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  • 451. Zamora-Ros, Raul
    et al.
    Agudo, Antonio
    Lujan-Barroso, Leila
    Romieu, Isabelle
    Ferrari, Pietro
    Knaze, Viktoria
    Bueno-de-Mesquita, H. Bas
    Leenders, Max
    Travis, Ruth C.
    Navarro, Carmen
    Sanchez-Cantalejo, Emilio
    Slimani, Nadia
    Scalbert, Augustin
    Fedirko, Veronika
    Hjartaker, Anette
    Engeset, Dagrun
    Skeie, Guri
    Boeing, Heiner
    Foerster, Jana
    Li, Kuanrong
    Teuchet, Birgit
    Agnoli, Claudia
    Tumino, Rosario
    Mattiello, Amalia
    Saieva, Calogero
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Stenling, Roger
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Luisa Redondo, Maria
    Wallstrom, Peter
    Ericson, Ulrika
    Khaw, Kay-Tee
    Mulligan, Angela A.
    Trichopoulou, Antonia
    Dilis, Vardis
    Katsoulis, Michael
    Peeters, Petra H. M.
    Igali, Lazslo
    Tjonneland, Anne
    Halkjaer, Jytte
    Touillaud, Marina
    Perquier, Florence
    Fagherazzi, Guy
    Amiano, Pilar
    Ardanaz, Eva
    Bredsdorff, Lea
    Overvad, Kim
    Ricceri, Fulvio
    Riboli, Elio
    Gonzalez, Carlos A.
    Dietary flavonoid and lignan intake and gastric adenocarcinoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study2012In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 96, no 6, p. 1398-1408Article in journal (Refereed)
    Abstract [en]

    Background: Several experimental studies have suggested potential anticarcinogenic effects of flavonoids, although epidemiologic evidence for the impact of dietary flavonoids on risk of gastric cancer (GC) is limited. Objective: We investigated the association between intake of dietary flavonoids and lignans and incident GC. Design: The study followed 477,312 subjects (29.8% men) aged 35-70 y from 10 European countries who participated in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Validated dietary questionnaires and lifestyle information were collected at baseline. A food-composition database on flavonoids and lignans was compiled by using data from USDA and Phenol-Explorer databases. Results: During an average follow-up of 11 y, 683 incident GC cases (57.8% men) were mostly validated by a panel of pathologists and used in this analysis. We observed a significant inverse association between total flavonoid intake and GC risk in women (HR: 0.81; 95% CI: 0.70, 0.94; for the continuous variable after log2 transformation) but not in men (HR: 0.97; 95% CI: 0.85, 1.09). in women, significant inverse associations with GC risk were also observed for intakes of some flavonoid subgroups (anthocyanidins, flavonols, flavones, and flavanols), particularly with intestinal type tumors for total flavonoid and flavanol intakes (P-heterogeneity < 0.1). After stratification by smoking status and sex, there was no significant heterogeneity in these associations between ever- and never-smokers. Conclusion: Total dietary flavonoid intake is associated with a significant reduction in the risk of GC in women. Am J Clin Nutr 2012;96:1398-408.

