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.
BACKGROUND: Increased consumption of dietary fiber is widely recommended to maintain or improve health, but knowledge of the relation between dietary fiber sources and cardiovascular disease risk ...factors is limited. OBJECTIVE: We examined the relation between the source or type of dietary fiber intake and cardiovascular disease risk factors in a cohort of adult men and women. DESIGN: In a cross-sectional study, quintiles of fiber intake were determined from dietary records, separately for 2532 men and 3429 women. Age- and multivariate-controlled logistic models investigated the odds ratios of abnormal markers for quintiles 2-5 of fiber intake compared with the lowest quintile. RESULTS: The highest total dietary fiber and nonsoluble dietary fiber intakes were associated with a significantly (P < 0.05) lower risk of overweight and elevated waist-to-hip ratio, blood pressure, plasma apolipoprotein (apo) B, apo B:apo A-I, cholesterol, triacylglycerols, and homocysteine. Soluble dietary fiber was less effective. Fiber from cereals was associated with a lower body mass index, blood pressure, and homocysteine concentration; fiber from vegetables with a lower blood pressure and homocysteine concentration; and fiber from fruit with a lower waist-to-hip ratio and blood pressure. Fiber from dried fruit or nuts and seeds was associated with a lower body mass index, waist-to-hip ratio, and fasting apo B and glucose concentrations. Fiber from pulses had no specific effect. CONCLUSION: Dietary fiber intake is inversely correlated with several cardiovascular disease risk factors in both sexes, which supports its protective role against cardiovascular disease and recommendations for its increased consumption.
Purpose
Saturated fat has long been associated with cardiovascular disease in multiple prospective studies, and randomized controlled trials. Few studies have assessed the relative associations ...between saturated fat and other macronutrients with hypertension, a major risk factor for cardiovascular disease. The aim of this study was to assess the relative associations between saturated fat, other macronutrients such as monounsaturated and polyunsaturated fat, proteins, and carbohydrates, and incident hypertension in a large prospective cohort of French women.
Methods
This study used data from the E3N cohort study, including participants free of hypertension at baseline. A food frequency questionnaire was used to determine dietary intakes of saturated fat (SFA), monounsaturated fat (MUFA), polyunsaturated fat (PUFA), animal protein (AP), vegetable protein (VP), carbohydrates (CH) and various foods. Cases of hypertension were based on self-report, validated by drug reimbursement data. Covariates were based on self-report. Cox proportional hazard models were used to estimate the relative associations between different macronutrients and hypertension risk, using the ‘substitution’ framework. Bootstrapping was used to generate 95% confidence intervals.
Results
This study included 45,854 women free of hypertension at baseline. During 708,887 person-years of follow-up, 12,338 incident cases of hypertension were identified. Compared to saturated fat, higher consumption of all other macronutrients was associated with a lower risk of hypertension (HR
MUFA
= 0.74 0.67: 0.81, HR
PUFA
= 0.84 0.77: 0.92, HR
CH
= 0.83 0.77: 0.88, HR
AP
= 0.91 0.85: 0.97, HR
VP
= 0.93 0.83: 1.03).
Conclusion
This study finds that relative to other macronutrients such as monounsaturated or polyunsaturated fat, higher intake of saturated fat is associated with a higher risk of hypertension among women.
Little is known about the dietary patterns associated with colorectal tumors along the adenoma-carcinoma sequence. Scores for dietary patterns were obtained by factor analysis in women from the ...French cohort of the European Prospective Investigation into Cancer and Nutrition (1993–2000). Their association with colorectal tumors was investigated in 516 adenoma cases (175 high-risk adenomas) and 4,804 polyp-free women and in 172 colorectal cancer cases and 67,312 cancer-free women. The authors identified four dietary patterns: “healthy” (vegetables, fruit, yogurt, sea products, and olive oil); “Western” (potatoes, pizzas and pies, sandwiches, sweets, cakes, cheese, cereal products, processed meat, eggs, and butter); “drinker” (sandwiches, snacks, processed meat, and alcoholic beverages); and “meat eaters” (meat, poultry, and margarine). For quartile 4 versus quartile 1, an increased risk of adenoma was observed with high scores of the Western pattern (multivariate relative risk (RR) = 1.39, 95% confidence interval: 1.00, 1.94; ptrend = 0.03) and the drinker pattern (RR = 1.42, 95% confidence interval: 1.10, 1.83; ptrend = 0.01). The meat-eaters pattern was positively associated with colorectal cancer risk (for quartile 4 vs. quartile 1: RR = 1.58, 95% confidence interval: 0.98, 2.53; ptrend = 0.02). Dietary patterns that reflect a Western way of life are associated with a higher risk of colorectal tumors.
Objectives
Processed meat has been associated with an increased risk of hypertension (1). This study aimed to determine the possible effect of substituting processed meat (PM) with fish using ...specified food substitution models (2), in the French E3N cohort study.
