De nombreuses associations entre la consommation de certains groupes alimentaires et les apports en certains nutriments (par ex. consommation de fruits et apports en vitamine C ou de viande et ...apports en vitamine B12) ont été rapportées. Cependant, ces données sont parcellaires et ne rendent pas compte des liens entre la consommation de certains groupes alimentaires et l’adéquation nutritionnelle. L’objectif de cette étude était d’étudier dans les populations française et allemande les relations entre l’adéquation nutritionnelle considérée de façon globale et la consommation des grands groupes alimentaires contributeurs à l’apport protéique.
L’adéquation nutritionnelle des régimes a été évaluée à l’aide de l’indice PANDiet, préalablement validé pour les deux populations. Les versions française et allemande du PANDiet considèrent respectivement 34 et 31 probabilités d’adéquation (PA) en 31 et 28 nutriments. En utilisant les données de consommations alimentaires de 1 330 adultes français participant à l’Enquête nationale nutrition santé (ENNS) et de 808 adultes allemands participant à une sous-cohorte issue de l’European Prospective Investigation into Cancer and Nutrition (EPIC)–Postdam, les scores de PANDiet et les consommations de 8 groupes alimentaires (légumineuses, céréales et féculents, viande, poisson et œufs ; légumes, fruits et graines) ont été estimés pour les deux populations. Les associations entre score de PANDiet et consommations des groupes alimentaires ont été évaluées à l’aide de modèles de régression linéaire simple ajustés pour l’âge et le sexe.
Le score de PANDiet est de 60,8±7,6 points (sur 100) dans la population française (F) et 61,1±5,9 points dans la population allemande (A). Dans les deux populations, les consommations de légumes (F : β=2,14 et A : β=0,62, p<0,01) et de fruits et graines (F : β=2,19 et A : β=0,47, p<0,01) sont positivement associées au score de PANDiet. Parmi les groupes contributeurs à l’apport protéique d’origine animale, les consommations de produits laitiers (F : β=0,77 et A : β=0,21, p<0,01) et de poisson (F : β=3,94 et A : β=1,06, p<0,01) sont positivement associées au score de PANDiet dans les deux populations, alors que les consommations de viandes (F : β=–1,18 et A : β=–0,33, p<0,01) et d’œufs (F : β=–2,06, p=0,03 et A : β=–1,10, p<0,01) le sont négativement. Parmi les groupes contributeurs à l’apport protéique d’origine végétale, la consommation de céréales (F : β=2,03, p<0,01 et A : β=0,21, p=0,02) est positivement associée au score de PANDiet dans les deux populations, alors que celle de légumineuses (F : β=2,03, p<0,01 et A : β=0,37, p=0,26) ne l’est significativement que dans la population française.
Dans deux populations aux profils alimentaires différents, l’adéquation nutritionnelle est fortement associée à la consommation de produits laitiers, poisson et céréales (positivement) et de viande et d’œufs (négativement). Ces résultats suggèrent que la consommation de ce profil de sources protéiques contribue directement à la qualité des régimes, vue comme leur adéquation nutritionnelle.
Our objective was to analyze detailed anthropometric characterization for risk of breast cancer in Uruguayan women. The design was a case-control study. The setting was Pereira Rossell Women's ...Hospital, Montevideo, Uruguay. Subjects were 343 incident breast cancer cases and 1,042 frequency-matched healthy controls who were interviewed on menstrual and reproductive story; and a series of skin folds, circumferences, and diameters were measured to calculate fat and muscle fractions and the derived fat-to-muscle ratio (FMR). Odds ratio (ORs) coefficients were taken as estimates of relative risk derived from unconditional logistic regression. Muscle fraction was negatively associated with risk OR for highest quartile = 0.23, 95% confidence interval (CI) = 0.15-0.34, fat fraction was positively associated (OR = 3.90, 95% CI = 2.62-5.80), and FMR was positively associated (OR = 4.45, 95% CI = 2.99-6.62). Stratified analyses by body mass index levels also showed risk increases for the highest tertiles of FMR, always displaying significant linear trends. Since increases of risk were found in overweight and in normal weight women, results suggest that fractions and amount of muscle and fat components might be risk factors for breast cancer on the basis of currently existing metabolic and immune interrelationships between adipose and muscular tissue given by glutamine, exercise-derived myokines, and other cytokines produced by these tissues.