  • 452. Zamora-Ros, Raul
    et al.
    Beraud, Virginie
    Franceschi, Silvia
    Cayssials, Valerie
    Tsilidis, Konstantinos K.
    Boutron-Ruault, Marie-Christine
    Weiderpass, Elisabete
    Overvad, Kim
    Tjonneland, Anne
    Eriksen, Anne K.
    Bonnet, Fabrice
    Affret, Aurelie
    Katzke, Verena
    Kuehn, Tilman
    Boeing, Heiner
    Trichopoulou, Antonia
    Valanou, Elisavet
    Karakatsani, Anna
    Masala, Giovanna
    Grioni, Sara
    de Magistris, Maria Santucci
    Tumino, Rosario
    Ricceri, Fulvio
    Skeie, Guri
    Parr, Christine L.
    Merino, Susana
    Salamanca-Fernandez, Elena
    Chirlaque, Maria-Dolores
    Ardanaz, Eva
    Amiano, Pilar
    Almquist, Martin
    Drake, Isabel
    Hennings, Joakim
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Sandström, Maria
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Bueno-de-Mesquita, H. B(as)
    Peeters, Petra H.
    Khaw, Kay-Thee
    Wareham, Nicholas J.
    Schmidt, Julie A.
    Perez-Cornago, Aurora
    Aune, Dagfinn
    Riboli, Elio
    Slimani, Nadia
    Scalbert, Augustin
    Romieu, Isabelle
    Agudo, Antonio
    Rinaldi, Sabina
    Consumption of fruits, vegetables and fruit juices and differentiated thyroid carcinoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study2018In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 142, no 3, p. 449-459Article in journal (Refereed)
    Abstract [en]

    Fruit and vegetable (F&V) intake is considered as probably protective against overall cancer risk, but results in previous studies are not consistent for thyroid cancer (TC). The purpose of this study is to examine the association between the consumption of fruits, vegetables, fruit juices and differentiated thyroid cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The EPIC study is a cohort including over half a million participants, recruited between 1991 and 2000. During a mean follow-up of 14 years, 748 incident first primary differentiated TC cases were identified. F&V and fruit juice intakes were assessed through validated country-specific dietary questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models adjusted for potential confounding factors. Comparing the highest versus lowest quartile of intake, differentiated TC risk was not associated with intakes of total F&V (HR: 0.89; 95% CI: 0.68-1.15; p-trend=0.44), vegetables (HR: 0.89; 95% CI: 0.69-1.14; p-trend=0.56), or fruit (HR: 1.00; 95% CI: 0.79-1.26; p-trend=0.64). No significant association was observed with any individual type of vegetable or fruit. However, there was a positive borderline trend with fruit juice intake (HR: 1.23; 95% CI: 0.98-1.53; p-trend=0.06). This study did not find any significant association between F&V intakes and differentiated TC risk; however a positive trend with fruit juice intake was observed, possibly related to its high sugar content.

  • 453. Zamora-Ros, Raul
    et al.
    Castaneda, Jazmin
    Rinaldi, Sabina
    Cayssials, Valerie
    Slimani, Nadia
    Weiderpass, Elisabete
    Tsilidis, Konstantinos K.
    Boutron-Ruault, Marie-Christine
    Overvad, Kim
    Eriksen, Anne K.
    Tjonneland, Anne
    Kuehn, Tilman
    Katzke, Verena
    Boeing, Heiner
    Trichopoulou, Antonia
    La Vecchia, Carlo
    Kotanidou, Anastasia
    Palli, Domenico
    Grioni, Sara
    Mattiello, Amalia
    Tumino, Rosario
    Sciannameo, Veronica
    Lund, Eiliv
    Merino, Susana
    Salamanca-Fernandez, Elena
    Amiano, Pilar
    Huerta, Jose Maria
    Barricarte, Aurelio
    Ericson, Ulrika
    Almquist, Martin
    Hennings, Joakim
    Sandström, Maria
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Bueno-de-Mesquita, H. Bas
    Peeters, Petra H.
    Khaw, Kay-Tee
    Wareham, Nicholas J.
    Schmidt, Julie A.
    Cross, Amanda J.
    Riboli, Elio
    Scalbert, Augustin
    Romieu, Isabelle
    Agudo, Antonio
    Franceschi, Silvia
    Consumption of Fish Is Not Associated with Risk of Differentiated Thyroid Carcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study2017In: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100, Vol. 147, no 7, p. 1366-1373Article in journal (Refereed)
    Abstract [en]

