Meat and fish intakes have been associated with various chronic diseases. The use of specific biomarkers may help to assess meat and fish intake and improve subject classification according to the ...amount and type of meat or fish consumed.
A metabolomic approach was applied to search for biomarkers of meat and fish intake in a dietary intervention study and in free-living subjects from the European Prospective Investigation into Cancer and Nutrition (EPIC) study.
In the dietary intervention study, 4 groups of 10 subjects consumed increasing quantities of chicken, red meat, processed meat, and fish over 3 successive weeks. Twenty-four-hour urine samples were collected during each period and analyzed by high-resolution liquid chromatography-mass spectrometry. Signals characteristic of meat or fish intake were replicated in 50 EPIC subjects for whom a 24-h urine sample and 24-h dietary recall were available and who were selected for their exclusive intake or no intake of any of the 4 same foods.
A total of 249 mass spectrometric features showed a positive dose-dependent response to meat or fish intake in the intervention study. Eighteen of these features best predicted intake of the 4 food groups in the EPIC urine samples on the basis of partial receiver operator curve analyses with permutation testing (areas under the curve ranging between 0.61 and 1.0). Of these signals, 8 metabolites were identified. Anserine was found to be specific for chicken intake, whereas trimethylamine-
oxide showed good specificity for fish. Carnosine and 3 acylcarnitines (acetylcarnitine, propionylcarnitine, and 2-methylbutyrylcarnitine) appeared to be more generic indicators of meat and meat and fish intake, respectively.
The meat and fish biomarkers identified in this work may be used to study associations between meat and fish intake and disease risk in epidemiologic studies. This trial was registered at clinicaltrials.gov as NCT01684917.
Background
Micronutrients play a key role in type 2 diabetes mellitus (T2DM), but methodological difficulties arise from their collinearity and interdependencies with foods. The aim of the present ...study was to identify micronutrient dietary patterns in the E3N‐EPIC (Etude Epidémiologique auprès de femmes de l'Education Nationale) cohort and to investigate their association with risk of T2DM.
Methods
Principal component analysis was used to identify micronutrient patterns among 71 270 women from the E3N‐EPIC cohort. Associations between micronutrient patterns and risk of T2DM were quantified by hazard ratios (HRs) and 95% confidence intervals (CIs) from Cox proportional hazards regression models, adjusted for potential confounders.
Results
Six micronutrient patterns were identified explaining 78% of the total variance in micronutrient intake. A positive association was found between T2DM and a pattern highly correlated with intake of vitamins B2 and B5 (HR 1.34; 95% CI 1.16–1.56). Similarly, a positive association was found with a pattern characterized by high intakes of vitamin B12 and retinol, and a low intake of vitamin C (HR 1.30; 95% CI 1.15–1.48). An inverse association was observed between T2DM and another two patterns: one correlated with magnesium and vitamin B3 (HR 0.75; 95% CI 0.66–0.86), and the other correlated with manganese intake (HR 0.82; 95% CI 0.72–0.94).
Conclusions
The findings of the present study identify micronutrients that have an effect on the risk of T2DM, and enable better understanding of the complexity of the diet when investigating the association between micronutrients and T2DM.
摘要
背景
微量营养物质对于2型糖尿病(T2DM)具有重要的影响, 但是对其的研究却很困难, 因为它们与食物之间具有共线性以及相互依赖性。当前这项研究的目的是在国家妇女教育改革计划(Etude Epidémiologique auprès de femmes de l’Education Nationale, E3N‐EPIC)队列研究中鉴定出相关的微量营养物质膳食模式, 并且调查它们与T2DM风险之间的关系。
方法
使用主成分分析法明确了71270名来自E3N‐EPIC队列研究的妇女的微量营养物质膳食模式。使用Cox比例风险回归模型, 校正潜在混杂因素后, 根据危险比(HRs)以及95%置信区间(CIs)进行量化, 评估微量营养物质膳食模式与T2DM风险之间的关系。
结果
明确了6种微量营养物质膳食模式, 在摄入的微量营养物质总方差中占比为78%。发现T2DM与摄入维生素B2以及B5的膳食模式呈高度正相关(HR 1.34;95% CI 1.16‐1.56)。同样, 还发现T2DM与大量摄入B12以及视黄醇, 并且较少摄入维生素C的膳食模式呈正相关(HR 1.30;95% CI 1.15‐1.48)。观察到T2DM与另外两种膳食模式呈负相关:一种与镁以及维生素B3的摄入量有关(HR 0.75;95% CI 0.66‐0.86), 另一种与锰的摄入量有关(HR 0.82;95% CI 0.72‐0.94)。
结论
当前这项研究结果表明微量营养物质可以影响T2DM的风险, 有助于我们在进一步研究微量营养物质与T2DM之间关系时能够更好地理解饮食的复杂性。
Highlights
This study shows how the use of micronutrient patterns enables investigation of the association between diet and type 2 diabetes mellitus (T2DM), explaining the complexity of the diet.
