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31.
  • Zamora-Ros, Raul, et al. (författare)
  • Dietary flavonoid intake and colorectal cancer risk in the European prospective investigation into cancer and nutrition (EPIC) cohort
  • 2017
  • Ingår i: International Journal of Cancer. - John Wiley and Sons Inc.. - 0020-7136. ; 140:8, s. 1836-1844
  • Tidskriftsartikel (refereegranskat)abstract
    • Flavonoids have been shown to inhibit colon cancer cell proliferation in vitro and protect against colorectal carcinogenesis in animal models. However, epidemiological evidence on the potential role of flavonoid intake in colorectal cancer (CRC) development remains sparse and inconsistent. We evaluated the association between dietary intakes of total flavonoids and their subclasses and risk of development of CRC, within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A cohort of 477,312 adult men and women were recruited in 10 European countries. At baseline, dietary intakes of total flavonoids and individual subclasses were estimated using centre-specific validated dietary questionnaires and composition data from the Phenol-Explorer database. During an average of 11 years of follow-up, 4,517 new cases of primary CRC were identified, of which 2,869 were colon (proximal = 1,298 and distal = 1,266) and 1,648 rectal tumours. No association was found between total flavonoid intake and the risk of overall CRC (HR for comparison of extreme quintiles 1.05, 95% CI 0.93–1.18; p-trend = 0.58) or any CRC subtype. No association was also observed with any intake of individual flavonoid subclasses. Similar results were observed for flavonoid intake expressed as glycosides or aglycone equivalents. Intake of total flavonoids and flavonoid subclasses, as estimated from dietary questionnaires, did not show any association with risk of CRC development.
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32.
  • Zamora-Ros, Raul, et al. (författare)
  • Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study
  • 2013
  • Ingår i: International Journal of Cancer. - John Wiley and Sons Inc.. - 0020-7136. ; 133:10, s. 2429-2443
  • Tidskriftsartikel (refereegranskat)abstract
    • Limited epidemiological evidence suggests a protective role for plant foods rich in flavonoids and antioxidants in hepatocellular cancer (HCC) etiology. Our aim was to prospectively investigate the association between dietary intake of flavonoids, lignans and nonenzymatic antioxidant capacity (NEAC) and HCC risk. Data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 477,206 subjects (29.8% male) recruited from ten Western European countries, was analyzed. Flavonoid, lignan and NEAC intakes were calculated using a compilation of existing food composition databases linked to dietary information from validated dietary questionnaires. Dietary NEAC was based on ferric reducing antioxidant capacity (FRAP) and total radical-trapping antioxidant parameter (TRAP). Hepatitis B/C status was measured in a nested case-control subset. During a mean follow-up of 11-years, 191 incident HCC cases (66.5% men) were identified. Using Cox regression, multivariable adjusted models showed a borderline nonsignificant association of HCC with total flavonoid intake (highest versus lowest tertile, HR=0.65, 95% CI: 0.40-1.04; p(trend)=0.065), but not with lignans. Among flavonoid subclasses, flavanols were inversely associated with HCC risk (HR=0.62, 95% CI: 0.39-0.99; p(trend)=0.06). Dietary NEAC was inversely associated with HCC (FRAP: HR 0.50, 95% CI: 0.31-0.81; p(trend)=0.001; TRAP: HR 0.49, 95% CI: 0.31-0.79; p(trend)=0.002), but statistical significance was lost after exclusion of the first 2 years of follow-up. This study suggests that higher intake of dietary flavanols and antioxidants may be associated with a reduced HCC risk. What's new? Coffee, tea, fruits and vegetables, and certain other foods may protect against hepatocellular carcinoma (HCC), thanks to their antioxidant ingredients. This study lends fresh support to that idea, revealing specifically that dietary flavanols, which possess antioxidant activity, could play a favourable role in HCC prevention. Dietary antioxidant capacity from coffee intake in particular was found to be inversely associated with HCC risk, though statistical significance was lost after exclusion of the first two years of follow-up. Assessment of the bioavailability of flavonoids and other antioxidants is needed to confirm links between antioxidant intake and HCC risk.