    Background: Differentiated thyroid cancer (TC) is the most common endocrine cancer. Fish can be an important source of iodine and other micronutrients and contaminants that may affect the thyroid gland and TC risk. Objective: We prospectively evaluated the relations between the consumption of total fish and different fish types and shellfish and TC risk in the EPIC (European Prospective Investigation into Cancer and Nutrition) study. Methods: EPIC is a cohort of >500,000 men and women, mostly aged 35-70 y, who were recruited in 10 European countries. After a mean follow-up of 14 y, 748 primary differentiated TC cases were diagnosed; 666 were in women and 601 were papillary TC. Data on intakes of lean fish, fatty fish, fish products, and shellfish were collected by using country-specific validated dietary questionnaires at recruitment. Multivariable Cox regression was used to calculate HRs and 95% CIs adjusted for many potential confounders, including dietary and nondietary factors. Results: No significant association was observed between total fish consumption and differentiated TC risk for the highest compared with the lowest quartile (HR: 1.03; 95% CI: 0.81, 1.32; P-trend = 0.67). Likewise, no significant association was observed with the intake of any specific type of fish, fish product, or shellfish. No significant heterogeneity was found by TC subtype (papillary or follicular tumors), by sex, or between countries with low and high TC incidence. Conclusion: This large study shows that the intake of fish and shellfish was not associated with differentiated TC risk in Europe, a region in which iodine deficiency or excess is rare.

  • 454. Zamora-Ros, Raul
    et al.
    Forouhi, Nita G.
    Sharp, Stephen J.
    Gonzalez, Carlos A.
    Buijsse, Brian
    Guevara, Marcela
    van der Schouw, Yvonne T.
    Amiano, Pilar
    Boeing, Heiner
    Bredsdorff, Lea
    Fagherazzi, Guy
    Feskens, Edith J.
    Franks, Paul W.
    Grioni, Sara
    Katzke, Verena
    Key, Timothy J.
    Khaw, Kay-Tee
    Kuehn, Tilman
    Masala, Giovanna
    Mattiello, Amalia
    Molina-Montes, Esther
    Nilsson, Peter M.
    Overvad, Kim
    Perquier, Florence
    Luisa Redondo, M.
    Ricceri, Fulvio
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Romieu, Isabelle
    Roswall, Nina
    Scalbert, Augustin
    Schulze, Matthias
    Slimani, Nadia
    Spijkerman, Annemieke M. W.
    Tjonneland, Anne
    Jose Tormo, Maria
    Touillaud, Marina
    Tumino, Rosario
    van der A, Daphne L.
    van Woudenbergh, Geertruida J.
    Langenberg, Claudia
    Riboli, Elio
    Wareham, Nicholas J.
    Dietary intakes of individual flavanols and flavonols are inversely associated with incident type 2 diabetes in european populations2014In: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100, Vol. 144, no 3, p. 335-343Article in journal (Refereed)
    Abstract [en]

    Dietary flavanols and flavonols, flavonoid subclasses, have been recently associated with a lower risk of type 2 diabetes (T2D) in Europe. Even within the same subclass, flavonoids may differ considerably in bioavailability and bioactivity. We aimed to examine the association between individual flavanol and flavonol intakes and risk of developing T2D across European countries. The European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study was conducted in 8 European countries across 26 study centers with 340,234 participants contributing 3.99 million person-years of follow-up, among whom 12,403 incident T2D cases were ascertained and a center-stratified subcohort of 16,154 individuals was defined. We estimated flavonoid intake at baseline from validated dietary questionnaires using a database developed from Phenol-Explorer and USDA databases. We used country-specific Prentice-weighted Cox regression models and random-effects meta-analysis methods to estimate HRs. Among the flavanol subclass, we observed significant inverse trends between intakes of all individual flavan-3-ol monomers and risk of T2D in multivariable models (all P-trend < 0.05). We also observed significant trends for the intakes of proanthocyanidin dimers (HR for the highest vs. the lowest quintile. 0.81; 95% Cl: 0.71, 0.92; P-trend = 0.003) and trimers (HR: 0.91; 95% Cl: 0.80, 1.04; P-trend = 0.07) but not for proanthocyanidins with a greater polymerization degree. Among the flavonol subclass, myricetin (HR: 0.77; 95% Cl: 0.64, 0.93; P-trend = 0.001) was associated with a lower incidence of T2D. This large and heterogeneous European study showed inverse associations between all individual flavan-3-ol monomers, proanthocyanidins with a low polymerization degree, and the flavonol myricetin and incident T2D. These results suggest that individual flavonoids have different roles in the etiology of T2D.