The results suggest a protective effect of vitamins C and B3, magnesium, and manganese against T2DM.
A positive association was found between the intake of vitamins B2, B12, and retinol and the risk of T2DM.
Perturbations in circulating metabolites prior to a breast cancer diagnosis are not well characterised. We aimed to gain more detailed knowledge to help understand and prevent the disease.
Baseline ...plasma samples from 791 breast cancer cases and 791 matched controls from the E3N (EPIC-France) cohort were profiled by nuclear magnetic resonance (NMR)-based untargeted metabolomics. Partial least-squares discriminant analysis (PLS-DA) models were built from NMR profiles to predict disease outcome, and odds ratios and false discovery rate (FDR)-adjusted CIs were calculated for 43 identified metabolites by conditional logistic regression.
Breast cancer onset was predicted in the premenopausal subgroup with modest accuracy (AUC 0.61, 95% CI: 0.49-0.73), and 10 metabolites associated with risk, particularly histidine (OR = 1.70 per SD increase, FDR-adjusted CI 1.19-2.41), N-acetyl glycoproteins (OR = 1.53, FDR-adjusted CI 1.18-1.97), glycerol (OR = 1.55, FDR-adjusted CI 1.11-2.18) and ethanol (OR = 1.44, FDR-adjusted CI 1.05-1.97). No predictive capacity or significant metabolites were found overall or for postmenopausal women.
Perturbed metabolism compared to controls was observed in premenopausal but not postmenopausal cases. Histidine and NAC have known involvement in inflammatory pathways, and the robust association of ethanol with risk suggests the involvement of alcohol intake.
Abstract
Background
Bile acids have been proposed to promote colon carcinogenesis. However, there are limited prospective data on circulating bile acid levels and colon cancer risk in humans.
Methods
...Associations between prediagnostic plasma levels of 17 primary, secondary, and tertiary bile acid metabolites (conjugated and unconjugated) and colon cancer risk were evaluated in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Bile acid levels were quantified by tandem mass spectrometry in samples from 569 incident colon cancer cases and 569 matched controls. Multivariable logistic regression analyses were used to estimate odds ratios (ORs) for colon cancer risk across quartiles of bile acid concentrations.
Results
Positive associations were observed between colon cancer risk and plasma levels of seven conjugated bile acid metabolites: the primary bile acids glycocholic acid (ORquartile 4 vs quartile 1= 2.22, 95% confidence interval CI = 1.52 to 3.26), taurocholic acid (OR = 1.78, 95% CI = 1.23 to 2.58), glycochenodeoxycholic acid (OR = 1.68, 95% CI = 1.13 to 2.48), taurochenodeoxycholic acid (OR = 1.62, 95% CI = 1.11 to 2.36), and glycohyocholic acid (OR = 1.65, 95% CI = 1.13 to 2.40), and the secondary bile acids glycodeoxycholic acid (OR = 1.68, 95% CI = 1.12 to 2.54) and taurodeoxycholic acid (OR = 1.54, 95% CI = 1.02 to 2.31). By contrast, unconjugated bile acids and tertiary bile acids were not associated with risk.
Conclusions
This prospective study showed that prediagnostic levels of certain conjugated primary and secondary bile acids were positively associated with risk of colon cancer. Our findings support experimental data to suggest that a high bile acid load is colon cancer promotive.
•The role of allergy in associations between irritants and asthma was sparsely studied.•Irritant cleaning agents used at home was associated with an increased risk of asthma.•Risk of current asthma ...increased with exposure as low as weekly use.•Risk of asthma gradually increased with frequency and number of products used.•Associations were observed whatever the allergic status, evaluated by drug refunds.
