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  • 1. Asli, Lene A.
    et al.
    Braaten, Tonje
    Olsen, Anja
    Tjonneland, Anne
    Overvad, Kim
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Renstrom, Frida
    Umeå University, Faculty of Medicine, Department of Biobank Research. Department of Clinical Sciences, Lund University, Sweden.
    Lund, Eiliv
    Skeie, Guri
    Potato consumption and risk of pancreatic cancer in the HELGA cohort2018In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 119, no 12, p. 1408-1415Article, review/survey (Refereed)
    Abstract [en]

    Potatoes have been a staple food in many countries throughout the years. Potatoes have a high glycaemic index (GI) score, and high GI has been associated with several chronic diseases and cancers. Still, the research on potatoes and health is scarce and contradictive, and we identified no prospective studies that had investigated the association between potatoes as a single food and the risk of pancreatic cancer. The aim of this study was to prospectively investigate the association between potato consumption and pancreatic cancer among 114 240 men and women in the prospective HELGA cohort, using Cox proportional hazard models. Information on diet (validated FFQ's), lifestyle and health was collected by means of a questionnaire, and 221 pancreatic cancer cases were identified through cancer registries. The mean follow-up time was 11.4 (95 % CI 0.3, 169) years. High consumption of potatoes showed a non-significantly higher risk of pancreatic cancer in the adjusted model (hazard ratio (HR) 1.44; 95 % CI 0.93, 2.22, P-for trend 0.030) when comparing the highest v. the lowest quartile of potato consumption. In the sex-specific analyses, significant associations were found for females (HR 2.00; 95 % CI 1.07, 3.72, P-for trend 0.020), but not for males (HR 1.01; 95 % CI 0.56, 1.84, P-for trend 0.34). In addition, we explored the associations by spline regression, and the absence of dose-response effects was confirmed. In this study, high potato consumption was not consistently associated with a higher risk of pancreatic cancer. Further studies with larger populations are needed to explore the possible sex difference.

  • 2. Bamia, C
    et al.
    Orfanos, P
    Ferrari, P
    Overvad, K
    Hundborg, HH
    Tjonneland, A
    Olsen, A
    Kesse, E
    Boutron-Ruault, MC
    Clavel-Chapelon, F
    Nagel, G
    Boffetta, P
    Boeing, H
    Hoffmann, K
    Trichopoulos, D
    Baibas, N
    Psaltopoulou, T
    Norat, T
    Slimani, N
    Palli, D
    Krogh, V
    Panico, S
    Tumino, R
    Sacerdote, C
    Bueno-de-Mesquita, HB
    Ocke, MC
    Peeters, PH
    van Rossum, CT
    Quiros, JR
    Sanchez, MJ
    Navarro, C
    Barricarte, A
    Dorronsoro, M
    Berglund, G
    Wirfalt, E
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Bingham, S
    Khaw, KT
    Spencer, EA
    Roddam, AW
    Riboli, E
    Trichopoulou, A
    Dietary patterns among older Europeans: the EPIC-Elderly study.2005In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 94, no 1, p. 100-13Article in journal (Refereed)
    Abstract [en]

    Overall dietary patterns have been associated with health and longevity. We used principal component (PC) and cluster analyses to identify the prevailing dietary patterns of 99 744 participants, aged 60 years or older, living in nine European countries and participating in the European Prospective Investigation into Cancer and Nutrition (EPIC-Elderly cohort) and to examine their socio-demographic and lifestyle correlates. Two PC were identified: PC1 reflects a 'vegetable-based' diet with an emphasis on foods of plant origin, rice, pasta and other grain rather than on margarine, potatoes and non-alcoholic beverages. PC2 indicates a 'sweet- and fat-dominated' diet with a preference for sweets, added fat and dairy products but not meat, alcohol, bread and eggs. PC1 was associated with a younger age, a higher level of education, physical activity, a higher BMI, a lower waist:hip ratio and never and past smoking. PC2 was associated with older age, less education, never having smoked, a lower BMI and waist:hip ratio and lower levels of physical activity. Elderly individuals in southern Europe scored positively on PC1 and about zero on PC2, whereas the elderly in northern Europe scored negatively on PC1 and variably on PC2. The results of cluster analysis were compatible with the indicated dietary patterns. 'Vegetable-based' and a 'sweet- and fat-dominated' diets are prevalent among the elderly across Europe, and there is a north-south gradient regarding their dietary choices. Our study contributes to the identification of groups of elderly who are likely to have different prospects for long-term disease occurrence and survival.

  • 3.
    Berglund, Staffan K.
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. EURISTIKOS Excellence Centre for Paediatric Research, University of Granada, Granada, Spain.
    Torres-Espinola, Francisco J.
    Garcia-Valdes, Luz
    Teresa Segura, Ma
    Martinez-Zaldivar, Cristina
    Padilla, Carmen
    Rueda, Ricardo
    Petez Garcia, Miguel
    McArdle, Harry J.
    Campoy, Cristina
    The impacts of maternal iron deficiency and being overweight during pregnancy on neurodevelopment of the offspring2017In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 118, no 7, p. 533-540Article in journal (Refereed)
    Abstract [en]

    Both maternal Fe deficiency (ID) and being overweight or obese (Ow/Ob, BMI >= 25 kg/m(2)) may negatively affect offspring brain development. However, the two risk factors correlate and their independent effects on infant neurodevelopment are unclear. PREOBE is a prospective observational study that included 331 pregnant Spanish women, of whom 166 had pre-gestational Ow/Ob. Fe status was analysed at 34 weeks and at delivery, and babies were assessed using Bayley III scales of neurodevelopment at 18 months. In confounder-adjusted analyses, maternal ID at 34 weeks was associated with lower composite motor scores at 18 months (mean 113.3 (SD 9.9) v. 117.1 (SD 9.2), P=0.039). Further, the offspring of mothers with ID at delivery had lower cognitive scores (114.0 (SD 9.7) v. 121.5 (SD 10.9), P = 0.039) and lower receptive, expressive and composite (99.5 (SD 8.6) v. 107.6 (SD 8.3), P= 0.004) language scores. The negative associations between maternal ID at delivery and Bayley scores remained even when adjusting for maternal Ow/Ob and gestational diabetes. Similarly, maternal Ow/Ob correlated with lower gross motor scores in the offspring (12.3 (SD 2.0) v. 13.0 (SD 2.1), P = 0.037), a correlation that remained when adjusting for maternal ID. In conclusion, maternal ID and pre-gestational Ow/Ob are both negatively associated with Bayley scores at 18 months, but independently and on different subscales. These results should be taken into account when considering Fe supplementation for pregnant women.

  • 4.
    Chorell, Elin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Videhult, Frida Karlsson
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hernell, Olle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Antti, Henrik
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    West, Christina E
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Impact of probiotic feeding during weaning on the serum lipid profile and plasma metabolome in infants2013In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 110, no 1, p. 116-126Article in journal (Refereed)
    Abstract [en]

    The gut microbiome interacts with the host in the metabolic response to diet, and early microbial aberrancies may be linked to the development of obesity and metabolic disorders later in life. Probiotics have been proposed to affect metabolic programming and blood lipid levels, although studies are lacking in infants. Here, we report on the lipid profile and global metabolic response following daily feeding of probiotics during weaning. A total of 179 healthy, term infants were randomised to daily intake of cereals with (n 89) or without (n 90) the addition of Lactobacillus paracasei ssp. paracasei F19 (LF19) 108 colony-forming units per serving from 4 to 13 months of age. Weight, length and skinfold thickness were monitored. Venous blood was drawn at 5·5 and 13 months of age for analysis of the serum lipid profile. In a subsample, randomly selected from each group, GC-time-of-flight/MS was used to metabolically characterise plasma samples from thirty-seven infants. A combination of multi- and univariate analysis was applied to reveal differences related to LF19 treatment based on 228 putative metabolites, of which ninety-nine were identified or classified. We observed no effects of probiotic feeding on anthropometrics or the serum lipid profile. However, we detected significantly lower levels of palmitoleic acid (16 : 1) (P < 0·05) and significantly higher levels of putrescine (P < 0·01) in LF19-treated infants. Palmitoleic acid is a major MUFA strongly linked to visceral obesity, while putrescine is a polyamine with importance for gut integrity. Whether the observed differences will have long-term health consequences are being followed.