  • 455. 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.

  • 456. 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.

  • 457. 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.

  • 458. Zamora-Ros, Raul
    et al.
    Knaze, Viktoria
    Rothwell, Joseph A.
    Hémon, Bertrand
    Moskal, Aurelie
    Overvad, Kim
    Tjønneland, Anne
    Kyrø, Cecilie
    Fagherazzi, Guy
    Boutron-Ruault, Marie-Christine
    Touillaud, Marina
    Katzke, Verena
    Kühn, Tilman
    Boeing, Heiner
    Förster, Jana
    Trichopoulou, Antonia
    Valanou, Elissavet
    Peppa, Eleni
    Palli, Domenico
    Agnoli, Claudia
    Ricceri, Fulvio
    Tumino, Rosario
    de Magistris, Maria Santucci
    Peeters, Petra H. M.
    Bueno-de-Mesquita, H Bas
    Engeset, Dagrun
    Skeie, Guri
    Hjartåker, Anette
    Menéndez, Virginia
    Agudo, Antonio
    Molina-Montes, Esther
    Huerta, José María
    Barricarte, Aurelio
    Amiano, Pilar
    Sonestedt, Emily
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Arctic Research Centre at Umeå University.
    Landberg, Rikard
    Key, Timothy J.
    Khaw, Kay-Thee
    Wareham, Nicholas J.
    Lu, Yunxia
    Slimani, Nadia
    Romieu, Isabelle
    Riboli, Elio
    Scalbert, Augustin
    Dietary polyphenol intake in Europe: the European Prospective Investigation into Cancer and Nutrition (EPIC) study2016In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 55, no 4, p. 1359-1375Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/OBJECTIVES: Polyphenols are plant secondary metabolites with a large variability in their chemical structure and dietary occurrence that have been associated with some protective effects against several chronic diseases. To date, limited data exist on intake of polyphenols in populations. The current cross-sectional analysis aimed at estimating dietary intakes of all currently known individual polyphenols and total intake per class and subclass, and to identify their main food sources in the European Prospective Investigation into Cancer and Nutrition cohort.

    METHODS: Dietary data at baseline were collected using a standardized 24-h dietary recall software administered to 36,037 adult subjects. Dietary data were linked with Phenol-Explorer, a database with data on 502 individual polyphenols in 452 foods and data on polyphenol losses due to cooking and food processing.

    RESULTS: Mean total polyphenol intake was the highest in Aarhus-Denmark (1786 mg/day in men and 1626 mg/day in women) and the lowest in Greece (744 mg/day in men and 584 mg/day in women). When dividing the subjects into three regions, the highest intake of total polyphenols was observed in the UK health-conscious group, followed by non-Mediterranean (non-MED) and MED countries. The main polyphenol contributors were phenolic acids (52.5-56.9 %), except in men from MED countries and in the UK health-conscious group where they were flavonoids (49.1-61.7 %). Coffee, tea, and fruits were the most important food sources of total polyphenols. A total of 437 different individual polyphenols were consumed, including 94 consumed at a level >1 mg/day. The most abundant ones were the caffeoylquinic acids and the proanthocyanidin oligomers and polymers.

    CONCLUSION: This study describes the large number of dietary individual polyphenols consumed and the high variability of their intakes between European populations, particularly between MED and non-MED countries.