An adverse role of frequent domestic use of cleaning agents, especially in spray form, on asthma has been reported. However, sparse studies have investigated respiratory health effects of chronic domestic exposure to irritant cleaning agents. This study aims to investigate associations between weekly use of irritant domestic cleaning products and current allergic and non-allergic asthma in a large cohort of elderly women.
We used data from the Asthma-E3N nested case-control study on asthma (n = 19,404 women, response rate: 91%, 2011), in which participants completed standardized questionnaires on asthma and on the use of domestic cleaning products including irritants (bleach, ammonia, solvents and acids). Allergic multimorbidity in asthma was assessed from allergic-related medications recorded in drug refunds database. The association between use of irritants and current asthma was estimated by logistic regression (current vs. never asthma) and multinomial logistic regression (never asthma, non-allergic asthma, allergic asthma) adjusted on age, smoking status and body mass index (BMI).
In the 12,758 women included in the analysis (mean age: 70 years, current smokers: 4%, BMI ≥ 25 kg/m2: 32%, low education: 11%, current asthma: 23%), 47% reported weekly use of at least one irritant cleaning product at home. Weekly use of irritant products was associated with a higher risk of current asthma (adjusted Odds-Ratio: 1.17, 1.07–1.27). A statistically significant dose–response association was reported (p trend < 0.0001), with both the number of irritant products used weekly (1 irritant: 1.12, 1.02–1.23; 2 irritants: 1.21, 1.05–1.39; 3 irritants or more: 2.08, 1.57–2.75) and the frequency of use (1–3 days/week: 1.12, 1.02–1.23; 4–7 days/week: 1.41,1.22–1.64). A dose–response association was observed with the frequency of products used (p trend < 0.05), for both non-allergic (4–7 days/week: 1.27, 1.02–1.57) and allergic asthma (1.52, 1.27–1.82).
In conclusion, weekly use of common cleaning irritants was associated with an increased risk of current asthma, whatever the allergic status.
Many dietary guidelines recommend restricting the consumption of processed red meat (PRM) in favour of healthier foods such as fish, to reduce the risk of chronic conditions such as hypertension and ...diabetes. The objective of this study was to estimate the potential effect of replacing PRM for fatty fish, lean fish, red meat, eggs, pulses, or vegetables, on the risk of incident hypertension and diabetes. This was a prospective study of women in the E3N cohort study. Cases of diabetes and hypertension were based on self-report, specific questionnaires, and drug reimbursements. In the main analysis, information on regular dietary intake was assessed with a single food history questionaire, and food substitutions were modelled using cox proportional hazard models. 95 % confidence intervals were generated via bootstrapping. 71 081 women free of diabetes and 45 771 women free of hypertension were followed for an average of 18·7 and 18·3 years, respectively. 2681 incident cases of diabetes and 12 327 incident cases of hypertension were identified. Relative to PRM, fatty fish was associated with a 15 % lower risk of diabetes (HR = 0·85, 95 CI (0·73, 0·97)) and hypertension (HR = 0 85 (0·79, 0·91)). Between 3 and 10 % lower risk of hypertension or diabetes was also observed when comparing PRM with vegetables, unprocessed red meat or pulses. Relative to PRM, alternative protein sources such as fatty fish, unprocessed red meat, vegetables or pulses was associated with a lower risk of hypertension and diabetes.
Aims/hypothesis
The objective of this study was to evaluate the prospective relationship between dietary acid load, assessed with both the potential renal acid load (PRAL) and the net endogenous acid ...production (NEAP) scores, and type 2 diabetes risk.
Methods
A total of 66,485 women from the E3N-EPIC cohort were followed for incident diabetes over 14 years. PRAL and NEAP scores were derived from nutrient intakes. HRs for type 2 diabetes risk across quartiles of the baseline PRAL and NEAP scores were estimated with multivariate Cox regression models.
Results
During follow-up, 1,372 cases of incident type 2 diabetes were validated. In the overall population, the highest PRAL quartile, reflecting a greater acid-forming potential, was associated with a significant increase in type 2 diabetes risk, compared with the first quartile (HR 1.56, 95% CI 1.29, 1.90). The association was stronger among women with BMI <25 kg/m
2
(HR 1.96, 95% CI 1.43, 2.69) than in overweight women (HR 1.28, 95% CI 1.00, 1.64); statistically significant trends in risk across quartiles were observed in both groups (
p
trend
< 0.0001 and
p
trend
= 0.03, respectively). The NEAP score provided similar findings.
