Obesity is a serious childhood health problem today. Studies have shown that overweight and obesity tend to be stable (track) from birth, through childhood and adolescence, to adulthood. However, ...existing studies are heterogeneous; there is still no consensus on the strength of the association between high birth weight or high body mass index (BMI) early in life and overweight and obesity later in life, nor on the appropriate age or target group for intervention and prevention efforts. This study aimed to determine the presence and degree of tracking of overweight and obesity and development in BMI and BMI standard deviation scores (SDS) from childhood to adolescence in the Fit Futures cohort from North Norway.
Using a retrospective cohort design, data on 532 adolescents from the Fit Futures cohort were supplemented with height and weight data from childhood health records, and BMI was calculated at 2-4, 5-7, and 15-17 years of age. Participants were categorized into weight classes by BMI according to the International Obesity Taskforce's age- and sex-specific cut-off values for children 2-18 years of age (thinness: adult BMI <18.5 kg/m(2), normal weight: adult BMI ≥18.5- < 25 kg/m(2), overweight: adult BMI ≥25- < 30 kg/m(2), obesity: adult BMI ≥30 kg/m(2)). Non-parametric tests, Cohen's weighted Kappa statistic and logistic regression were used in the analyses.
The prevalence of overweight and obesity combined, increased from 11.5 % at 2-4 years of age and 13.7 % at 5-7 years of age, to 20.1 % at 15-17 years of age. Children who were overweight/obese at 5-7 years of age had increased odds of being overweight/obese at 15-17 years of age, compared to thin/normal weight children (crude odds ratio: 11.1, 95 % confidence interval: 6.4-19.2). Six out of 10 children who were overweight/obese at 5-7 years of age were overweight/obese at 15-17 years of age.
The prevalence of overweight and obesity increased with age. We found a moderate indication of tracking of overweight/obesity from childhood to adolescence. Preventive and treatment initiatives among children at high risk of overweight and obesity should start before 5-7 years of age, but general preventive efforts targeting all children are most important.
Cereals and cereal products have traditionally been staple foods in many countries including in the Nordics and Baltics. Cereals can be consumed with their entire grain kernel and are then referred ...to as whole grains or can be consumed after removal of the bran or germ and are then referred to as refined grains. The terms cereals and grains are often used interchangeably. In this scoping review, we examine the associations between intake of cereals and cereal products and major health outcomes to contribute to up-to-date food-based dietary guidelines for the Nordic and Baltic countries in the Nordic Nutrition Recommendations 2023 project. Five qualified systematic reviews that covered non-communicable diseases, mortality, and risk factors were identified, and a supplementary literature search was performed in the MEDLINE and Cochrane databases for more recent studies and other endpoints. Compared to other high-income countries, the Nordic populations have a high consumption of whole grain foods. In some of the countries, rye constitutes a substantial fraction of the cereal consumption. However, few studies are available for specific cereals, and most of the research has been performed in predominantly wheat-consuming populations. The evidence suggests clear dose-response associations between a high intake of whole grains and lower risks of cardiovascular disease, colorectal cancer, type 2 diabetes, and premature mortality. The lowest risks of morbidity and mortality were observed for 3-7 servings of whole grains per day, equivalent of 90-210 g/day (fresh weight or ready-to-eat whole grain products, such as oatmeal or whole grain rye bread). Evidence from randomized trials indicates that a high intake of whole grains is beneficial for reducing weight gain. There is less evidence for refined grains, but the available evidence does not seem to indicate similar beneficial associations as for whole grains. It is suggested that replacing refined grains with whole grains would improve several important health outcomes. Cereals are plant foods that can be grown in most of the Nordic and Baltic regions.
Colorectal cancer located at different anatomical subsites may have distinct etiologies and risk factors. Previous studies that have examined this hypothesis have yielded inconsistent results, ...possibly because most studies have been of insufficient size to identify heterogeneous associations with precision.
In the European Prospective Investigation into Cancer and Nutrition study, we used multivariable joint Cox proportional hazards models, which accounted for tumors at different anatomical sites (proximal colon, distal colon, and rectum) as competing risks, to examine the relationships between 14 established/suspected lifestyle, anthropometric, and reproductive/menstrual risk factors with colorectal cancer risk. Heterogeneity across sites was tested using Wald tests.