  • 5. Eussen, Simone JPM
    et al.
    Nilsen, Roy M
    Midttun, Oivind
    Hustad, Steinar
    IJssennagger, Noortje
    Meyer, Klaus
    Fredriksen, Ase
    Ulvik, Arve
    Ueland, Per M
    Brennan, Paul
    Johansson, Mattias
    Bueno-de-Mesquita, Bas
    Vineis, Paolo
    Chuang, Shu-Chun
    Boutron-Ruault, Marie Christine
    Dossus, Laure
    Perquier, Florence
    Overvad, Kim
    Teucher, Birgit
    Grote, Verena A
    Trichopoulou, Antonia
    Adarakis, George
    Plada, Maria
    Sieri, Sabina
    Tumino, Rosario
    Santucci de Magistris, Maria
    Ros, Martine M
    Peeters, Petra HM
    Luisa Redondo, Maria
    Zamora-Ros, Raul
    Chirlaque, Maria-Dolores
    Ardanaz, Eva
    Sonestedt, Emily
    Ericson, Ulrika
    Schneede, Jörn
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology.
    van Guelpen, Bethany
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Wark, Petra A
    Gallo, Valentina
    Norat, Teresa
    Riboli, Elio
    Vollset, Stein Emil
    North-south gradients in plasma concentrations of B-vitamins and other components of one-carbon metabolism in Western Europe: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) Study2013In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 110, no 2, p. 363-374Article in journal (Refereed)
    Abstract [en]

    Different lifestyle patterns across Europe may influence plasma concentrations of B-vitamins and one-carbon metabolites and their relation to chronic disease. Comparison of published data on one-carbon metabolites in Western European regions is difficult due to differences in sampling procedures and analytical methods between studies. The present study aimed, to compare plasma concentrations of one-carbon metabolites in Western European regions with one laboratory performing all biochemical analyses. We performed the present study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort among 5446 presumptively healthy individuals. Quantile regression was used to compare sex-specific median concentrations between Northern (Denmark and Sweden), Central (France, Germany, The Netherlands and United Kingdom) and Southern (Greece, Spain and Italy) European regions. The lowest folate concentrations were observed in Northern Europe (men, 10.4 nmol/l; women, 10.7 nmol/l) and highest concentrations in Central Europe. Cobalamin concentrations were slightly higher in Northern Europe (men, 330 pmol/l; women, 352 pmol/l) compared with Central and Southern Europe, but did not show a clear north-south gradient. Vitamin B-2 concentrations were highest in Northern Europe (men, 22.2 nmol/l; women, 26.0 nmol/l) and decreased towards Southern Europe (P-trend < 0.001). Vitamin B-6 concentrations were highest in Central Europe in men (77.3 nmol/l) and highest in the North among women (70.4 nmol/l), with decreasing concentrations towards Southern Europe in women (P-trend < 0.001). In men, concentrations of serine, glycine and sarcosine increased from the north to south. In women, sarcosine increased from Northern to Southern Europe. These findings may provide relevant information for the study of regional differences of chronic disease incidence in association with lifestyle.

  • 6.
    Gradmark, Anna M I
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Rydh, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Renström, Frida
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    De Lucia-Rolfe, Emanuella
    Sleigh, Alison
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Brage, Sören
    Franks, Paul W
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Computed tomography-based validation of abdominal adiposity measurements from ultrasonography, dual-energy X-ray absorptiometry and anthropometry2010In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 104, no 4, p. 582-588Article in journal (Refereed)
    Abstract [en]

    Large-scale aetiological studies of obesity and its pathological consequences require accurate measurements of adipose mass, distribution and subtype. Here, we compared the validity of three abdominal obesity assessment methods (dual-energy X-ray absorptiometry (DXA), ultrasound and anthropometry) against the gold-standard method of computed tomography (CT) in twenty-nine non-diseased middle-aged men (BMI 26.5 (sd 3.1) kg/m(2)) and women (BMI 25.5 (sd 3.2) kg/m(2)). Assessments of adipose mass (kg) and distribution (total subcutaneous (TSAT), superficial subcutaneous (SSAT), deep subcutaneous (DSAT) and visceral (VAT)) were obtained. Spearman's correlations were performed adjusted for age and sex. VAT area that was assessed using ultrasound (r 0.79; P < 0.0001) and waist circumference (r 0.85; P < 0.0001) correlated highly with VAT from CT, as did BMI (r 0.67; P < 0.0001) and DXA (r 0.70; P < 0.0001). DXA (r 0.72; P = 0.0004), BMI (r 0.71; P = 0.0003), waist circumference (r 0.86; P < 0.0001) and ultrasound (r 0.52; P = 0.015) were less strongly correlated with CT TSAT. None of the comparison measures of DSAT was strongly correlated with CT DSAT (all r approximately 0.50; P < 0.02). BMI (r 0.76; P < 0.0001), waist circumference (r 0.65; P = 0.002) and DXA (r 0.75; P < 0.0001) were all fairly strongly correlated with the CT measure of SSAT, whereas ultrasound yielded a weaker yet statistically significant correlation (r 0.48; P = 0.03). Compared with CT, visceral and subcutaneous adiposity can be assessed with reasonable validity using waist circumference and BMI, respectively. Ultrasound or DXA does not generally provide substantially better measures of these traits. Highly valid assessments of DSAT do not appear to be possible with surrogate measures. These findings may help guide the selection of measures for epidemiological studies of obesity.

  • 7.
    Heikkila, Harri M.
    et al.
    Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.
    Krachler, Benno
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.
    Rauramaa, Rainer
    Kuopio Research Institute of Exercise Medicine, Kuopio, Finland and Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.
    Schwab, Ursula S.
    Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital, Kuopio, Finland and School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland.
    Diet, insulin secretion and insulin sensitivity: the Dose-Responses to Exercise Training (DR's EXTRA) Study (ISRCTN45977199)2014In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 112, no 9, p. 1530-1541Article in journal (Refereed)
    Abstract [en]

    Intakes of saturated fat (SF) and dietary fibre, body mass and physical activity are all associated with the incidence of type 2 diabetes mellitus. Their relative importance for the maintenance of normal glucose metabolism is not fully known. In a population-based sample of 1114 individuals, aged 58-78 years, dietary intakes were assessed by 4 d food records and cardiorespiratory fitness as maximal oxygen uptake. Insulin secretion, insulin sensitivity, the early-phase disposition index (DI30) and the total disposition index (DI120) were assessed based on an oral glucose tolerance test. Linear associations were modelled using linear regression. Combined effects were studied by introducing SF and fibre intakes, as well as cardiorespiratory fitness and waist circumference (WC) as dichotomised variables in general linear models. Intakes of dietary fibre and whole-grain bread were positively associated with insulin sensitivity, independent of physical fitness and WC. In women, dietary fibre intake was also positively associated with DI30. The negative association of high WC with DI30 was attenuated by a combination of low SF intake and high cardiorespiratory fitness. In conclusion, dietary fibre and a combination of low SF intake and high cardiorespiratory fitness may contribute to the maintenance of normal glucose metabolism, independent of WC.