Single, modifiable risk factors for stroke have extensively been studied. In contrast, differences of their combined effects among stroke and transitoy ischemic attack (TIA) have been rarely ...investigated. The aim of the present study was to assess single and joint effects of risk factors on the incidence of stroke and TIA and to compare their magnitudes in a large population-based German cohort.
Incident cases of stroke and TIA were identified among 25,538 participants (aged 35-65 at baseline) of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. Relative risks for stroke and TIA related to modifiable risk factors were estimated using Cox proportional hazard models.
During 4.3 years of follow-up 100 stroke cases and 112 TIA cases occurred. Incidences of stroke and TIA were 91.7 and 102.7 per 100,000 person-years, respectively. Relative risks for ischemic stroke (RR 5.12, 95% CI 1.49-17.6, p for trend<0.0001) and for TIA (RR 3.08, 95% CI 1.00-9.44, p for trend<0.024) were highest among participants having 4 or 5 modifiable risk factors. 58.5% of ischemic strokes and 26.2% of TIA cases were attributable to the 5 risk factors hypertension, diabetes mellitus, high alcohol consumption, hyperlipidemia, and smoking.
Our data indicate that classical risk factors may explain almost 60% of ischemic stroke but only one in four TIA cases. Analysing potential differences of known risk factors between ischemic stroke and TIAs and the identification of other determinants of ischemic attacks are important steps to better explain the burden of stroke.
The incidences of non-Hodgkin's lymphoma and multiple myeloma are increasing steadily. It has been hypothesized that this may be due, in part, to the parallel rising prevalence of obesity. It is ...biologically plausible that anthropometric characteristics can infuence the risk of non-Hodgkin's lymphoma and multiple myeloma.
In the context of the European Prospective Investigation into Cancer and Nutrition (EPIC), anthropometric characteristics were assessed in 371,983 cancer-free individuals at baseline. During the 8.5 years of follow-up, 1,219 histologically confirmed incident cases of non-Hodgkin's lymphoma and multiple myeloma occurred in 609 men and 610 women. Gender-specific proportional hazards models were used to estimate relative risks and 95% confidence intervals (95% CI) of development of non-Hodgkin's lymphoma and multiple myeloma in relation to the anthropometric characteristics.
Height was associated with overall non-Hodgkin's lymphoma and multiple myeloma in women (RR 1.50, 95% CI 1.14-1.98) for highest versus lowest quartile; p-trend < 0.01) but not in men. Neither obesity (weight and body mass index) nor abdominal fat (waist-to-hip ratio, waist or hip circumference) measures were positively associated with overall non-Hodgkin's lymphoma and multiple myeloma. Relative risks for highest versus lowest body mass index quartile were 1.09 (95% CI 0.85-1.38) and 0.92 (95% CI 0.71-1.19) for men and women, respectively. Women in the upper body mass index quartile were at greater risk of diffuse large B-cell lymphoma (RR 2.18, 95% CI 1.05-4.53) and taller women had an elevated risk of follicular lymphoma (RR 1.25, 95% CI 0.59-2.62). Among men, height and body mass index were non-significantly, positively related to follicular lymphoma. Multiple myeloma risk alone was elevated for taller women (RR 2.34, 95% CI 1.29-4.21) and heavier men (RR 1.77, 95% CI 1.02-3.05).
The EPIC analyses support an association between height and overall non-Hodgkin's lymphoma and multiple myeloma among women and suggest heterogeneous subtype associations. This is one of the first prospective studies focusing on central adiposity and non-Hodgkin's lymphoma subtypes.