  • 459. Zamora-Ros, Raul
    et al.
    Luján-Barroso, Leila
    Bueno-de-Mesquita, H Bas
    Dik, Vincent K
    Boeing, Heiner
    Steffen, Annika
    Tjønneland, Anne
    Olsen, Anja
    Bech, Bodil Hammer
    Overvad, Kim
    Boutron-Ruault, Marie-Christine
    Racine, Antoine
    Fagherazzi, Guy
    Kuhn, Tilman
    Katzke, Verena
    Trichopoulou, Antonia
    Lagiou, Pagona
    Trichopoulos, Dimitrios
    Tumino, Rosario
    Panico, Salvatore
    Vineis, Paolo
    Grioni, Sara
    Palli, Domenico
    Weiderpass, Elisabete
    Skeie, Guri
    Huerta, José María
    Sánchez, María-José
    Argüelles, Marcial
    Amiano, Pilar
    Ardanaz, Eva
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Arctic Research Centre at Umeå University.
    Wallner, Bengt
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Lindkvist, Björn
    Wallström, Peter
    Peeters, Petra H M
    Key, Timothy J
    Khaw, Kay-Thee
    Wareham, Nicholas J
    Freisling, Heinz
    Stepien, Magdalena
    Ferrari, Pietro
    Gunter, Marc J
    Murphy, Neil
    Riboli, Elio
    González, Carlos A
    Tea and coffee consumption and risk of esophageal cancer: the European Prospective Investigation into Cancer and Nutrition (EPIC) study2014In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 135, no 6, p. 1470-1479Article in journal (Refereed)
    Abstract [en]

    Epidemiological data regarding tea and coffee consumption and risk of esophageal cancer (EC) is still inconclusive. We examined the association of tea and coffee consumption with EC risk among 442,143 men and women without cancer at baseline from 9 countries of the European Prospective Investigation into Cancer and Nutrition (EPIC). Tea and coffee intakes were recorded using country-specific validated dietary questionnaires. Cox regression models were used to analyze the relationships between tea and coffee intake and EC risk. During a mean follow-up of 11.1 years, 339 participants developed EC, of which 142 were esophageal adenocarcinoma (EAC) and 174 were esophageal squamous cell carcinoma (ESCC). In the multivariable models, no significant associations between tea (mostly black tea), and coffee intake and risk of EC, EAC and ESCC were observed. In stratified analyses, among men coffee consumption was inversely related to ESCC (HR for comparison of extreme tertiles 0.42, 95% CI 0.20-0.88; P-trend=0.022), but not among women. In current smokers, a significant and inverse association was observed between ESCC risk and tea (HR 0.46, 95% CI 0.23-0.93; P-trend=0.053) and coffee consumption (HR 0.37, 95% CI 0.19-0.73; P-trend=0.011). However, no statistically significant findings were observed using the continuous variable (per 100mL/d). These data did not show a significant association between tea and coffee consumption and EC, EAC and ESCC, although a decreased risk of ESCC among men and current smokers is suggested, but need to be confirmed in further prospective studies including more cases.

  • 460. 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.

  • 461. Zheng, Ju-Sheng
    et al.
    Imamura, Fumiaki
    Sharp, Stephen J.
    van der Schouw, Yvonne T.
    Sluijs, Ivonne
    Gundersen, Thomas E.
    Ardanaz, Eva
    Boeing, Heiner
    Bonet, Catalina
    Humberto Gomez, Jesus
    Dow, Courtney
    Fagherazzi, Guy
    Franks, Paul W.
    Jenab, Mazda
    Kuehn, Tilman
    Kaaks, Rudolf
    Key, Timothy J.
    Khaw, Kay-Tee
    Lasheras, Cristina
    Mokoroa, Olatz
    Mancini, Francesca Romana
    Nilsson, Peter M.
    Overvad, Kim
    Panico, Salvatore
    Palli, Domenico
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Sieri, Sabina
    Salamanca-Fernandez, Elena
    Sacerdote, Carlotta
    Spijkerman, Annemieke M. W.
    Stepien, Magdalena
    Tjonneland, Anne
    Tumino, Rosario
    Butterworth, Adam S.
    Riboli, Elio
    Danesh, John
    Langenberg, Claudia
    Forouhi, Nita G.
    Wareham, Nicholas J.
    Association of Plasma Vitamin D Metabolites With Incident Type 2 Diabetes: EPIC-InterAct Case-Cohort Study2019In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 104, no 4, p. 1293-1303Article in journal (Refereed)
    Abstract [en]