  • 8.
    Hernell, Olle
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    West, Christina E.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Clinical effects of probiotics: scientific evidence from a paediatric perspective2013In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 109, no Suppplement 2, p. S70-S75Article in journal (Refereed)
    Abstract [en]

    Probiotics are live micro-organisms that when given in adequate amounts can cause health benefits. The safety and efficacy of probiotics in the prevention and treatment of various clinical conditions have been evaluated in randomised controlled clinical trials, systematic reviews and meta-analyses. Generally, their safety has been documented. As a supplement to standard rehydration therapy, probiotics have been demonstrated to shorten the duration of diarrhoea resulting from acute viral gastroenteritis and in preventing antibiotic-associated diarrhoea in healthy children. Preliminary evidence suggests that probiotics might prevent necrotising enterocolitis in very-low-birth-weight infants, but further studies are needed before definite conclusions can be drawn. Probiotics have also been assessed in the treatment and prevention of allergic disease but the results, although promising, need further confirmation. Targeting a paediatric population, probiotics have been evaluated in the treatment of irritable bowel syndrome, ulcerative colitis, Helicobacter pylori gastritis and infantile colic, but at this stage, there is no evidence to support their routine use for these indications. There is a great need for studies aiming at disentangling the mechanisms by which probiotics mediate their clinical effects and for comparative studies between various probiotic bacteria. We still need to know which probiotic(s) to use and for which indications. A clearer message on dosages, optimal timing and duration of administration is needed. For this purpose, more carefully designed and sufficiently powered, randomised controlled trials with predefined outcomes are needed.

  • 9. Jakobsen, Marianne U.
    et al.
    Dethlefsen, Claus
    Due, Karen M.
    May, Anne M.
    Romaguera, Dora
    Vergnaud, Anne-Claire
    Norat, Teresa
    Sorensen, Thorkild I. A.
    Halkjaer, Jytte
    Tjonneland, Anne
    Boutron-Ruault, Marie-Christine
    Clavel-Chapelon, Francoise
    Fagherazzi, Guy
    Teucher, Birgit
    Kuehn, Tilman
    Bergmann, Manuela M.
    Boeing, Heiner
    Naska, Androniki
    Orfanos, Philippos
    Trichopoulou, Antonia
    Palli, Domenico
    De Magistris, Maria Santucci
    Sieri, Sabina
    Bueno-de-Mesquita, H. B.
    van der A, Daphne L.
    Engeset, Dagrun
    Hjartaker, Anette
    Rodriguez, Laudina
    Agudo, Antonio
    Molina-Montes, Esther
    Huerta, Jose M.
    Barricarte, Aurelio
    Amiano, Pilar
    Manjer, Jonas
    Wirfalt, Elisabet
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Biobank Research. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Khaw, Kay-Tee
    Wareham, Nicholas J.
    Key, Timothy J.
    Chajes, Veronique
    Slimani, Nadia
    Riboli, Elio
    Peeters, Petra H. M.
    Overvad, Kim
    Fish consumption and subsequent change in body weight in European women and men2013In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 109, no 2, p. 353-362Article in journal (Refereed)
    Abstract [en]

    Fish consumption is the major dietary source of EPA and DHA, which according to rodent experiments may reduce body fat mass and prevent obesity. Only a few human studies have investigated the association between fish consumption and body-weight gain. We investigated the association between fish consumption and subsequent change in body weight. Women and men (n 344 757) participating in the European Prospective Investigation into Cancer and Nutrition were followed for a median of 5.0 years. Linear and logistic regression were used to investigate the associations between fish consumption and subsequent change in body weight. Among women, the annual weight change was 5.70 (95% CI 4.35, 7.06), 2.23 (95% CI 0.16, 4.31) and 11.12 (95% CI 8.17, 14.08) g/10 g higher total, lean and fatty fish consumption per d, respectively. The OR of becoming overweight in 5 years among women who were normal weight at enrolment was 1.02 (95% CI 1.01, 1.02), 1.01 (95% CI 1.00, 1.02) and 1.02 (95% CI 1.01, 1.04) g/10 g higher total, lean and fatty consumption per d, respectively. Among men, fish consumption was not statistically significantly associated with weight change. Adjustment for potential over-or underestimation of fish consumption did not systematically change the observed associations, but the 95% CI became wider. The results in subgroups from analyses stratified by age or BMI at enrolment were not systematically different. In conclusion, the present study suggests that fish consumption has no appreciable association with body-weight gain.

  • 10. Jenab, Mazda
    et al.
    Sabate, Joan
    Slimani, Nadia
    Ferrari, Pietro
    Mazuir, Mathieu
    Casagrande, Corinne
    Deharveng, Genevieve
    Tjonneland, Anne
    Olsen, Anja
    Overvad, Kim
    Boutron-Ruault, Marie-Christine
    Clavel-Chapelon, Francoise
    Boeing, Heiner
    Weikert, Cornelia
    Linseisen, Jakob
    Rohrmann, Sabine
    Trichopoulou, Antonia
    Naska, Androniki
    Palli, Domenico
    Sacerdote, Carlotta
    Tumino, Rosario
    Mattiello, Amalia
    Pala, Valeria
    Bueno-de-Mesquita, H Bas
    Ocke, Marga C
    Peeters, Petra H
    Engeset, Dagrun
    Skeie, Gurie
    Jakszyn, Paula
    Ardanaz, Eva
    Quiros, J Ramon
    Dolores Chirlaque, Maria
    Martinez, Carmen
    Amiano, Pilar
    Berglund, Göran
    Palmqvist, Richard
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    van Guelpen, Bethany
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Bingham, Sheila
    Key, Timothy
    Riboli, Elio
    Consumption and portion sizes of tree nuts, peanuts and seeds in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts from 10 European countries2006In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 96, no S2, p. 12-23Article in journal (Refereed)
    Abstract [en]

    Tree nuts, peanuts and seeds are nutrient dense foods whose intake has been shown to be associated with reduced risk of some chronic diseases. They are regularly consumed in European diets either as whole, in spreads or from hidden sources (e.g. commercial products). However, little is known about their intake profiles or differences in consumption between European countries or geographic regions. The objective of this study was to analyse the population mean intake and average portion sizes in subjects reporting intake of nuts and seeds consumed as whole, derived from hidden sources or from spreads. Data was obtained from standardised 24-hour dietary recalls collected from 36 994 subjects in 10 different countries that are part of the European Prospective Investigation into Cancer and Nutrition (EPIC). Overall, for nuts and seeds consumed as whole, the percentage of subjects reporting intake on the day of the recall was: tree nuts=4 center dot 4%, peanuts=2 center dot 3 % and seeds=1 center dot 3 %. The data show a clear northern (Sweden: mean intake=0 center dot 15 g/d, average portion size=15 center dot 1 g/d) to southern (Spain: mean intake=2 center dot 99 g/d, average portion size=34 center dot 7 g/d) European gradient of whole tree nut intake. The three most popular tree nuts were walnuts, almonds and hazelnuts, respectively. In general, tree nuts were more widely consumed than peanuts or seeds. In subjects reporting intake, men consumed a significantly higher average portion size of tree nuts (28 center dot 5 v. 23 center dot 1 g/d, P < 0 center dot 01) and peanuts (46 center dot 1 v. 35 center dot 1 g/d, P < 0 center dot 01) per day than women. These data may be useful in devising research initiatives and health policy strategies based on the intake of this food group.

