2% in people without HIV, respectively. HIV was associated with prefrailty/frailty [odds ratio = 1.89; 95% confidence interval = 1.37 to 2.61), but after adjusting for social and behavioral factors and comorbidities, HIV was not significantly associated with prefrailty/frailty (odds ratio = 1.24; 95% confidence interval: = 0.84 to 1.81). In PLHIV only, frailty/prefrailty was associated with depressive symptomatology, kidney disease, and time since HIV infection., Conclusions: Prevalence of frailty is increased in aging PLHIV with well-controlled HIV disease, but other factors than HIV are predominant, particularly depression and comorbidities., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2021
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9. HIV-mediated immune aging in young adults infected perinatally or during childhood.

Author

Fastenackels S, Sauce D, Vigouroux C, Avettand-Fènoël V, Bastard JP, Fellahi S, Nailler L, Arezes E, Rouzioux C, Warszawski J, Viard JP, and Appay V

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Biomarkers, CD4-Positive T-Lymphocytes immunology, CD8-Positive T-Lymphocytes immunology, Cell Separation, Disease Progression, Female, Flow Cytometry, HIV Infections virology, HIV-1 physiology, Hematopoietic Stem Cells cytology, Hematopoietic Stem Cells immunology, Humans, Male, Middle Aged, Prospective Studies, Viral Load, Young Adult, CD4 Lymphocyte Count, HIV Infections immunology, Immunosenescence, Lymphopoiesis, Virus Replication
Abstract

Background: HIV-infected patients progressing towards disease present a premature immune aging profile, characterized by the exhaustion of lymphopoiesis. The development of these anomalies may be prevented in young HIV-infected patients owing to their robust immune resources and lymphocyte regeneration capacities., Methods: An immunomonitoring substudy was designed for young adults aged between 18 and 25 years, living with HIV since childhood included in the national ANRS Co19 COVERTE Cohort. We compared markers associated with immune aging, including the frequency of circulating hematopoietic progenitors and the phenotype of lymphocyte populations, with those of patients infected with HIV in adulthood., Results: HIV-infected young adults displayed decreasing numbers of CD34 hematopoietic progenitors and mature lymphocytes, indicative of general lymphopenia and reminiscent of the alterations found in patients infected in adulthood or uninfected elderly people. This highlights the strong impact of HIV on the immune system despite patient's young age at infection. Immune aging-related alterations were particularly obvious in young patients who presented high viral loads., Conclusion: HIV-infected young adults can present increased markers of immune activation and senescence, related to uncontrolled viral replication. This highlights the issue of noncompliance to antiretroviral therapy in patients at a young age, resulting in loss of viral control, premature immunosenescence, and potentially irreversible damage of their lymphopoietic system.

Published
2019
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10. Metabolic risk factors in young adults infected with HIV since childhood compared with the general population.

Author

Arrive E, Viard JP, Salanave B, Dollfus C, Matheron S, Reliquet V, Arezes E, Nailler L, Vigouroux C, and Warszawski J

Subjects
Adolescent, Adult, Body Fat Distribution, Case-Control Studies, Child, Cohort Studies, Cross-Sectional Studies, Dyslipidemias etiology, Dyslipidemias metabolism, Female, France, HIV Infections pathology, Humans, Lipids blood, Male, Metabolic Diseases metabolism, Metabolic Diseases pathology, Metabolome, Risk Factors, Young Adult, HIV Infections complications, HIV Infections metabolism, Metabolic Diseases etiology
Abstract