After a median of 14.9 years of follow-up of 521,330 men and women, 6291 colorectal cancer cases occurred. Physical activity was related inversely to proximal colon and distal colon cancer, but not to rectal cancer (P heterogeneity = .03). Height was associated positively with proximal and distal colon cancer only, but not rectal cancer (P heterogeneity = .0001). For men, but not women, heterogeneous relationships were observed for body mass index (P heterogeneity = .008) and waist circumference (P heterogeneity = .03), with weaker positive associations found for rectal cancer, compared with proximal and distal colon cancer. Current smoking was associated with a greater risk of rectal and proximal colon cancer, but not distal colon cancer (P heterogeneity = .05). No heterogeneity by anatomical site was found for alcohol consumption, diabetes, nonsteroidal anti-inflammatory drug use, and reproductive/menstrual factors.
The relationships between physical activity, anthropometry, and smoking with colorectal cancer risk differed by subsite, supporting the hypothesis that tumors in different anatomical regions may have distinct etiologies.
Despite development in cancer treatment and prevention options during the past few years, cancer of the pancreas remains a diagnosis associated with poor prognosis and limited options for prevention. ...Diet has proven to be an important risk factor for development of many types of cancer, particularly for cancers of the digestive system. Still, evidence regarding its relation to pancreatic cancer remains ambiguous. To investigate the relationship between diet and pancreatic cancer, an analysis of dietary patterns in participants from the Norwegian Women and Cancer Study (n = 89,156; 305 pancreatic cancer cases) was performed. Cox regression analysis was used for studying possible associations between dietary patterns, derived from principal component analysis, and pancreatic cancer incidence. The four most prominent dietary patterns were identified and described: European pattern, animal food consumers' dietary pattern, traditional Norwegian pattern, and alcohol-abstaining dietary pattern. In analysis without adjustment for confounders, being in the highest tertile of the abstaining dietary pattern was associated with lower risk of pancreatic cancer in comparison to the lowest tertile (hazard ratios HR: 0.66, 95% confidence interval CI: 0.49-0.89). After additional adjustment for height and smoking status, no dietary pattern was associated with increased pancreatic cancer risk, nor was there any difference in effect estimates between strata of smokers and non-smokers. The results of our current analysis do not support the role of major dietary patterns in the development of pancreatic cancer.
High intake of sugar-sweetened beverages (SSB) has been associated with weight gain and chronic disease. The objective of this paper was to study the intake of SSB and characteristics associated with ...SSB intake in adolescents from Troms, Norway. We present results from a cross-sectional analysis from the Tromsø Study:
, with 426 female and 444 male students aged 15⁻17 years (93% participation rate). Descriptive statistics and logistic regression analyses were performed. Among females, 31.8% drank at least one glass of SSB per day on average, compared to 61.0% among males. The adjusted OR (odds ratio) of daily SSB drinking for males vs. females was 3.74 (95% CI (confidence interval) 2.68⁻5.22). Other dietary habits such as eating snacks, drinking artificially sweetened beverages, fruit juice, and seldom eating breakfast were associated with higher odds for daily SSB drinking, as was daily snuffing. Weight class was not associated with daily SSB drinking. Students in vocational studies, particularly males tended to be more likely to be daily SSB drinkers. The prevalence of participants who on average were daily drinkers was higher than in national studies. We have identified several possible targets for interventions. Clustering of unhealthy behaviours and tendencies to socioeconomic differences are of particular concern.
Human papillomavirus type 16 (HPV16) infection is causing an increasing number of oropharyngeal cancers in the United States and Europe. The aim of our study was to investigate whether HPV antibodies ...are associated with head and neck cancer risk when measured in prediagnostic sera.
We identified 638 participants with incident head and neck cancers (patients; 180 oral cancers, 135 oropharynx cancers, and 247 hypopharynx/larynx cancers) and 300 patients with esophageal cancers as well as 1,599 comparable controls from within the European Prospective Investigation Into Cancer and Nutrition cohort. Prediagnostic plasma samples from patients (collected, on average, 6 years before diagnosis) and control participants were analyzed for antibodies against multiple proteins of HPV16 as well as HPV6, HPV11, HPV18, HPV31, HPV33, HPV45, and HPV52. Odds ratios (ORs) of cancer and 95% CIs were calculated, adjusting for potential confounders. All-cause mortality was evaluated among patients using Cox proportional hazards regression.