  • 11. Johnsen, Nina F.
    et al.
    Frederiksen, Kirsten
    Christensen, Jane
    Skeie, Guri
    Lund, Eiliv
    Landberg, Rikard
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Nilsson, Lena M.
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Halkjaer, Jytte
    Olsen, Anja
    Overvad, Kim
    Tjonneland, Anne
    Whole-grain products and whole-grain types are associated with lower all-cause and cause-specific mortality in the Scandinavian HELGA cohort2015In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 114, no 4, p. 608-623Article in journal (Refereed)
    Abstract [en]

    No study has yet investigated the intake of different types of whole grain (WG) in relation to all-cause and cause-specific mortality in a healthy population. The aim of the present study was to investigate the intake of WG products and WG types in relation to all-cause and cause-specific mortality in a large Scandinavian HELGA cohort that, in 1992-8, included 120 010 cohort members aged 30-64 years from the Norwegian Women and Cancer Study, the Northern Sweden Health and Disease Study, and the Danish Diet Cancer and Health Study. Participants filled in a FFQ from which data on the intake of WG products were extracted. The estimation of daily intake of WG cereal types was based on country-specific products and recipes. Mortality rate ratios (MRR) and 95% CI were estimated using the Cox proportional hazards model. A total of 3658 women and 4181 men died during the follow-up (end of follow-up was 15 April 2008 in the Danish sub-cohort, 15 December 2009 in the Norwegian sub-cohort and 15 February 2009 in the Swedish sub-cohort). In the analyses of continuous WG variables, we found lower all-cause mortality with higher intake of total WG products (women: MRR 0.89 (95% CI 0.86, 0.91); men: MRR 0.89 (95% CI 0.86, 0.91) for a doubling of intake). In particular, intake of breakfast cereals and non-white bread was associated with lower mortality. We also found lower all-cause mortality with total intake of different WG types (women: MRR 0.88 (95% CI 0.86, 0.92); men: MRR 0.88 (95% CI 0.86, 0.91) for a doubling of intake). In particular, WG oat, rye and wheat were associated with lower mortality. The associations were found in both women and men and for different causes of deaths. In the analyses of quartiles of WG intake in relation to all-cause mortality, we found lower mortality in the highest quartile compared with the lowest for breakfast cereals, non-white bread, total WG products, oat, rye (only men), wheat and total WG types. The MRR for highest v. lowest quartile of intake of total WG products was 0.68 (95% CI 0.62, 0.75, P-trend over quartiles, 0.0001) for women and 0.75 (95% CI 0.68, 0.81, P-trend over quartiles, 0.0001) for men. The MRR for highest v. lowest quartile of intake of total WG types was 0.74 (95% CI 0.67, 0.81, P-trend over quartiles, 0.0001) for women and 0.75 (95% CI 0.68, 0.82, P-trend (over quartiles), 0.0001) for men. Despite lower statistical power, the analyses of cause-specific mortality according to quartiles of WG intake supported these results. In conclusion, higher intake of WG products and WG types was associated with lower mortality among participants in the HELGA cohort. The study indicates that intake of WG is an important aspect of diet in preventing early death in Scandinavia.

  • 12. Knaze, Viktoria
    et al.
    Zamora-Ros, Raul
    Lujan-Barroso, Leila
    Romieu, Isabelle
    Scalbert, Augustin
    Slimani, Nadia
    Riboli, Elio
    van Rossum, Caroline T. M.
    Bueno-de-Mesquita, H. Bas
    Trichopoulou, Antonia
    Dilis, Vardis
    Tsiotas, Konstantinos
    Skeie, Guri
    Engeset, Dagrun
    Ramon Quiros, J.
    Molina, Esther
    Maria Huerta, Jose
    Crowe, Francesca
    Wirfal, Elisabet
    Ericson, Ulrika
    Peeters, Petra H. M.
    Kaaks, Rudolf
    Teucher, Birgit
    Johansson, Gerd
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Tumino, Rosario
    Boeing, Heiner
    Drogan, Dagmar
    Amiano, Pilar
    Mattiello, Amalia
    Khaw, Kay-Tee
    Luben, Robert
    Krogh, Vittorio
    Ardanaz, Eva
    Sacerdote, Carlotta
    Salvini, Simonetta
    Overvad, Kim
    Tjonneland, Anne
    Olsen, Anja
    Boutron-Ruault, Marie-Christine
    Fagherazzi, Guy
    Perquier, Florence
    Gonzalez, Carlos A.
    Intake estimation of total and individual flavan-3-ols, proanthocyanidins and theaflavins, their food sources and determinants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study2012In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 108, no 6, p. 1095-1108Article in journal (Refereed)
    Abstract [en]

    Epidemiological studies suggest health-protective effects of flavan-3-ols and their derived compounds on chronic diseases. The present study aimed to estimate dietary flavan-3-ol, proanthocyanidin (PA) and theaflavin intakes, their food sources and potential determinants in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration cohort. Dietary data were collected using a standardised 24 h dietary recall software administered to 36 037 subjects aged 35-74 years. Dietary data were linked with a flavanoid food composition database compiled from the latest US Department of Agriculture and Phenol-Explorer databases and expanded to include recipes, estimations and retention factors. Total flavan-3-ol intake was the highest in UK Health-conscious men (453.6 mg/d) and women of UK General population (377.6 mg/d), while the intake was the lowest in Greece (men: 160.5 mg/d; women: 124.8 mg/d). Monomer intake was the highest in UK General population (men: 213.5 mg/d; women: 178.6 mg/d) and the lowest in Greece (men: 26.6 mg/d in men; women: 20.7 mg/d). Theaflavin intake was the highest in UK General population (men: 29.3 mg/d; women: 25.3 mg/d) and close to zero in Greece and Spain. PA intake was the highest in Asturias (men: 455.2 mg/d) and San Sebastian (women: 253 mg/d), while being the lowest in Greece (men: 134.6 mg/d; women: 101.0 mg/d). Except for the UK, non-citrus fruits (apples/pears) were the highest contributors to the total flavan-3-ol intake. Tea was the main contributor of total flavan-3-ols in the UK. Flavan-3-ol, PA and theaflavin intakes were significantly different among all assessed groups. This study showed heterogeneity in flavan-3-ol, PA and theaflavin intake throughout the EPIC countries.

