| 151. |
- Wallström, Peter, et al.
(författare)
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Dietary fiber and saturated fat intake associations with cardiovascular disease differ by sex in the malmö diet and cancer cohort: a prospective study.
- 2012
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 7:2
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim of the study was to examine associations between intake of macronutrients and dietary fiber and incident ischemic cardiovascular disease (iCVD) in men and women. METHODS: We used data from 8,139 male and 12,535 female participants (aged 44-73 y) of the Swedish population-based Malmö Diet and Cancer cohort. The participants were without history of CVD and diabetes mellitus, and had reported stable dietary habits in the study questionnaire. Diet was assessed by a validated modified diet history method, combining a 7-d registration of cooked meals and cold beverages, a 168-item food questionnaire (covering other foods and meal patterns), and a 1-hour diet interview. Sociodemographic and lifestyle data were collected by questionnaire. iCVD cases, which included coronary events (myocardial infarctions or deaths from chronic ischemic heart disease) and ischemic strokes, were ascertained via national and local registries. Nutrient-disease associations were examined by multivariate Cox regressions. RESULTS: During a mean follow-up of 13.5 years, we identified 1,089 male and 687 female iCVD cases. High fiber intakes were associated with lower incidence rates of iCVD in women and of ischemic stroke in men. In post-hoc analysis, we discovered statistically significant interactions between intake of fiber and saturated fat; these interactions also differed between men and women (p<0.001). CONCLUSIONS: In this well-defined population, a high fiber intake was associated with lower risk of iCVD, but there were no robust associations between other macronutrients and iCVD risk. Judging from this study, gender-specific nutrient analysis may be preferable in epidemiology.
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| 152. |
- Wallström, Peter, et al.
(författare)
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Fruit and vegetable consumption in relation to risk factors for cancer: a report from the Malmo Diet and Cancer Study
- 2000
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Ingår i: Public Health Nutrition. - 1475-2727. ; 3:3, s. 263-271
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine the associations between the consumption of fruit and vegetables and other markers of cancer risk. DESIGN: A cross-sectional survey within the population-based prospective Malmo Diet and Cancer (MDC) Study. Information on food habits was collected through the modified diet history method designed and validated for the MDC Study. Data on smoking and alcohol habits, leisure time physical activity, birth country, education, socioeconomic status and cohabitation status were collected through a questionnaire. SETTING: Malmo, the third largest city in Sweden. SUBJECTS: All subjects who entered the MDC Study during winter 1991 to summer 1994 (men and women living in Malmo, aged between 46 and 68 years), with a total of 15 173. RESULTS: Women consumed more fruit and vegetables than men. Low consumption of both fruits and vegetables was associated with unfavourable nutrient profiles: higher percentage of energy from fat and lower intakes of antioxidant nutrients and dietary fibre. Low consumption was also associated with smoking, low leisure time physical activity, low education and being born in Sweden. High age was associated with low vegetable consumption in both genders. CONCLUSION: This study indicates that several established risk markers and risk factors of cancer may be independently associated with low fruit and vegetable consumption. The findings suggest that the adverse effects of factors such as smoking, low physical activity and a high-fat diet could partly be explained by low consumption of fruit or vegetables. The implied health benefits of a low or moderate alcohol consumption may be similarly confounded by high consumption of fruit or vegetables.
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| 153. |
- Wallström, Peter, et al.