HPV16 E6 seropositivity was present in prediagnostic samples for 34.8% of patients with oropharyngeal cancer and 0.6% of controls (OR, 274; 95% CI, 110 to 681) but was not associated with other cancer sites. The increased risk of oropharyngeal cancer among HPV16 E6 seropositive participants was independent of time between blood collection and diagnosis and was observed more than 10 years before diagnosis. The all-cause mortality ratio among patients with oropharyngeal cancer was 0.30 (95% CI, 0.13 to 0.67), for patients who were HPV16 E6 seropositive compared with seronegative.
HPV16 E6 seropositivity was present more than 10 years before diagnosis of oropharyngeal cancers.
Earlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. ...We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location.
After a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95% CI: 0.79-0.96). Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals.
Our results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.
According to World Cancer Research Fund International/American Institute for Cancer Research, it is 'probable' that dairy products decrease the risk of colorectal cancer (CRC). However, meta-analyses ...restricted to women have not shown associations between milk intake and risk of CRC. The aim of this study was to examine the association between milk intake and risk of CRC, colon cancer and rectal cancer among women. Data from 81 675 participants in the Norwegian Women and Cancer Cohort Study were included, and multivariable Cox proportional hazard regression models were used to investigate milk intake using two different analytical approaches: one that included repeated measurements and one that included baseline measurements only (872 and 1084 CRC cases, respectively). A weak inverse association between milk intake and risk of colon cancer may be indicated both in repeated measurements analyses and in baseline data analyses. Hazard ratios (HR) for colon cancer of 0·80 (95 % CI 0·62, 1·03, P trend 0·07) and 0·81 (95 % CI 0·64, 1·01, P trend 0·03) and HR for rectal cancer of 0·97 (95 % CI 0·67, 1·42, P trend 0·92) and 0·71 (95 % CI 0·50, 1·01, P trend 0·03) were found when comparing the high with the no/seldom milk intake group in energy-adjusted multivariable models. Our study indicates that there may be a weak inverse association between milk intake and risk of colon cancer among women. The two analytical approaches yielded different results for rectal cancer and hence CRC. Our study indicates that the use of single or repeated measurements in analyses may influence the results.
Metabolomics is a promising molecular tool to identify novel etiologic pathways leading to cancer. Using a targeted approach, we prospectively investigated the associations between metabolite ...concentrations in plasma and breast cancer risk.
A nested case-control study was established within the European Prospective Investigation into Cancer cohort, which included 1624 first primary incident invasive breast cancer cases (with known estrogen and progesterone receptor and HER2 status) and 1624 matched controls. Metabolites (n = 127, acylcarnitines, amino acids, biogenic amines, glycerophospholipids, hexose, sphingolipids) were measured by mass spectrometry in pre-diagnostic plasma samples and tested for associations with breast cancer incidence using multivariable conditional logistic regression.
Among women not using hormones at baseline (n = 2248), and after control for multiple tests, concentrations of arginine (odds ratio OR per SD = 0.79, 95% confidence interval CI = 0.70-0.90), asparagine (OR = 0.83 (0.74-0.92)), and phosphatidylcholines (PCs) ae C36:3 (OR = 0.83 (0.76-0.90)), aa C36:3 (OR = 0.84 (0.77-0.93)), ae C34:2 (OR = 0.85 (0.78-0.94)), ae C36:2 (OR = 0.85 (0.78-0.88)), and ae C38:2 (OR = 0.84 (0.76-0.93)) were inversely associated with breast cancer risk, while the acylcarnitine C2 (OR = 1.23 (1.11-1.35)) was positively associated with disease risk. In the overall population, C2 (OR = 1.15 (1.06-1.24)) and PC ae C36:3 (OR = 0.88 (0.82-0.95)) were associated with risk of breast cancer, and these relationships did not differ by breast cancer subtype, age at diagnosis, fasting status, menopausal status, or adiposity.
These findings point to potentially novel pathways and biomarkers of breast cancer development. Results warrant replication in other epidemiological studies.
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