    Background: Existing evidence for the prospective association of vitamin D status with type 2 diabetes (T2D) is focused almost exclusively on circulating total 25-hydroxyvitamin D [25(OH)D] without distinction between its subtypes: nonepimeric and epimeric 25(OH)D3 stereoisomers, and 25(OH)D2, the minor component of 25(OH)D. We aimed to investigate the prospective associations of circulating levels of the sum and each of these three metabolites with incident T2D.

    Methods: This analysis in the European Prospective Investigation into Cancer and Nutrition (EPIC)–InterAct case-cohort study for T2D included 9671 incident T2D cases and 13,562 subcohort members. Plasma vitamin D metabolites were quantified by liquid chromatography–mass spectrometry. We used a multivariable Prentice-weighted Cox regression to estimate hazard ratios (HRs) of T2D for each metabolite. Analyses were performed separately within country, and estimates were combined across countries using random-effects meta-analysis.

    Results: The mean concentrations (SD) of total 25(OH)D, nonepimeric 25(OH)D3, epimeric 25(OH)D3, and 25(OH)D2 were 41.1 (17.2), 40.7 (17.3), 2.13 (1.31), and 8.16 (6.52) nmol/L, respectively. Plasma total 25(OH)D and nonepimeric 25(OH)D3 were inversely associated with incident T2D [multivariable-adjusted HR per 1 SD = 0.81 (95% CI, 0.77, 0.86) for both variables], whereas epimeric 25(OH)D3 was positively associated [per 1 SD HR = 1.16 (1.09, 1.25)]. There was no statistically significant association with T2D for 25(OH)D2 [per 1 SD HR = 0.94 (0.76, 1.18)].

    Conclusions: Plasma nonepimeric 25(OH)D3 was inversely associated with incident T2D, consistent with it being the major metabolite contributing to total 25(OH)D. The positive association of the epimeric form of 25(OH)D3 with incident T2D provides novel information to assess the biological relevance of vitamin D epimerization and vitamin D subtypes in diabetes etiology.

  • 462.
    Zhu, Yan-He
    et al.
    Institute of Endemic Diseases, Health Science Center, School of Public Health, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Xi'an, China.
    Wang, Xin-Feng
    Department of Physiology and Pathophysiology, School of Medicine, Xi'an Jiaotong University, Xi'an, China.
    Yang, Guang
    Second Department of Cardiology, Shaanxi Province People's Hospital, Xi'an, China.
    Wei, Jin
    Department of Cardiology, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China..
    Tan, Wu-Hong
    Institute of Endemic Diseases, Health Science Center, School of Public Health, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Xi'an, China.
    Wang, Li-Xin
    Institute of Endemic Diseases, Health Science Center, School of Public Health, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Xi'an, China.
    Guo, Xiong
    Institute of Endemic Diseases, Health Science Center, School of Public Health, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Xi'an, China.
    Lammi, Mikko
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB). Institute of Endemic Diseases, Health Science Center, School of Public Health, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Xi'an, China.
    Xu, Jie-Hua
    Department of Human Anatomy and Histo-Embryology, School of Medicine, Xi'an Jiaotong University, Xi'an, China.
    Efficacy of long-term selenium supplementation in the treatment of chronic Keshan disease with congestive heart failure2019In: Current medical science, ISSN 2096-5230, Vol. 39, no 2, p. 237-242Article in journal (Refereed)
    Abstract [en]