(författare)
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Plasma enterolactone and risk of prostate cancer in middle-aged Swedish men
- 2018
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Ingår i: European Journal of Nutrition. - : Springer Science and Business Media LLC. - 1436-6207 .- 1436-6215. ; 57:7, s. 2595-2606
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Enterolactone (ENL) is formed in the human gut after consumption of lignans, has estrogenic properties, and has been associated with risk of prostate cancer. We examined the association between plasma ENL levels and prostate cancer in a nested case–control study within the population-based Malmö Diet and Cancer cohort. We also examined the association between plasma ENL and dietary and lifestyle factors. Methods: The study population consisted of 1010 cases occurring during a mean follow-up of 14.6 years, and 1817 controls matched on age and study entry date. We used national registers (95%) and hospital records (5%) to ascertain cases. Diet was estimated by a modified diet history method. Plasma ENL concentrations were determined by a time-resolved fluoroimmunoassay. Odds ratios were calculated by unconditional logistic regression. Results: There were no significant associations between plasma ENL and incidence of all prostate cancer (odds ratio 0.99 [95% confidence interval 0.77–1.280] for the highest ENL quintile versus lowest, p for trend 0.66). However, in certain subgroups of men, including men with abdominal obesity (p for interaction = 0.012), we observed associations between high ENL levels and lower odds of high-risk prostate cancer. Plasma ENL was positively associated with consumption of high-fibre bread, fruit, tea, and coffee; with age, and with height, while it was negatively associated with smoking and waist circumference; however, although significant, all associations were rather weak (r ≤ |0.14|). Conclusion: ENL concentration was not consistently associated with lower prostate cancer risk, although it was weakly associated with a healthy lifestyle.
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| 154. |
- Wallström, Peter, et al.
(författare)
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Serum beta-carotene and alpha-tocopherol in smokers and non-smokers - associations with food sources and supplemental intakes. A report from the Malmo Diet and Cancer cohort
- 2003
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Ingår i: Nutrition Research. - 0271-5317. ; 23:2, s. 163-183
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Tidskriftsartikel (refereegranskat)abstract
- High blood concentrations of beta-carotene (BC) and alpha-tocopherol (AT) are markers of lower risk of cancer and cardiovascular disease. However, it is not clear how well they serve as markers of, food consumption in a general population setting, in a country with a traditionally low vegetable consumption, or if they work equally well in smokers and non-smokers. We performed a cross-sectional study of 366 non-smokers and 163 smokers of both sexes, aged 46-67 y, who participated in the Malmo Diet and Cancer study (Sweden). Serum concentrations of BC and AT were determined by HPLC. Food habits were assessed by a validated modified diet history method. Intake of dietary supplements was calculated from a 7-day self-registration. We found that non-smokers had higher serum BC concentrations than smokers (arithmetic means 550 +/- 25 (SE) vs. 400 +/- 27 nmol/l, p < 0.001), but serum AT concentrations were similar (27.2 less than or equal to 0.43 vs. 27.0 < 0.65 mumol/l, p = 0.88). After adjustment for sex, serum cholesterol, obesity, and other sources of BC, consumption of carrots and leafy vegetables were moderately but positively associated with serum BC in non-smokers. In smokers, serum BC was positively associated with consumption of BC supplements only. The only AT sources associated with serum AT were vitamin E supplements. We also observed a positive association between serum BC and consumption of coffee in smokers. We conclude that serum BC concentration may not be a useful marker of vegetable consumption when vegetable consumption is low, that the foods associated with serum concentrations of BC differed by smoking status in this population, and that serum AT concentrations were only associated with dietary supplements, not with foods. (C) 2003 Elsevier Science Inc. All rights reserved.
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| 155. |
- Weikert, Cornelia, et al.