  • 13. Kyro, Cecilie
    et al.
    Olsen, Anja
    Bueno-de-Mesquita, H. B(as).
    Skeie, Guri
    Loft, Steffen
    Aman, Per
    Leenders, Max
    Dik, Vincent K.
    Siersema, Peter D.
    Pischon, Tobias
    Christensen, Jane
    Overvad, Kim
    Boutron-Ruault, Marie-Christine
    Fagherazzi, Guy
    Cottet, Vanessa
    Kuehn, Tilman
    Chang-Claude, Jenny
    Boeing, Heiner
    Trichopoulou, Antonia
    Naska, Androniki
    Oikonomidou, Despoina
    Masala, Giovanna
    Pala, Valeria
    Tumino, Rosario
    Vineis, Paolo
    Mattiello, Amalia
    Peeters, Petra H.
    Bakken, Toril
    Weiderpass, Elisabete
    Asli, Lene Angell
    Sanchez, Soledad
    Jakszyn, Paula
    Sanchez, Maria-Jose
    Amiano, Pilar
    Maria Huerta, Jose
    Barricarte, Aurelio
    Ljuslinder, Ingrid
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Palmqvist, Richard
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Khaw, Kay-Tee
    Wareham, Nick
    Key, Timothy J.
    Travis, Ruth C.
    Slimani, Nadia
    Freisling, Heinz
    Ferrari, Pietro
    Gunter, Marc J.
    Murphy, Neil
    Riboli, Elio
    Tjonneland, Anne
    Landberg, Rikard
    Plasma alkylresorcinol concentrations, biomarkers of whole-grain wheat and rye intake, in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort2014In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 111, no 10, p. 1881-1890Article in journal (Refereed)
    Abstract [en]

    Whole-grain intake has been reported to be associated with a lower risk of several lifestyle-related diseases such as type 2 diabetes, CVD and some types of cancers. As measurement errors in self-reported whole-grain intake assessments can be substantial, dietary biomarkers are relevant to be used as complementary tools for dietary intake assessment. Alkylresorcinols (AR) are phenolic lipids found almost exclusively in whole-grain wheat and rye products among the commonly consumed foods and are considered as valid biomarkers of the intake of these products. In the present study, we analysed the plasma concentrations of five AR homologues in 2845 participants from ten European countries from a nested case-control study in the European Prospective Investigation into Cancer and Nutrition. High concentrations of plasma total AR were found in participants from Scandinavia and Central Europe and lower concentrations in those from the Mediterranean countries. The geometric mean plasma total AR concentrations were between 35 and 41nmol/l in samples drawn from fasting participants in the Central European and Scandinavian countries and below 23nmol/l in those of participants from the Mediterranean countries. The whole-grain source (wheat or rye) could be determined using the ratio of two of the homologues. The main source was wheat in Greece, Italy, the Netherlands and the UK, whereas rye was also consumed in considerable amounts in Germany, Denmark and Sweden. The present study demonstrates a considerable variation in the plasma concentrations of total AR and concentrations of AR homologues across ten European countries, reflecting both quantitative and qualitative differences in the intake of whole-grain wheat and rye.

  • 14.
    Naska, Androniki
    et al.
    Athens, Greece.
    Katsoulis, Michail
    Athens, Greece.
    Orfanos, Philippos
    Athens, Greece.
    Lachat, Carl
    Gent, Belgium.
    Gedrich, Kurt
    Freising, Germany.
    Rodrigues, Sara S P
    Porto, Portugal.
    Freisling, Heinz
    Lyon, France.
    Kolsteren, Patrick
    Antwerp, Belgium.
    Engeset, Dagrun
    Tromsø, Norway.
    Lopes, Carla
    Porto, Portugal.
    Elmadfa, Ibrahim
    Vienna, Austria .
    Wendt, Andrea
    Heidelberg, Germany.
    Knüppel, Sven
    Nuthetal, Germany.
    Turrini, Aida
    Rome, Italy .
    Tumino, Rosario
    Ragusa, Italy.
    Ocké, Marga C
    Bilthoven, The Netherlands.
    Sekula, Wlodzimierz
    Warsaw, Poland.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Key, Tim
    Oxford OX3 7LF, UK.
    Trichopoulou, Antonia
    Athens, Greece.
    Eating out is different from eating at home among individuals who occasionally eat out: A cross-sectional study among middle-aged adults from eleven European countries2015In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 113, no 12, p. 1951-1964Article in journal (Refereed)
    Abstract [en]

    Eating out has been linked to the current obesity epidemic, but the evaluation of the extent to which out of home (OH) dietary intakes are different from those at home (AH) is limited. Data collected among 8849 men and 14 277 women aged 35-64 years from the general population of eleven European countries through 24-h dietary recalls or food diaries were analysed to: (1) compare food consumption OH to those AH; (2) describe the characteristics of substantial OH eaters, defined as those who consumed 25 % or more of their total daily energy intake at OH locations. Logistic regression models were fit to identify personal characteristics associated with eating out. In both sexes, beverages, sugar, desserts, sweet and savoury bakery products were consumed more OH than AH. In some countries, men reported higher intakes of fish OH than AH. Overall, substantial OH eating was more common among men, the younger and the more educated participants, but was weakly associated with total energy intake. The substantial OH eaters reported similar dietary intakes OH and AH. Individuals who were not identified as substantial OH eaters reported consuming proportionally higher quantities of sweet and savoury bakery products, soft drinks, juices and other non-alcoholic beverages OH than AH. The OH intakes were different from the AH ones, only among individuals who reported a relatively small contribution of OH eating to their daily intakes and this may partly explain the inconsistent findings relating eating out to the current obesity epidemic.

  • 15. Peluso, Marco
    et al.
    Airoldi, Luisa
    Munnia, Armelle
    Colombi, Alessandro
    Veglia, Fabrizio
    Autrup, Herman
    Dunning, Alison
    Garte, Seymour
    Gormally, Emmanuelle
    Malaveille, Christian
    Matullo, Giuseppe
    Overvad, Kim
    Raaschou-Nielsen, Ole
    Clavel-Chapelon, Francoise
    Linseisen, Jacob
    Boeing, Heiner
    Trichopoulou, Antonia
    Palli, Domenico
    Krogh, Vittorio
    Tumino, Rosario
    Panico, Salvatore
    Bueno-De-Mesquita, Bas H
    Peeters, Petra H
    Kumle, Merethe
    Agudo, Antonio
    Martinez, Carmen
    Dorronsoro, Miren
    Barricarte, Aurelio
    Tormo, Marìa Jose
    Quiros, José Ramón
    Berglund, Goran
    Jarvholm, Bengt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Day, Nicholas E
    Key, Timothy J
    Saracci, Rodolfo
    Kaaks, Rudolf
    Riboli, Elio
    Bingham, Shelia
    Vineis, Paolo
    Bulky DNA adducts, 4-aminobiphenyl-haemoglobin adducts and diet in the European Prospective Investigation into Cancer and Nutrition (EPIC) prospective study.2008In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 100, no 3, p. 489-95Article in journal (Refereed)
    Abstract [en]

    In contrast to some extensively examined food mutagens, for example, aflatoxins, N-nitrosamines and heterocyclic amines, some other food contaminants, in particular polycyclic aromatic hydrocarbons (PAH) and other aromatic compounds, have received less attention. Therefore, exploring the relationships between dietary habits and the levels of biomarkers related to exposure to aromatic compounds is highly relevant. We have investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort the association between dietary items (food groups and nutrients) and aromatic DNA adducts and 4-aminobiphenyl-Hb adducts. Both types of adducts are biomarkers of carcinogen exposure and possibly of cancer risk, and were measured, respectively, in leucocytes and erythrocytes of 1086 (DNA adducts) and 190 (Hb adducts) non-smokers. An inverse, statistically significant, association has been found between DNA adduct levels and dietary fibre intake (P = 0.02), vitamin E (P = 0.04) and alcohol (P = 0.03) but not with other nutrients or food groups. Also, an inverse association between fibre and fruit intake, and BMI and 4-aminobiphenyl-Hb adducts (P = 0.03, 0.04, and 0.03 respectively) was observed. After multivariate regression analysis these inverse correlations remained statistically significant, except for the correlation adducts v. fruit intake. The present study suggests that fibre intake in the usual range can modify the level of DNA or Hb aromatic adducts, but such role seems to be quantitatively modest. Fibres could reduce the formation of DNA adducts in different manners, by diluting potential food mutagens and carcinogens in the gastrointestinal tract, by speeding their transit through the colon and by binding carcinogenic substances.