Alcohol intake has been associated to breast cancer in pre and postmenopausal women; however results are inconclusive regarding tumor hormonal receptor status, and potential modifying factors like ...age at start drinking. Therefore, we investigated the relation between alcohol intake and the risk of breast cancer using prospective observational data from the European Prospective Investigation into Cancer and Nutrition (EPIC). Up to 334,850 women, aged 35–70 years at baseline, were recruited in ten European countries and followed up an average of 11 years. Alcohol intake at baseline and average lifetime alcohol intake were calculated from country‐specific dietary and lifestyle questionnaires. The study outcomes were the Hazard ratios (HR) of developing breast cancer according to hormonal receptor status. During 3,670,439 person‐years, 11,576 incident breast cancer cases were diagnosed. Alcohol intake was significantly related to breast cancer risk, for each 10 g/day increase in alcohol intake the HR increased by 4.2% (95% CI: 2.7–5.8%). Taking 0 to 5 g/day as reference, alcohol intake of >5 to 15 g/day was related to a 5.9% increase in breast cancer risk (95% CI: 1–11%). Significant increasing trends were observed between alcohol intake and ER+/PR+, ER−/PR−, HER2− and ER−/PR−HER2− tumors. Breast cancer risk was stronger among women who started drinking prior to first full‐time pregnancy. Overall, our results confirm the association between alcohol intake and both hormone receptor positive and hormone receptor negative breast tumors, suggesting that timing of exposure to alcohol drinking may affect the risk. Therefore, women should be advised to control their alcohol consumption.
What's new?
Although it is now established that alcohol consumption increases breast cancer risk, many questions remain. Using a prospective study design with 11,576 incident breast cancer cases across 10 European countries, the authors confirmed the increased risk of alcohol on breast cancer development. They further show that women who started drinking before their first full‐term pregnancy have a higher risk than women who started afterwards. These effects were observed in hormone‐receptor positive and –negative tumors pointing to non‐hormonal pathways that need to be further investigated.
Epidemiologic studies have reported that moderate alcohol consumption is inversely associated with the risk of renal cancer. However, there is no information available on the associations in renal ...cancer subsites. From 1992 through to 2010, 477,325 men and women in the European Prospective Investigation into Cancer and Nutrition cohort were followed for incident renal cancers (
n
= 931). Baseline and lifetime alcohol consumption was assessed by country‐specific, validated dietary questionnaires. Information on past alcohol consumption was collected by lifestyle questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from Cox proportional hazard models. In multivariate analysis, total alcohol consumption at baseline was inversely associated with renal cancer; the HR and 95% CI for the increasing categories of total alcohol consumption at recruitment versus the light drinkers category were 0.78 (0.62–0.99), 0.82 (0.64–1.04), 0.70 (0.55–0.90), 0.91 (0.63–1.30), respectively, (
p
trend
= 0.001). A similar relationship was observed for average lifetime alcohol consumption and for all renal cancer subsites combined or for renal parenchyma subsite. The trend was not observed in hypertensive individuals and not significant in smokers. In conclusion, moderate alcohol consumption was associated with a decreased risk of renal cancer.
What's new?
Previous studies have indicated that environmental or lifestyle factors may be involved in the etiology of renal cancer, and that moderate alcohol consumption may reduce the risk of this type of cancer. In this very large European study (nearly 500,000 subjects), the authors found that, indeed, total alcohol consumption was inversely associated with renal cancer overall (for all subsites combined), and also with cancers of the renal parenchyma.
Genetic polymorphisms of transcription factor 7-like 2 (TCF7L2) have been associated with type 2 diabetes and BMI.
The objective was to investigate whether TCF7L2 HapA is associated with weight ...development and whether such an association is modulated by protein intake or by the glycemic index (GI).
The investigation was based on prospective data from 5 cohort studies nested within the European Prospective Investigation into Cancer and Nutrition. Weight change was followed up for a mean (±SD) of 6.8 ± 2.5 y. TCF7L2 rs7903146 and rs10885406 were successfully genotyped in 11,069 individuals and used to derive HapA. Multiple logistic and linear regression analysis was applied to test for the main effect of HapA and its interaction with dietary protein or GI. Analyses from the cohorts were combined by random-effects meta-analysis.