    Few effective treatments for chronic Keshan disease have been available till now. The efficacy of long-term selenium supplementation in the treatment of chronic Keshan disease with congestive heart failure is inconclusive. This study aimed to determine whether selenium supplementation is associated with a decreased risk of cardiac death in chronic Keshan disease with congestive heart failure by ten years of follow-up. A retrospective long-term follow-up analysis was performed on a monitored cohort consisting of 302 chronic Keshan disease patients with a mean age of 40.8±11.4 years. Of the 302 chronic Keshan disease patients, 170 (56.3%) were given selenium supplementation until the end point of follow-up. Cox proportional hazards regression models were used to identify the independent predictors of cardiac events. Our results showed that during the follow-up, there were 101 deaths of patients with chronic Keshan disease in the selenium supplementation group (101/170, 59.4%) and 98 in non-selenium supplementation group (98/132, 74.2%). Multivariate analyses suggested that selenium supplementation was associated with a decreased risk of cardiac death (HR 0.39, 95% CI 0.28-0.53) after adjustment for baseline age, sex, cigarette smoking, family history of Keshan disease, body mass index (BMI), heart rate, electrocardiogram (ECG) abnormalities, blood pressure, initial cardiothoracic ratio, left ventricular ejection fractions (LVEF) and whole-blood selenium concentration. Our ten-year follow-up analysis indicated that selenium supplementation, specifically combined with the use of angiotensin-converting enzyme inhibitor and beta blocker therapy, improved the survival of patients with chronic Keshan disease with congestive heart failure. BMI, selenium deficiency, male, combined ECG abnormalities, LVEF, and fast heart rate increased the risk of cardiac events.

  • 463.
    Ådén, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Carlsson, Maine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Poortvliet, Eric
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Linder, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Edström, Mona
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Forsgren, Lars
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Håglin, Lena
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Dietary intake and olfactory function in patients with newly diagnosed Parkinson's disease: a case-control study.2011In: Nutritional neuroscience, ISSN 1476-8305, Vol. 14, no 1, p. 25-31Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate energy and nutrient intake in newly diagnosed Parkinson's disease (PD) patients and association between olfaction and nutrient density of the diet.

    DESIGN: Baseline data from a prospective cohort study.

    SUBJECTS: Eighty-seven patients and 28 age- and sex-matched controls participated in the study.

    METHODS: Dietary intake was assessed by using 3-day dietary records and 24-hour dietary recalls. The Brief Smell Identification Test (B-SIT) was used to test olfaction.

    RESULTS: Patients, compared with controls, had lower intake of polyunsaturated fatty acids (P = 0.024) and a higher intake of carbohydrates (P = 0.027) in energy percent (E%). Lower intake of protein (E%) (P = 0.045), and a low nutrient density of folate (P = 0.022), magnesium (P = 0.012), and phosphorus (P = 0.029) were associated with lower B-SIT score in both patients and controls. PD patients had a lower B-SIT score than controls (P < 0.001).

    CONCLUSION: The results indicate a higher relative contribution of energy from carbohydrates in PD patients. An association between low protein, folate, magnesium, and phosphorus density of the diet and olfaction was seen in the whole population.

  • 464.
    Öhlund, Inger
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Studiebesök på the Royal London Hospital2008In: Dietistaktuellt, ISSN 1102-9285, Vol. XIX, no 2, p. 24-25/27Article, review/survey (Other (popular science, discussion, etc.))
  • 465.
    Öhlund, Inger
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Lind, Torbjörn
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hernell, Olle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Silfverdal, Sven-Arne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Karlsland Åkeson, Pia
    Increased vitamin D intake differentiated according to skin color is needed to meet requirements in young Swedish children during winter: a double-blind randomized clinical trial2017In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 106, no 1, p. 105-112Article in journal (Refereed)
    Abstract [en]