Aim: Metabolic risk factors are poorly documented for the first generation of young adults who have lived with HIV since childhood. We compared their metabolic profile with that of adults of same age from the general population., Methods: We conducted a cross-sectional analysis of data from two populations: (1) COVERTE (ANRS-CO19), a French national cohort of 18 to 30-year-old patients HIV-infected since childhood, and (2) ENNS, a national cross-sectional population-based household survey on nutrition. Body mass index (BMI), blood pressure, waist circumference, fasting glucose, triglycerides, and HDL-, LDL- and total cholesterol were measured in both studies. Direct standardization on overweight and education level and logistic regression were used to compare the prevalence of metabolic abnormalities between the two populations., Results: Data from 268 patients from COVERTE and 245 subjects from ENNS were analyzed. Tobacco use was similar in both groups. HIV-infected patients had increased mean waist-to-hip ratio and triglycerides to HDL-cholesterol ratio and decreased mean HDL-cholesterol as compared to their counterparts from the general population in both genders. In HIV-infected patients, metabolic syndrome was identified in 13.2% of men (95% confidence interval [CI]: 7.1-19.2) and 10.4% (95% CI: 5.4-15.3) of women versus 10.6% (95%CI: 1.5-19.7) and 1.7% (95%CI: 0-4.1) in subjects from the general population, respectively., Conclusion: Young adults infected with HIV since childhood had a higher prevalence of dyslipidemia and metabolically detrimental fat distribution than adults of same age of the general population, supporting close monitoring for cardiometabolic diseases., Competing Interests: The authors have declared that no competing interests exist.

Published
2018
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11. Nutrient patterns and their food sources in an International Study Setting: report from the EPIC study.

Author

Moskal A, Pisa PT, Ferrari P, Byrnes G, Freisling H, Boutron-Ruault MC, Cadeau C, Nailler L, Wendt A, Kühn T, Boeing H, Buijsse B, Tjønneland A, Halkjær J, Dahm CC, Chiuve SE, Quirós JR, Buckland G, Molina-Montes E, Amiano P, Huerta Castaño JM, Gurrea AB, Khaw KT, Lentjes MA, Key TJ, Romaguera D, Vergnaud AC, Trichopoulou A, Bamia C, Orfanos P, Palli D, Pala V, Tumino R, Sacerdote C, de Magistris MS, Bueno-de-Mesquita HB, Ocké MC, Beulens JW, Ericson U, Drake I, Nilsson LM, Winkvist A, Weiderpass E, Hjartåker A, Riboli E, and Slimani N

Subjects
Adult, Aged, Diet, Europe epidemiology, Feeding Behavior, Female, Food, Humans, Life Style, Male, Middle Aged, Prospective Studies, Public Health Surveillance, Socioeconomic Factors, Surveys and Questionnaires, Food Analysis, Nutrition Assessment
Abstract

Background: Compared to food patterns, nutrient patterns have been rarely used particularly at international level. We studied, in the context of a multi-center study with heterogeneous data, the methodological challenges regarding pattern analyses., Methodology/principal Findings: We identified nutrient patterns from food frequency questionnaires (FFQ) in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study and used 24-hour dietary recall (24-HDR) data to validate and describe the nutrient patterns and their related food sources. Associations between lifestyle factors and the nutrient patterns were also examined. Principal component analysis (PCA) was applied on 23 nutrients derived from country-specific FFQ combining data from all EPIC centers (N = 477,312). Harmonized 24-HDRs available for a representative sample of the EPIC populations (N = 34,436) provided accurate mean group estimates of nutrients and foods by quintiles of pattern scores, presented graphically. An overall PCA combining all data captured a good proportion of the variance explained in each EPIC center. Four nutrient patterns were identified explaining 67% of the total variance: Principle component (PC) 1 was characterized by a high contribution of nutrients from plant food sources and a low contribution of nutrients from animal food sources; PC2 by a high contribution of micro-nutrients and proteins; PC3 was characterized by polyunsaturated fatty acids and vitamin D; PC4 was characterized by calcium, proteins, riboflavin, and phosphorus. The nutrients with high loadings on a particular pattern as derived from country-specific FFQ also showed high deviations in their mean EPIC intakes by quintiles of pattern scores when estimated from 24-HDR. Center and energy intake explained most of the variability in pattern scores., Conclusion/significance: The use of 24-HDR enabled internal validation and facilitated the interpretation of the nutrient patterns derived from FFQs in term of food sources. These outcomes open research opportunities and perspectives of using nutrient patterns in future studies particularly at international level.