  • 16. Rosell, Magdalena
    et al.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Berglund, L
    de Faire, Ulf
    Hellenius, Mai-Lis
    The relation between alcohol intake and physical activity and the fatty acids 14:0, 15:0 and 17:0 in serum phospholipids and adipose tissue used as markers for dairy fat intake2005In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 93, no 1, p. 115-121Article in journal (Refereed)
  • 17. Sluik, Diewertje
    et al.
    Boeing, Heiner
    Bergmann, Manuela M
    Schütze, Madlen
    Teucher, Birgit
    Kaaks, Rudolf
    Tjønneland, Anne
    Overvad, Kim
    Arriola, Larraitz
    Ardanaz, Eva
    Bendinelli, Benedetta
    Agnoli, Claudia
    Tumino, Rosario
    Ricceri, Fulvio
    Mattiello, Amalia
    Spijkerman, Annemieke M W
    Beulens, Joline W J
    Grobbee, Diederick E
    Nilsson, Peter M
    Melander, Olle
    Franks, Paul W
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Riboli, Elio
    Gallo, Valentina
    Romaguera, Dora
    Nöthlings, Ute
    Alcohol consumption and mortality in individuals with diabetes mellitus2012In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 108, no 7, p. 1307-1315Article in journal (Refereed)
    Abstract [en]

    Studies have suggested that moderate alcohol consumption is associated with a reduced risk of CVD and premature mortality in individuals with diabetes mellitus. However, history of alcohol consumption has hardly been taken into account. We investigated the association between current alcohol consumption and mortality in men and women with diabetes mellitus accounting for past alcohol consumption. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort was defined of 4797 participants with a confirmed diagnosis of diabetes mellitus. Men and women were assigned to categories of baseline and past alcohol consumption. Hazard ratios (HR) and 95 % CI for total mortality were estimated with multivariable Cox regression models, using light alcohol consumption (>0-6 g/d) as the reference category. Compared with light alcohol consumption, no relationship was observed between consumption of 6 g/d or more and total mortality. HR for >6-12 g/d was 0·89 (95 % CI 0·61, 1·30) in men and 0·86 (95 % CI 0·46, 1·60) in women. Adjustment for past alcohol consumption did not change the estimates substantially. In individuals who at baseline reported abstaining from alcohol, mortality rates were increased relative to light consumers: HR was 1·52 (95 % CI 0·99, 2·35) in men and 1·81 (95 % CI 1·04, 3·17) in women. The present study in diabetic individuals showed no association between current alcohol consumption >6 g/d and mortality risk compared with light consumption. The increased mortality risk among non-consumers appeared to be affected by their past alcohol consumption rather than their current abstinence.

  • 18.
    Szymlek-Gay, Ewa A.
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Domellöf, Magnus
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hernell, Olle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hurrell, Richard F.
    Lind, Torbjörn
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Lonnerdal, Bo
    Zeder, Christophe
    Egli, Ines M.
    Mode of oral iron administration and the amount of iron habitually consumed do not affect iron absorption, systemic iron utilisation or zinc absorption in iron-sufficient infants: a randomised trial2016In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 116, no 6, p. 1046-1060Article in journal (Refereed)
    Abstract [en]

    Different metabolic pathways of supplemental and fortification Fe, or inhibition of Zn absorption by Fe, may explain adverse effects of supplemental Fe in Fe-sufficient infants. We determined whether the mode of oral Fe administration or the amount habitually consumed affects Fe absorption and systemic Fe utilisation in infants, and assessed the effects of these interventions on Zn absorption, Fe and Zn status, and growth. Fe-sufficient 6-month-old infants (n 72) were randomly assigned to receive 6<bold></bold>6 mg Fe/d from a high-Fe formula, 1<bold></bold>3 mg Fe/d from a low-Fe formula or 6<bold></bold>6 mg Fe/d from Fe drops and a formula with no added Fe for 45 d. Fractional Fe absorption, Fe utilisation and fractional Zn absorption were measured with oral (Fe-57 and Zn-67) and intravenous (Fe-58 and Zn-70) isotopes. Fe and Zn status, infection and growth were measured. At 45 d, Hb was 6<bold></bold>3 g/l higher in the high-Fe formula group compared with the Fe drops group, whereas serum ferritin was 34 and 35 % higher, respectively, and serum transferrin 0<bold></bold>1 g/l lower in the high-Fe formula and Fe drops groups compared with the low-Fe formula group (all P<0<bold></bold>05). No intervention effects were observed on Fe absorption, Fe utilisation, Zn absorption, other Fe status indices, plasma Zn or growth. We concluded that neither supplemental or fortification Fe nor the amount of Fe habitually consumed altered Fe absorption, Fe utilisation, Zn absorption, Zn status or growth in Fe-sufficient infants. Consumption of low-Fe formula as the only source of Fe was insufficient to maintain Fe stores.

  • 19. Vedtofte, Mia Sadowa
    et al.
    Jakobsen, Marianne U.
    Lauritzen, Lotte
    O'Reilly, Eilis J.
    Virtamo, Jarmo
    Knekt, Paul
    Colditz, Graham
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Biobank Research.
    Buring, Julie
    Steffen, Lyn M.
    Robien, Kimberly
    Rimm, Eric B.
    Heitmann, Berit L.
    Association between the intake of alpha-linolenic acid and the risk of CHD2014In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 112, no 5, p. 735-743Article in journal (Refereed)
    Abstract [en]

    The intake of the mainly plant-derived n-3 PUFA alpha-linolenic acid (ALA) has been reported to be associated with a lower risk of CHD. However, the results have been inconsistent. Therefore, the objective of the present study was to examine the association between the intake of ALA and the risk of CHD. Potential effect modification by the intake of long-chain n-3 PUFA (n-3 LCPUFA) was also investigated. Data from eight American and European prospective cohort studies including 148 675 women and 80 368 men were used. The outcome measure was incident CHD (CHD event and death). During 4-10 years of follow-up, 4493 CHD events and 1751 CHD deaths occurred. Among men, an inverse association (not significant) between the intake of ALA and the risk of CHD events and deaths was observed. For each additional gram of ALA consumed, a 15% lower risk of CHD events (hazard ratios (HR) 0.85, 95% CI 0.72, 1.01) and a 23% lower risk of CHD deaths (HR 0.77, 95% CI 0.58, 1.01) were observed. No consistent association was observed among women. No effect modification by the intake of n-3 LCPUFA was observed.