(författare)
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Lifetime and baseline alcohol intake and risk of cancer of the upper aero-digestive tract in the European prospective investigation into cancer and nutrition (EPIC) study
- 2009
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Ingår i: International Journal of Cancer. - Geneve : Wiley. - 0020-7136 .- 1097-0215. ; 125:2, s. 406-412
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Tidskriftsartikel (refereegranskat)abstract
- Recent alcohol consumption is all established risk factor for squamous cell carcinoma (SCC) or the upper aero-digestive tract. In contrast, the role or lifetime exposure to alcohol with regard to risk of SCC is not well established. Historical data oil alcohol use are available in 271,253 participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). During 2,330,381 person years, 392 incident SCC cases (279 men and 113 women) were identified. Cox regression vas applied to model sex-specific associations between lifetime alcohol intake and SCC risk adjusting for potential confounders including smoking. Compared to men who drank 0.1-6.0 g/day alcohol at lifetime, the relative risks (RR) for developing SCC were significantly increased for men who drank 30.1-60.0 g/day (RR 1.65, 95% confidence interval: 1.00-2.71), 60.1-96.0 g/day (RR 2.20, 95%CI 1.23-3.95), and >96.0 g/day, (RR 4.63, 95% CI 2.52-8.48), and for former drinkers (RR 4.14, 95% CI 2.38-7.19). These risk estimates did not considerably change when baseline alcohol intake was analyzed. Compared to women who drank 0.1-6.0 g/day alcohol intake at lifetime, the RR were significantly increased for women who drank >30 g/d (RR 6.05, 95% CI 2.98-12.3). Applying similar categories, the relative risk for baseline alcohol intake was 3.26 (95%CI 1.82-5.87). We observed a stronger association between alcohol intake at lifetime and risk of SCC in women compared to men (p for interaction = 0.045). The strong dose-response relation for lifetime alcohol use underscores that alcohol is an important risk factor of SCC of the upper aero-digestive tract throughout life. (C) 2009 UICC
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| 156. |
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| 157. |
- Wirfält, Elisabet, et al.
(författare)
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A methodological report from the Malmö Diet and Cancer study: development and evaluation of altered routines in dietary data processing
- 2002
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Ingår i: Nutrition Journal. - : Springer Science and Business Media LLC. - 1475-2891. ; 1:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: In the Malmö Diet and Cancer study, information on dietary habits was obtained through a modified diet history method, combining a 7-day menu book for cooked meals and a diet questionnaire for foods with low day-to-day variation. Half way through the baseline data collection, a change of interview routines was implemented in order to reduce interview time. Methods: Changes concentrated on portion-size estimation and recipe coding of mixed dishes reported in the menu book. All method development and tests were carefully monitored, based on experiential knowledge, and supplemented with empirical data. A post hoc evaluation study using "real world" data compared observed means of selected dietary variables before and after the alteration of routines handling dietary data, controlling for potential confounders. Results: These tests suggested that simplified coding rules and standard portion-sizes could be used on a limited number of foods, without distortions of the group mean nutrient intakes, or the participants' ranking. The post hoc evaluation suggested that mean intakes of energy-adjusted fat were higher after the change in routines. The impact appeared greater in women than in men. Conclusions: Future descriptive studies should consider selecting subsets assessed with either method version to avoid distortion of observed mean intakes. The impact in analytical studies may be small, because method version and diet assistant explained less than 1 percent of total variation. The distribution of cases and non-cases across method versions should be monitored.
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| 158. |
- Wirfält, Elisabet, et al.
(författare)
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Associations between estimated acrylamide intakes, and hemoglobin AA adducts in a sample from the Malmö Diet and Cancer cohort.
- 2008
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Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 1476-5640 .- 0954-3007. ; 62:3, s. 314-323
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the coherence of estimated intakes of acrylamide (AA) from foods, with hemoglobin (Hb) AA adduct levels, an objective marker of environmental AA exposure. Design: A cross-sectional study. Setting: The Malmö Diet and Cancer study, a large population-based prospective cohort (n=28 098) in the south of Sweden. Subjects: A sample of non-smoking (n=70) and smoking (n=72) women and men selected to obtain large variation in Hb AA adducts. Methods: Self-reported data on the usual consumption of foods were combined with published data on the AA content in Swedish foods. The Hb AA adduct levels were determined by a modified Edman degradation method. Linear regression and correlation analysis examined associations between estimated AA intakes, and Hb AA adducts. Results: In randomly selected individuals (n=40), the estimated median AA intake was 28 mug per day. In linear regression models, adjusting for sex, significant associations were seen in non-smokers between Hb AA adducts and estimated AA from foods (P=0.006). In smokers both AA from foods (P=0.006) and the calculated amount of tobacco consumed (P=0.003) were significantly associated with Hb AA adducts. Positive partial correlations between dietary AA estimates and Hb AA adducts were seen in smoking men (r=0.37) and women (r=0.59), and in non-smoking men (r=0.60), but not in non-smoking women. Conclusions: This study suggests that both diet and tobacco are important sources of the environmental AA exposure, although the lack of correlations in non-smoking women cast doubt on the validity of dietary AA intake estimates used in cancer epidemiology, or suggest that unrecognized factors may influence the internal dose measure of AA exposure.