Conclusions/interpretation
We have demonstrated for the first time in a large prospective study that dietary acid load was positively associated with type 2 diabetes risk, independently of other known risk factors for diabetes. Our results need to be validated in other populations, and may lead to promotion of diets with a low acid load for the prevention of diabetes. Further research is required on the underlying mechanisms.
Although there is evidence for a reduced risk of hypertension associated with fruit and vegetable consumption, the relationship between the total antioxidant capacity of the diet (TAC) and the risk ...of hypertension has not been previously examined. We aimed to evaluate that association in the large E3N French prospective cohort of women.
Dietary TAC was estimated using total radical-trapping ability parameter (TRAP) assay food values; self-reported incident hypertension cases were validated. Cox regression models were adjusted for conventional risk factors, body mass index, physical activity, energy, sodium, magnesium, omega-3 fatty acids, and alcohol.
After an average 12.7 years of follow up, there were 9350 incident cases of hypertension among 40,576 women. Dietary TAC was inversely associated with the risk of hypertension with a 15% lower risk of hypertension in those in the fifth vs. first quintile (HR
0.85 CI 95% 0.74; 0.95 p-trend 0.03) An inverse dose-effect relationship was observed for dietary TAC excluding coffee (HR
0.85 CI 95% 0.74; 0.95, p-trend 0.0008), while for dietary TAC from coffee, only the highest quintile was inversely associated with risk (HR
0.86 0.75, 0.97, p-trend 0.20). In a fully partitioned model with major dietary TAC contributors, TAC from fruit/vegetables, wine, and miscellaneous sources was inversely associated with risk, while associations with TAC from coffee, tea, and chocolate were not statistically significant.
In a large prospective cohort, the risk of incident hypertension in women was inversely associated with the antioxidant capacity of the diet, suggesting that promoting a diet naturally rich in antioxidants might help prevent the development of hypertension.
Several studies have reported associations of hypertension with cancer, but not all results were conclusive. We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with the ...development of incident cancer at all anatomical sites in the European Prospective Investigation into Cancer and Nutrition (EPIC). Hazard ratios (HRs) (95% confidence intervals) were estimated using multivariable Cox proportional hazards models, stratified by EPIC‐participating center and age at recruitment, and adjusted for sex, education, smoking, body mass index, physical activity, diabetes and dietary (in women also reproductive) factors. The study included 307,318 men and women, with an average follow‐up of 13.7 (standard deviation 4.4) years and 39,298 incident cancers. We confirmed the expected positive association with renal cell carcinoma: HR = 1.12 (1.08–1.17) per 10 mm Hg higher SBP and HR = 1.23 (1.14–1.32) for DBP. We additionally found positive associations for esophageal squamous cell carcinoma (SCC): HR = 1.16 (1.07–1.26) (SBP), HR = 1.31 (1.13–1.51) (DBP), weaker for head and neck cancers: HR = 1.08 (1.04–1.12) (SBP), HR = 1.09 (1.01–1.17) (DBP) and, similarly, for skin SCC, colon cancer, postmenopausal breast cancer and uterine adenocarcinoma (AC), but not for esophageal AC, lung SCC, lung AC or uterine endometroid cancer. We observed weak inverse associations of SBP with cervical SCC: HR = 0.91 (0.82–1.00) and lymphomas: HR = 0.97 (0.93–1.00). There were no consistent associations with cancers in other locations. Our results are largely compatible with published studies and support weak associations of blood pressure with cancers in specific locations and morphologies.
What's new?
Is there a link between high blood pressure and cancer? In this large, prospective study, the authors found that hypertension is indeed associated with a moderate increase in risk for several cancers, including renal, esophageal (only squamous cell carcinoma), head and neck, skin, colon, post‐menopausal breast cancer, and uterine cancer (only adenocarcinoma). These results may potentially enhance screening and risk assessment. Further research may also identify shared mechanisms for both hypertension and cancer, such as inflammation, lipid peroxidation, etc.