  • 20. Ward, Heather A
    et al.
    Norat, Teresa
    Overvad, Kim
    Dahm, Christina C
    Bueno-de-Mesquita, H Bas
    Jenab, Mazda
    Fedirko, Veronika
    van Duijnhoven, Fränzel J B
    Skeie, Guri
    Romaguera-Bosch, Dora
    Tjønneland, Anne
    Olsen, Anja
    Carbonnel, Franck
    Affret, Aurélie
    Boutron-Ruault, Marie-Christine
    Katzke, Verena
    Kühn, Tilman
    Aleksandrova, Krassimira
    Boeing, Heiner
    Trichopoulou, Antonia
    Lagiou, Pagona
    Bamia, Christina
    Palli, Domenico
    Sieri, Sabina
    Tumino, Rosario
    Naccarati, Alessio
    Mattiello, Amalia
    Peeters, Petra H
    Weiderpass, Elisabete
    Åsli, Lene Angell
    Jakszyn, Paula
    Ramón Quirós, J
    Sánchez, María-José
    Dorronsoro, Miren
    Huerta, José-María
    Barricarte, Aurelio
    Jirström, Karin
    Ericson, Ulrika
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Gylling, Björn
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Bradbury, Kathryn E
    Khaw, Kay-Tee
    Wareham, Nicholas J
    Stepien, Magdalena
    Freisling, Heinz
    Murphy, Neil
    Cross, Amanda J
    Riboli, Elio
    Pre-diagnostic meat and fibre intakes in relation to colorectal cancer survival in the European Prospective Investigation into Cancer and Nutrition2016In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 116, no 2, p. 316-325Article in journal (Refereed)
    Abstract [en]

    Improvements in colorectal cancer (CRC) detection and treatment have led to greater numbers of CRC survivors, for whom there is limited evidence on which to provide dietary guidelines to improve survival outcomes. Higher intake of red and processed meat and lower intake of fibre are associated with greater risk of developing CRC, but there is limited evidence regarding associations with survival after CRC diagnosis. Among 3789 CRC cases in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, pre-diagnostic consumption of red meat, processed meat, poultry and dietary fibre was examined in relation to CRC-specific mortality (n 1008) and all-cause mortality (n 1262) using multivariable Cox regression models, adjusted for CRC risk factors. Pre-diagnostic red meat, processed meat or fibre intakes (defined as quartiles and continuous grams per day) were not associated with CRC-specific or all-cause mortality among CRC survivors; however, a marginal trend across quartiles of processed meat in relation to CRC mortality was detected (P 0·053). Pre-diagnostic poultry intake was inversely associated with all-cause mortality among women (hazard ratio (HR)/20 g/d 0·92; 95 % CI 0·84, 1·00), but not among men (HR 1·00; 95 % CI 0·91, 1·09) (Pfor heterogeneity=0·10). Pre-diagnostic intake of red meat or fibre is not associated with CRC survival in the EPIC cohort. There is suggestive evidence of an association between poultry intake and all-cause mortality among female CRC survivors and between processed meat intake and CRC-specific mortality; however, further research using post-diagnostic dietary data is required to confirm this relationship.

  • 21.
    Wennberg, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Bergdahl, Ingvar A
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Stegmayr, Birgitta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Medicin.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Lundh, Thomas
    Skerfving, Staffan
    Strömberg, Ulf
    Vessby, Bengt
    Jansson, Jan-Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Medicin.
    Fish intake, mercury, long-chain n-3 polyunsaturated fatty acids and risk of stroke in northern Sweden2007In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 98, no 5, p. 1038-1045Article in journal (Refereed)
  • 22.
    West, Christina E
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Prebiotics in infancy and childhood; clinical research warranted2011In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 106, no 11, p. 1628-1629Article in journal (Refereed)
  • 23. Zamora-Ros, Raul
    et al.
    Knaze, Viktoria
    Lujan-Barroso, Leila
    Romieu, Isabelle
    Scalbert, Augustin
    Slimani, Nadia
    Hjartaker, Anette
    Engeset, Dagrun
    Skeie, Guri
    Overvad, Kim
    Bredsdorff, Lea
    Tjonneland, Anne
    Halkjaer, Jytte
    Key, Timothy J
    Khaw, Kay-Tee
    Mulligan, Angela A
    Winkvist, Anna
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Bueno-de-Mesquita, H Bas
    Peeters, Petra HM
    Wallström, Peter
    Ericson, Ulrika
    Pala, Valeria
    de Magistris, Maria Santucci
    Polidoro, Silvia
    Tumino, Rosario
    Trichopoulou, Antonia
    Dilis, Vardis
    Katsoulis, Michael
    Maria Huerta, Jose
    Martinez, Virginia
    Sanchez, Maria-Jose
    Ardanaz, Eva
    Amiano, Pilar
    Teucher, Birgit
    Grote, Verena
    Bendinelli, Benedetta
    Boeing, Heiner
    Foerster, Jana
    Touillaud, Marina
    Perquier, Florence
    Fagherazzi, Guy
    Gallo, Valentina
    Riboli, Elio
    Gonzalez, Carlos A
    Differences in dietary intakes, food sources and determinants of total flavonoids between Mediterranean and non-Mediterranean countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study2013In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 109, no 8, p. 1498-1507Article in journal (Refereed)
    Abstract [en]

    A greater adherence to the traditional Mediterranean (MED) diet is associated with a reduced risk of developing chronic diseases. This dietary pattern is based on higher consumption of plant products that are rich in flavonoids. We compared the total flavonoid dietary intakes, their food sources and various lifestyle factors between MED and non-MED countries participating in the EPIC study. Flavonoid intakes and their food sources for 35 628 subjects, aged 35-74 years and recruited between 1992 and 2000, in twenty-six study centres were estimated using standardised 24 h dietary recall software (EPIC-Soft (R)). An ad hoc food composition database on flavonoids was compiled using analytical data from the United States Department of Agriculture and Phenol-Explorer databases. Moreover, it was expanded to include using recipes, estimations of missing values and flavonoid retention factors. No significant differences in total flavonoid mean intake between non-MED countries (373.7 mg/d) and MED countries (370.2 mg/d) were observed. In the non-MED region, the main contributors were proanthocyanidins (48.2 %) and flavan-3-ol monomers (24.9 %) and the principal food sources were tea (25.7 %) and fruits (32.8 %). In the MED region, proanthocyanidins (59.0 %) were by far the most abundant contributor and fruits (55.1 %), wines (16.7 %) and tea (6.8 %) were the main food sources. The present study shows similar results for total dietary flavonoid intakes, but significant differences in flavonoid class intakes, food sources and some characteristics between MED and non-MED countries. These differences should be considered in studies about the relationships between flavonoid intake and chronic diseases.

  • 24. Zamora-Ros, Raul
    et al.
    Knaze, Viktoria
    Lujan-Barroso, Leila
    Slimani, Nadia
    Romieu, Isabelle
    Fedirko, Veronika
    de Magistris, Maria Santucci
    Ericson, Ulrica
    Amiano, Pilar
    Trichopoulou, Antonia
    Dilis, Vardis
    Naska, Androniki
    Engeset, Dagrun
    Skeie, Guri
    Cassidy, Aedin
    Overvad, Kim
    Peeters, Petra H. M.
    Maria Huerta, Jose
    Sanchez, Maria-Jose
    Ramon Quiros, J.
    Sacerdote, Carlotta
    Grioni, Sara
    Tumino, Rosario
    Johansson, Gerd
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Drake, Isabel
    Crowe, Francesca L.
    Barricarte, Aurelio
    Kaaks, Rudolf
    Teucher, Birgit
    Bueno-de-Mesquita, H. Bas
    van Rossum, Caroline T. M.
    Norat, Teresa
    Romaguera, Dora
    Vergnaud, Anne-Claire
    Tjonneland, Anne
    Halkjaer, Jytte
    Clavel-Chapelon, Francoise
    Boutron-Ruault, Marie-Christine
    Touillaud, Marina
    Salvini, Simonetta
    Khaw, Kay-Thee
    Wareham, Nicholas
    Boeing, Heiner
    Foerster, Jana
    Riboli, Elio
    Gonzalez, Carlos A.
    Estimated dietary intakes of flavonols, flavanones and flavones in the European Prospective Investigation into Cancer and Nutrition (EPIC) 24 hour dietary recall cohort2011In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 106, no 12, p. 1915-1925Article in journal (Refereed)
    Abstract [en]