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| 159. |
- Wirfält, Elisabet, et al.
(författare)
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Associations between food patterns defined by cluster analysis and colorectal cancer incidence in the NIH-AARP diet and health study.
- 2009
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Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 1476-5640 .- 0954-3007. ; 63, s. 707-717
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Tidskriftsartikel (refereegranskat)abstract
- Background/Objectives:To examine associations between food patterns, constructed with cluster analysis, and colorectal cancer incidence within the National Institutes of Health-AARP Diet and Health Study.Subjects/Methods:A prospective cohort, aged 50-71 years at baseline in 1995-1996, followed until the end of 2000. Food patterns were constructed, separately in men (n=293 576) and women (n=198 730), with 181 food variables (daily intake frequency per 1000 kcal) from a food frequency questionnaire. Four large clusters were identified in men and three in women. Cox proportional hazards regression examined associations between patterns and cancer incidence.Results:In men, a vegetable and fruit pattern was associated with reduced colorectal cancer incidence (multivariate hazard ratio, HR: 0.85; 95% confidence interval, CI: 0.76, 0.94), when compared to less salutary food choices. Both the vegetable and fruit pattern and a fat-reduced foods pattern were associated with reduced rectal cancer incidence in men. In women, a similar vegetable and fruit pattern was associated with colorectal cancer protection (age-adjusted HR: 0.82; 95% CI: 0.70, 0.95), but the association was not statistically significant in multivariate analysis.Conclusions:These results, together with findings from previous studies support the hypothesis that micronutrient dense, low-fat, high-fiber food patterns protect against colorectal cancer.European Journal of Clinical Nutrition advance online publication, 6 August 2008; doi:10.1038/ejcn.2008.40.
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| 160. |
- Wirfält, Elisabet, et al.
(författare)
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Comparison of food frequency questionnaires: the reduced Block and Willett questionnaires differ in ranking on nutrient intakes
- 1998
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Ingår i: American Journal of Epidemiology. - 0002-9262. ; 148:12, s. 1148-1156
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Tidskriftsartikel (refereegranskat)abstract
- Food frequency questionnaires, major tools in epidemiologic studies, are often criticized for biased and imprecise intake estimates. The aim of this study was to compare the performance of two widely used food frequency questionnaires, a reduced 60-item Block questionnaire and a 153-item Willett food frequency questionnaire, relative to three 24-hour recalls administered by telephone. The dietary data were collected in 1991 from a group of healthy women age 25-49 years (n=101) during the baseline period of a weight-loss intervention study in Minneapolis, Minnesota. Total energy and macro- and micronutrient intakes were compared across methods by using four analytic approaches: comparison of means and correlation coefficients, regression analysis, and estimation of percent agreement between each questionnaire and recalls. The Block instrument showed an overall underestimation bias, but was more successful in categorizing individuals on percent energy from fat and carbohydrate intakes than was the Willett instrument. The Willett instrument showed no overall underestimation bias and was more successful in classifying individuals on vitamin A and calcium intakes. Diverging performance characteristics of diet assessment methods have an implication for the design of studies, interpretation of results, and comparison of findings across studies.
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