Published
2014
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12. Consumption of dairy products and colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC).

Author

Murphy N, Norat T, Ferrari P, Jenab M, Bueno-de-Mesquita B, Skeie G, Olsen A, Tjønneland A, Dahm CC, Overvad K, Boutron-Ruault MC, Clavel-Chapelon F, Nailler L, Kaaks R, Teucher B, Boeing H, Bergmann MM, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Pala V, Tumino R, Vineis P, Panico S, Peeters PH, Dik VK, Weiderpass E, Lund E, Garcia JR, Zamora-Ros R, Pérez MJ, Dorronsoro M, Navarro C, Ardanaz E, Manjer J, Almquist M, Johansson I, Palmqvist R, Khaw KT, Wareham N, Key TJ, Crowe FL, Fedirko V, Gunter MJ, and Riboli E

Subjects
Aged, Animals, Calcium, Dietary, Cheese, Female, Humans, Male, Middle Aged, Milk, Prospective Studies, Yogurt, Colorectal Neoplasms epidemiology, Dairy Products
Abstract

Background: Prospective studies have consistently reported lower colorectal cancer risks associated with higher intakes of total dairy products, total milk and dietary calcium. However, less is known about whether the inverse associations vary for individual dairy products with differing fat contents., Materials and Methods: In the European Prospective Investigation into Cancer and Nutrition (EPIC), we investigated the associations between intakes of total milk and milk subtypes (whole-fat, semi-skimmed and skimmed), yoghurt, cheese, and dietary calcium with colorectal cancer risk amongst 477,122 men and women. Dietary questionnaires were administered at baseline. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusted for relevant confounding variables., Results: During the mean 11 years of follow-up, 4,513 incident cases of colorectal cancer occurred. After multivariable adjustments, total milk consumption was inversely associated with colorectal cancer risk (HR per 200 g/day 0.93, 95% CI: 0.89-0.98). Similar inverse associations were observed for whole-fat (HR per 200 g/day 0.90, 95% CI: 0.82-0.99) and skimmed milk (HR per 200 g/day 0.90, 95% CI: 0.79-1.02) in the multivariable models. Inverse associations were observed for cheese and yoghurt in the categorical models; although in the linear models, these associations were non-significant. Dietary calcium was inversely associated with colorectal cancer risk (HR per 200 mg/day 0.95, 95% CI: 0.91-0.99); this association was limited to dairy sources of calcium only (HR per 200 mg/day 0.95, 95% CI: 0.91-0.99), with no association observed for non-dairy calcium sources (HR per 200 mg/day 1.00, 95% CI: 0.81-1.24)., Conclusions: Our results strengthen the evidence for a possible protective role of dairy products on colorectal cancer risk. The inverse associations we observed did not differ by the fat content of the dairy products considered.

Published
2013
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13. Fruit and vegetable consumption and mortality: European prospective investigation into cancer and nutrition.

Author

Leenders M, Sluijs I, Ros MM, Boshuizen HC, Siersema PD, Ferrari P, Weikert C, Tjønneland A, Olsen A, Boutron-Ruault MC, Clavel-Chapelon F, Nailler L, Teucher B, Li K, Boeing H, Bergmann MM, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Pala V, Panico S, Tumino R, Sacerdote C, Peeters PH, van Gils CH, Lund E, Engeset D, Redondo ML, Agudo A, Sánchez MJ, Navarro C, Ardanaz E, Sonestedt E, Ericson U, Nilsson LM, Khaw KT, Wareham NJ, Key TJ, Crowe FL, Romieu I, Gunter MJ, Gallo V, Overvad K, Riboli E, and Bueno-de-Mesquita HB