    Background: Dark skin and low exposure to sunlight increase the risk of vitamin D insufficiency in children. Objective: The aim of the study was to evaluate the amount of vitamin D needed to ascertain that most children >4 y of age attain sufficient serum25-hydroxyvitamin D [S-25(OH) D; i.e., >= 50 nmol/L] during winter regardless of latitude and skin color. Design: In a longitudinal, double-blind, randomized, food-based intervention study, 5- to 7-y-old children from northern (638 degrees N) and southern (558 degrees N) Sweden with fair (n = 108) and dark (n = 98) skin were included. Children, stratified by skin color by using Fitzpa-trick's definition, were randomly assigned to receive milk-based vitamin D-3 supplements that provided 2 (placebo), 10, or 25 mu g/d during 3 winter months. Results: Mean daily vitamin D intake increased from 6 to 17 mu g and 26 mu g in the intervention groups supplemented with 10 and 25 mu g, respectively. In the intention-to-treat analysis, 90.2% (95% CI: 81.1%, 99.3%) of fair-skinned children randomly assigned to supplementation of 10 mu g/d attained sufficient concentrations, whereas 25 mu g/d was needed in dark-skinned children to reach sufficiency in 95.1% (95% CI: 88.5%, 100%). In children adherent to the study product, 97% (95% CI: 91.3%, 100%) and 87.9% (95% CI: 76.8%, 99%) of fair-and dark-skinned children, respectively, achieved sufficient concentrations if supplemented with 10 mu g/d. By using 95% prediction intervals for 30 and 50 nmol S-25(OH) D/L, intakes of 6 and 20 mu g/d are required in fair-skinned children, whereas 14 and 28 mu g/d are required in children with dark skin. Conclusion: Children with fair and dark skin require vitamin D intakes of 20 and 28 mu g/d, respectively, to maintain S-25(OH) D >= 50 nmol/L, whereas intakes of 6 and 14 mu g/d, respectively, are required to maintain concentrations >= 30 nmol/L during winter.

  • 466.
    Öhlund, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Hernell, Olle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Öhlund, Inger
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Dietary shortcomings in children on a gluten-free diet2010In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 23, no 3, p. 294-300Article in journal (Refereed)
    Abstract [en]

    Background: Coeliac disease (CD), or permanent gluten intolerance, is one of the most common chronic food-related diseases among children in Europe and the USA. The treatment is lifelong gluten-free diet (GFD) (i.e. the exclusion of wheat, rye and barley from the diet, which are important sources particularly of iron, dietary fibre and vitamin B). The present study aimed to evaluate dietary intakes of energy and nutrients in children and adolescents on GFD and compare these with intake of comparable age groups on a normal diet as well as current recommendations.

    Methods: Thirty children, 4-17 years of age with confirmed CD and on GFD were agreed to participate in this study at the Department of Pediatrics, Umeå University Hospital. Weight and height were used to calculate individual energy requirement according to Nordic Nutrition Recommendations 2004 (NNR-04). Dietary intake was assessed using 5-day food records and household measures were used for quantities. Twenty-five children completed their dietary record.

    Results: Thirteen of the 25 children did not meet the recommended energy intake and the dietary intakes were inadequate regarding quality of macronutrients and quantity of minerals and vitamins. The mean intakes of sucrose and saturated fatty acids were above and the intakes of dietary fibre, vitamin D, magnesium and selenium below the NNR-04. High intakes of sucrose and saturated fat and a low intake of dietary fibre were also noted in a previous national survey on healthy children on a normal diet. The nutrient density of vitamin D, riboflavin, niacin, thiamine, magnesium and selenium were lower among CD children than healthy children but, for iron and calcium, it was higher in CD children.

    Conclusions: Children on GFD appear to follow the same trends as healthy children on a normal diet, with high intakes of saturated fat and sucrose and low intakes of dietary fibre, vitamin D and magnesium compared to recommendations.

78910 451 - 466 of 466
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