    Flavonols, flavanones and flavones (FLAV) are sub-classes of flavonoids that exert cardioprotective and anti-carcinogenic properties in vitro and in vivo. We aimed to estimate the FLAV dietary intake, their food sources and associated lifestyle factors in ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. FLAV intake and their food sources for 36 037 subjects, aged between 35 and 74 years, in twenty-seven study centres were obtained using standardised 24 h dietary recall software (EPIC-SOFT). An ad hoc food composition database on FLAV was compiled using data from US Department of Agriculture and Phenol-Explorer databases and was expanded using recipes, estimations and flavonoid retention factors in order to increase its correspondence with the 24 h dietary recall. Our results showed that the highest FLAV-consuming centre was the UK health-conscious group, with 130.9 and 97.0 mg/d for men and women, respectively. The lowest FLAV intakes were 36.8 mg/d in men from Umea and 37.2 mg/d in women from Malmo (Sweden). The flavanone sub-class was the main contributor to the total FLAV intake ranging from 46.6 to 52.9% depending on the region. Flavonols ranged from 38.5 to 47.3% and flavones from 5.8 to 8.6%. FLAV intake was higher in women, non-smokers, increased with level of education and physical activity. The major food sources were citrus fruits and citrus-based juices (especially for flavanones), tea, wine, other fruits and some vegetables. We concluded that the present study shows heterogeneity in intake of these three sub-classes of flavonoids across European regions and highlights differences by sex and other sociodemographic and lifestyle factors.

  • 25. Zamora-Ros, Raul
    et al.
    Knaze, Viktoria
    Lujan-Barroso, Leila
    Slimani, Nadia
    Romieu, Isabelle
    Touillaud, Marina
    Kaaks, Rudolf
    Teucher, Birgit
    Mattiello, Amalia
    Grioni, Sara
    Crowe, Francesca
    Boeing, Heiner
    Foerster, Jana
    Ramon Quiros, J.
    Molina, Esther
    Maria Huerta, Jose
    Engeset, Dagrun
    Skeie, Guri
    Trichopoulou, Antonia
    Dilis, Vardis
    Tsiotas, Konstantinos
    Peeters, Petra H. M.
    Khaw, Kay-Thee
    Wareham, Nicholas
    Bueno-de-Mesquita, Bas
    Ocke, Marga C.
    Olsen, Anja
    Tjonneland, Anne
    Tumino, Rosario
    Johansson, Gerd
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Ardanaz, Eva
    Sacerdote, Carlotta
    Sonestedt, Emily
    Ericson, Ulrika
    Clavel-Chapelon, Francoise
    Boutron-Ruault, Marie-Christine
    Fagherazzi, Guy
    Salvini, Simonetta
    Amiano, Pilar
    Riboli, Elio
    Gonzalez, Carlos A.
    Estimation of the intake of anthocyanidins and their food sources in the European Prospective Investigation into Cancer and Nutrition (EPIC) study2011In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 106, no 7, p. 1090-1099Article in journal (Refereed)
    Abstract [en]

    Anthocyanidins are bioactive flavonoids with potential health-promoting effects. These may vary among single anthocyanidins considering differences in their bioavailability and some of the mechanisms involved. The aim of the present study was to estimate the dietary intake of anthocyanidins, their food sources and the lifestyle factors (sex, age, BMI, smoking status, educational level and physisical activity) involved among twenty-seven centres in ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Anthocyanidin intake and their food sources for 36 037 subjects, aged between 35 and 74 years, in twenty-seven redefined centres were obtained using standardised 24 h dietary recall software (EPIC-SOFT). An ad hoc food composition database on anthocyanidins (cyanidin, delphinidin, malvidin, pelargonidin, peonidin, petunidin) was compiled using data from the US Department of Agriculture and Phenol-Explorer databases and was expanded by adding recipes, estimated values and cooking factors. For men, the total anthocyanidin mean intake ranged from 19.83 (SE 1.53) mg/d (Bilthoven, The Netherlands) to 64.88 (SE 1.86) mg/d (Turin, Italy), whereas for women the range was 18.73 (SE 2.80) mg/d (Granada, Spain) to 44.08 (SE 2.45) mg/d (Turin, Italy). A clear south to north gradient intake was observed. Cyanidins and malvidins were the main anthocynidin contributors depending on the region and sex. Anthocyanidin intake was higher in non-obese older females, non-smokers, and increased with educational level and physical activity. The major food sources were fruits, wine, non-alcoholic beverages and some vegetables. The present study shows differences in both total and individual anthocyanidin intakes and various lifestyle factors throughout Europe, with some geographical variability in their food sources.

  • 26. Zamora-Ros, Raul
    et al.
    Rothwell, Joseph A.
    Scalbert, Augustin
    Knaze, Viktoria
    Romieu, Isabelle
    Slimani, Nadia
    Fagherazzi, Guy
    Perquier, Florence
    Touillaud, Marina
    Molina-Montes, Esther
    Maria Huerta, Jose
    Barricarte, Aurelio
    Amiano, Pilar
    Menendez, Virginia
    Tumino, Rosario
    Santucci de Magistris, Maria
    Palli, Domenico
    Ricceri, Fulvio
    Sieri, Sabina
    Crowe, Francesca L.
    Khaw, Kay-Thee
    Wareham, Nicholas J.
    Grote, Verena
    Li, Kuanrong
    Boeing, Heiner
    Foerster, Jana
    Trichopoulou, Antonia
    Benetou, Vassiliki
    Tsiotas, Konstantinos
    Bueno-de-Mesquita, H. Bas
    Ros, Martine
    Peeters, Petra H. M.
    Tjonneland, Anne
    Halkjaer, Jytte
    Overvad, Kim
    Ericson, Ulrika
    Wallstrom, Peter
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Landberg, Rikard
    Weiderpass, Elisabete
    Engeset, Dagrun
    Skeie, Guri
    Wark, Petra
    Riboli, Elio
    Gonzalez, Carlos A.
    Dietary intakes and food sources of phenolic acids in the European Prospective Investigation into Cancer and Nutrition (EPIC) study2013In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 110, no 8, p. 1500-1511Article in journal (Refereed)
    Abstract [en]

    Phenolic acids are secondary plant metabolites that may have protective effects against oxidative stress, inflammation and cancer in experimental studies. To date, limited data exist on the quantitative intake of phenolic acids. We estimated the intake of phenolic acids and their food sources and associated lifestyle factors in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Phenolic acid intakes were estimated for 36 037 subjects aged 35-74 years and recruited between 1992 and 2000 in ten European countries using a standardised 24 h recall software (EPIC-Soft), and their food sources were identified. Dietary data were linked to the Phenol-Explorer database, which contains data on forty-five aglycones of phenolic acids in 452 foods. The total phenolic acid intake was highest in Aarhus, Denmark (1265.5 and 980.7 mg/d in men and women, respectively), while the intake was lowest in Greece (213.2 and 158.6 mg/d in men and women, respectively). The hydroxycinnamic acid subclass was the main contributor to the total phenolic acid intake, accounting for 84.6-95.3% of intake depending on the region. Hydroxybenzoic acids accounted for 4.6-14.4%, hydroxyphenylacetic acids 0.1-0.8% and hydroxyphenylpropanoic acids <= 0.1% for all regions. An increasing south-north gradient of consumption was also found. Coffee was the main food source of phenolic acids and accounted for 55.3-80.7% of the total phenolic acid intake, followed by fruits, vegetables and nuts. A high heterogeneity in phenolic acid intake was observed across the European countries in the EPIC cohort, which will allow further exploration of the associations with the risk of diseases.

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