Subjects
Adult, Aged, Cause of Death, Europe epidemiology, Female, Humans, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Survival Analysis, Diet Surveys statistics & numerical data, Fruit, Neoplasms mortality, Vegetables
Abstract

In this study, the relation between fruit and vegetable consumption and mortality was investigated within the European Prospective Investigation Into Cancer and Nutrition. Survival analyses were performed, including 451,151 participants from 10 European countries, recruited between 1992 and 2000 and followed until 2010. Hazard ratios, rate advancement periods, and preventable proportions to respectively compare risk of death between quartiles of consumption, to estimate the period by which the risk of death was postponed among high consumers, and to estimate proportions of deaths that could be prevented if all participants would shift their consumption 1 quartile upward. Consumption of fruits and vegetables was inversely associated with all-cause mortality (for the highest quartile, hazard ratio = 0.90, 95% confidence interval (CI): 0.86, 0.94), with a rate advancement period of 1.12 years (95% CI: 0.70, 1.54), and with a preventable proportion of 2.95%. This association was driven mainly by cardiovascular disease mortality (for the highest quartile, hazard ratio = 0.85, 95% CI: 0.77, 0.93). Stronger inverse associations were observed for participants with high alcohol consumption or high body mass index and suggested in smokers. Inverse associations were stronger for raw than for cooked vegetable consumption. These results support the evidence that fruit and vegetable consumption is associated with a lower risk of death.

Published
2013
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14. Challenges in estimating the validity of dietary acrylamide measurements.

Author

Ferrari P, Freisling H, Duell EJ, Kaaks R, Lujan-Barroso L, Clavel-Chapelon F, Boutron-Ruault MC, Nailler L, Polidoro S, Mattiello A, Palli D, Tumino R, Grioni S, Knüppel S, Tjønneland A, Olsen A, Overvad K, Orfanos P, Katsoulis M, Trichopoulou A, Quirós JR, Ardanaz E, Huerta JM, Etxezarreta PA, Sánchez MJ, Crowe F, Khaw KT, Wareham NJ, Ocke M, Bueno-de-Mesquita B, Peeters PH, Ericson U, Wirfält E, Hallmans G, Johansson I, Engeset D, Nicolas G, Gallo V, Norat T, Riboli E, and Slimani N

Subjects
Acrylamide metabolism, Adult, Biomarkers blood, Europe, Female, Hemoglobins chemistry, Humans, Male, Mental Recall, Middle Aged, Nutrition Assessment, Prospective Studies, Surveys and Questionnaires, Acrylamide administration & dosage, Diet, Food Contamination analysis
Abstract

Background: Acrylamide is a chemical compound present in tobacco smoke and food, classified as a probable human carcinogen and a known human neurotoxin. Acrylamide is formed in foods, typically carbohydrate-rich and protein-poor plant foods, during high-temperature cooking or other thermal processing. The objectives of this study were to compare dietary estimates of acrylamide from questionnaires (DQ) and 24-h recalls (R) with levels of acrylamide adduct (AA) in haemoglobin., Methods: In the European Prospective Investigation into Cancer and Nutrition (EPIC) study, acrylamide exposure was assessed in 510 participants from 9 European countries, randomly selected and stratified by age, sex, with equal numbers of never and current smokers. After adjusting for country, alcohol intake, smoking status, number of cigarettes and energy intake, correlation coefficients between various acrylamide measurements were computed, both at the individual and at the aggregate (centre) level., Results: Individual level correlation coefficient between DQ and R measurements (r DQ,R) was 0.17, while r DQ,AA and r R,AA were 0.08 and 0.06, respectively. In never smokers, r DQ,R, r DQ,AA and r R,AA were 0.19, 0.09 and 0.02, respectively. The correlation coefficients between means of DQ, R and AA measurements at the centre level were larger (r > 0.4)., Conclusions: These findings suggest that estimates of total acrylamide intake based on self-reported diet correlate weakly with biomarker AA Hb levels. Possible explanations are the lack of AA levels to capture dietary acrylamide due to individual differences in the absorption and metabolism of acrylamide, and/or measurement errors in acrylamide from self-reported dietary assessments, thus limiting the possibility to validate acrylamide DQ measurements.