HapA was associated neither with baseline BMI (0.03 ± 0.07 BMI units per allele; P = 0.6) nor with annual weight change (8.8 ± 11.7 g/y per allele; P = 0.5). However, a previously shown positive association between intake of protein, particularly of animal origin, and subsequent weight change in this population proved to be attenuated by TCF7L2 HapA (P-interaction = 0.01). We showed that weight gain becomes independent of protein intake with an increasing number of HapA alleles. Substitution of protein with either fat or carbohydrates showed the same effects. No interaction with GI was observed.
TCF7L2 HapA attenuates the positive association between animal protein intake and long-term body weight change in middle-aged Europeans but does not interact with the GI of the diet.
Background: Exposure to second-hand smoke has been shown to be associated with increased cardiovascular mortality in several, but not all, epidemiologic studies. Our aim was to investigate the risk ...of circulatory death associated with exposure to second-hand smoke in never-smokers in a very large prospective study, the European Prospective Investigation into Cancer and Nutrition. A secondary aim was to use cotinine levels for cross-validating self-reported second-hand smoke exposure. Methods: Cox proportional hazard models were used to investigate the risk of death due to circulatory causes associated with second-hand smoke exposure in 135,233 never-smokers. Exposure to second-hand smoke was assessed through a questionnaire at enrollment and then validated against plasma cotinine measurements in a subsample. Results: Study participants who reported second-hand smoke exposure at home had higher cotinine levels (median plasma cotinine concentration in exposed = 0.82 μg/L; in those unexposed 0.02 μg/L). Second-hand smoke exposure at home was associated with an increased risk of dying from cardiovascular diseases (hazard ratio HR = 1.38 95% confidence interval = 1.01–1.90), all circulatory diseases (1.28 0.98–1.69), and coronary heart disease (1.31 0.83–2.08) after adjustment for age, sex, education, physical activity, and body mass index. Dose-response relationships were observed between exposure to second-hand smoke at home and risk of circulatory death (HR per each additional hour/d = 1.25 1.04–1.50). Having a partner who smokes more than 30 cigarettes per day considerably increased the risk of a circulatory death (2.94 1.11–7.78). Second-hand smoke exposure at home was not associated with total mortality (1.03 0.93–1.13). Discussion: Exposure to second-hand smoke at home (as confirmed by plasma cotinine levels) increases the risk of cardiovascular mortality.
Physical activity has been identified as protective factor for invasive breast cancer risk, whereas comparable studies on in situ carcinoma are rare.
The study included data from 283,827 women of the ...multinational European Prospective Investigation into C7ancer and Nutrition (EPIC)-cohort study. Detailed information on different types of physical activity conducted during the prior year, such as occupational, recreational, and household activity, as well as on important cofactors, was assessed at baseline. Adjusted HRs for in situ breast cancer were estimated by Cox proportional hazards models.
During a median follow-up period of 11.7 years, 1,059 incidents of breast carcinoma in situ were identified. In crude and adjusted multivariable models, no associations were found for occupational, household, and recreational physical activity. Furthermore, total physical activity was not associated with risk of in situ breast cancer. Comparing moderately inactive, moderately active, and active participants with inactive study participants resulted in adjusted HRs of 0.99 95% confidence interval (CI), 0.83-1.19, 0.99 (95% CI, 0.82-1.20), and 1.07 (95% CI, 0.81-1.40), respectively (P value of trend test: 0.788). No inverse associations were found in any substrata defined by age at diagnosis or body mass index (BMI) status.
In this large prospective study, we did not find any evidence of an association between physical activity and in situ breast cancer risk. If not by chance, the contrast between our results for carcinoma in situ and the recognized inverse association for invasive breast cancer suggests that physical activity may have stronger effects on proliferation and late stage carcinogenesis.
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