Methods
This study included 46843 women from the prospective E3N study who had no hypertension at 1993, and completed a first food frequency questionnaire (FFQ) sent in 1993 which was used to estimate dietary intakes of various foods including PM, and fish, considering serving sizes of 150 g. Estimates of the hazard ratio for incident hypertension were obtained using Cox Proportional Hazard Models, and the substitution method (2) was used to obtain estimates for substitution of PM for fish. Boot-strapping with 50 samples was used to estimate 95% confidence intervals for the substitution. Models were sequentially adjusted for age and risk-factors for hypertension, then dietary variables, and finally energy.
Results
During follow-up, 12,465 cases of hypertension were reported over 712,703 personyears. Mean consumption of processed meat was 1.3 servings/week, 1.3 servings/week for fish and 2.3 servings/week for poultry. Substitution of one serving of processed meat for fish per week was associated with a slightly reduced risk of hypertension in all models, regardless of the underlying restrictions placed on diet, or energy (HR = 0.95(0.91: 0.98)). The association was weaker for poultry (HR = 0.98 (0.96, 1.01)).
Conclusions
Substitution one serving of PM for fish per week could be associated with a small reduction in the risk of hypertension amongst French women.
References: (1) Lajous M, et al. Processed and unprocessed red meat consumption and hypertension in women. Am J Clin Nutr. 2014 Sep;100(3):948-52. (2) Ibsen D, et al, Food substitution models for nutritional epidemiology, Am J Clin Nutr, 2021 Feb;113(2):294-303
Key messages
Processed meat is associated with an increased risk of hypertension.
Substitution of processed meat for fish may reduce this risk.
Background & Aims: The short bowel syndrome (SBS) may be associated with either transient or permanent intestinal failure, presently treated by parenteral nutrition (PN). Survival and PN-dependence ...probabilities, taking into account both small bowel remnant length and the type of the digestive circuit of anastomosis, are not known in adult SBS patients. The aim of this study was to assess such prognostic factors.
Methods: A total of 124 consecutive adults with nonmalignant SBS were enrolled from 1980 to 1992 at 2 home PN centers. They were analyzed for survival and PN-dependence probabilities using the Cox model and for PN dependence using linear discriminant analysis. Data were updated in April 1996.
Results: Survival and PN-dependence probabilities were 86% and 49% and 75% and 45% at 2 and 5 years, respectively. In multivariate analysis, survival was related negatively to end-enterostomy, to small bowel length of <50 cm, and to arterial infarction as a cause of SBS, but not to PN dependence. The latter was related negatively to postduodenal small bowel lengths of <50 and 50–99 cm and to absence of terminal ileum and/or colon in continuity. Cutoff values of small bowel lengths separating transient and permanent intestinal failure were 100, 65, and 30 cm in end-enterostomy, jejunocolic, and jejunoileocolic type of anastomosis, respectively.
Conclusions: In adult SBS patients, small bowel length of <100 cm is highly predictive of permanent intestinal failure. Presence of terminal ileum and/or colon in continuity enhances both weaning off PN and survival probabilities. After 2 years of PN, probability of permanent intestinal failure is 94%. These rates may lead to selection of other treatments, especially intestinal transplantation, instead of PN, for permanent intestinal failure caused by SBS.
GASTROENTEROLOGY 1999;117:1043-1050
There is a lack of prospective data on the potential association of
(
) and colorectal cancer risk. In this study, we assessed whether antibody responses to
are associated with colorectal cancer risk ...in prediagnostic serum samples in the European Prospective Investigation into Nutrition and Cancer (EPIC) cohort.
We applied a multiplex serology assay to simultaneously measure antibody responses to 11
antigens in prediagnostic serum samples from 485 colorectal cancer cases and 485 matched controls. Conditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI).
We observed neither a statistically significant colorectal cancer risk association for antibodies to individual
proteins nor for combined positivity to any of the 11 proteins (OR, 0.81; 95% CI, 0.62-1.06).
Antibody responses to
proteins in prediagnostic serum samples from a subset of colorectal cancer cases and matched controls within the EPIC study were not associated with colorectal cancer risk.
Our findings in prospectively ascertained serum samples contradict the existing literature on the association of
with colorectal cancer risk. Future prospective studies, specifically detecting
in stool or tissue biopsies, are needed to complement our findings.
The gut is an obvious target for the development of functional foods, acting as it does as the interface between diet and the metabolic events which sustain life. The key processes in digestive ...physiology which can be regulated by modifying diet are satiety, the rate and extent of macronutrient breakdown and absorption from the small bowel, sterol metabolism, the colonic microflora, fermentation, mucosal function and bowel habit, and the gut immune system. The intestinal microflora is the main focus of many current functional foods. Probiotics are foods which contain live bacteria which are beneficial to health whilst prebiotics, such as certain non-digestible oligosaccharides which selectively stimulate the growth of bifidobacteria in the colon, are already on the market. Their claimed benefits are to alleviate lactose maldigestion, increase resistance to invasion by pathogenic species of bacteria in the gut, stimulate the immune system and possibly protect against cancer. There are very few reports of well-designed human intervention studies with prebiotics as yet. Certain probiotic species have been shown to shorten the duration of rotavirus diarrhoea in children but much more work is needed on the mechanism of immunomodulation and of competitive exclusion and microflora modification. The development of functional foods for the gut is in its infancy and will be successful only if more fundamental research is done on digestive physiology, the gut microflora, immune system and mucosal function.
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