Published
2013
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15. Dietary acrylamide intake of adults in the European Prospective Investigation into Cancer and Nutrition differs greatly according to geographical region.

Author

Freisling H, Moskal A, Ferrari P, Nicolas G, Knaze V, Clavel-Chapelon F, Boutron-Ruault MC, Nailler L, Teucher B, Grote VA, Boeing H, Clemens M, Tjønneland A, Olsen A, Overvad K, Quirós JR, Duell EJ, Sánchez MJ, Amiano P, Chirlaque MD, Barricarte A, Khaw KT, Wareham NJ, Crowe FL, Gallo V, Oikonomou E, Naska A, Trichopoulou A, Palli D, Agnoli C, Tumino R, Polidoro S, Mattiello A, Bueno-de-Mesquita HB, Ocké MC, Peeters PH, Wirfält E, Ericson U, Bergdahl IA, Johansson I, Hjartåker A, Engeset D, Skeie G, Riboli E, and Slimani N

Subjects
Adult, Aged, Alcohol Drinking, Bread analysis, Coffee chemistry, Cohort Studies, Cross-Sectional Studies, Databases, Factual, Europe, Female, Humans, Male, Middle Aged, Neurotoxins administration & dosage, Prospective Studies, Sex Characteristics, Acrylamide administration & dosage, Diet adverse effects, Food Contamination, Life Style
Abstract

Purpose: Methodological differences in assessing dietary acrylamide (AA) often hamper comparisons of intake across populations. Our aim was to describe the mean dietary AA intake in 27 centers of 10 European countries according to selected lifestyle characteristics and its contributing food sources in the European Prospective Investigation into Cancer and Nutrition (EPIC) study., Methods: In this cross-sectional analysis, 36 994 men and women, aged 35-74 years completed a single, standardized 24-hour dietary recall using EPIC-Soft. Food consumption data were matched to a harmonized AA database. Intake was computed by gender and center, and across categories of habitual alcohol consumption, smoking status, physical activity, education, and body mass index (BMI). Adjustment was made for participants' age, height, weight, and energy intake using linear regression models., Results: Adjusted mean AA intake across centers ranged from 13 to 47 μg/day in men and from 12 to 39 μg/day in women; intakes were higher in northern European centers. In most centers, intake in women was significantly higher among alcohol drinkers compared with abstainers. There were no associations between AA intake and physical activity, BMI, or education. At least 50 % of AA intake across centers came from two food groups "bread, crisp bread, rusks" and "coffee." The third main contributing food group was "potatoes"., Conclusions: Dietary AA intake differs greatly among European adults residing in different geographical regions. This observed heterogeneity in AA intake deserves consideration in the design and interpretation of population-based studies of dietary AA intake and health outcomes.

Published
2013
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16. Meat consumption and mortality--results from the European Prospective Investigation into Cancer and Nutrition.

Author

Rohrmann S, Overvad K, Bueno-de-Mesquita HB, Jakobsen MU, Egeberg R, Tjønneland A, Nailler L, Boutron-Ruault MC, Clavel-Chapelon F, Krogh V, Palli D, Panico S, 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, Sánchez 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
Adult, Aged, Cardiovascular Diseases epidemiology, Cohort Studies, Female, Humans, Male, Middle Aged, Neoplasms epidemiology, Nutrition Surveys, Prospective Studies, Survival Analysis, United States, Cardiovascular Diseases mortality, Diet adverse effects, Feeding Behavior, Meat, Neoplasms mortality
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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