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33.
  • Zamora-Ros, Raul, et al. (författare)
  • Dietary intake of total polyphenol and polyphenol classes and the risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort
  • 2018
  • Ingår i: European Journal of Epidemiology. - Springer. - 0393-2990. ; 33:11, s. 1063-1075
  • Tidskriftsartikel (refereegranskat)abstract
    • Polyphenols may play a chemopreventive role in colorectal cancer (CRC); however, epidemiological evidence supporting a role for intake of individual polyphenol classes, other than flavonoids is insufficient. We evaluated the association between dietary intakes of total and individual classes and subclasses of polyphenols and CRC risk and its main subsites, colon and rectum, within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The cohort included 476,160 men and women from 10 European countries. During a mean follow-up of 14 years, there were 5991 incident CRC cases, of which 3897 were in the colon and 2094 were in the rectum. Polyphenol intake was estimated using validated centre/country specific dietary questionnaires and the Phenol-Explorer database. In multivariable-adjusted Cox regression models, a doubling in total dietary polyphenol intake was not associated with CRC risk in women (HRlog2 = 1.06, 95% CI 0.99–1.14) or in men (HRlog2 = 0.97, 95% CI 0.90–1.05), respectively. Phenolic acid intake, highly correlated with coffee consumption, was inversely associated with colon cancer in men (HRlog2 = 0.91, 95% CI 0.85–0.97) and positively associated with rectal cancer in women (HRlog2 = 1.10, 95% CI 1.02–1.19); although associations did not exceed the Bonferroni threshold for significance. Intake of other polyphenol classes was not related to colorectal, colon or rectal cancer risks. Our study suggests a possible inverse association between phenolic acid intake and colon cancer risk in men and positive with rectal cancer risk in women.
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34.
  • Zimmermann, E., et al. (författare)
  • Is the adiposity-associated FTO gene variant related to all-cause mortality independent of adiposity? Meta-analysis of data from 169,551 Caucasian adults
  • 2015
  • Ingår i: Obesity Reviews. - Wiley-Blackwell. - 1467-7881. ; 16:4, s. 327-340
  • Tidskriftsartikel (refereegranskat)abstract
    • Previously, a single nucleotide polymorphism (SNP), rs9939609, in the FTO gene showed a much stronger association with all-cause mortality than expected from its association with body mass index (BMI), body fat mass index (FMI) and waist circumference (WC). This finding implies that the SNP has strong pleiotropic effects on adiposity and adiposity-independent pathological pathways that leads to increased mortality. To investigate this further, we conducted a meta-analysis of similar data from 34 longitudinal studies including 169,551 adult Caucasians among whom 27,100 died during follow-up. Linear regression showed that the minor allele of the FTO SNP was associated with greater BMI (n=169,551; 0.32kgm(-2); 95% CI 0.28-0.32, P<1x10(-32)), WC (n=152,631; 0.76cm; 0.68-0.84, P<1x10(-32)) and FMI (n=48,192; 0.17kgm(-2); 0.13-0.22, P=1.0x10(-13)). Cox proportional hazard regression analyses for mortality showed that the hazards ratio (HR) for the minor allele of the FTO SNPs was 1.02 (1.00-1.04, P=0.097), but the apparent excess risk was eliminated after adjustment for BMI and WC (HR: 1.00; 0.98-1.03, P=0.662) and for FMI (HR: 1.00; 0.96-1.04, P=0.932). In conclusion, this study does not support that the FTO SNP is associated with all-cause mortality independently of the adiposity phenotypes.
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35.
36.
  • Alsharari, Zayed (författare)
  • Dietary Intake, Fatty Acid Biomarkers, and Abdominal Obesity Population-Based Observational Studies
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p>The aim of this thesis was to investigate the associations between fatty acid (FA) biomarkers, carbohydrate intake, and abdominal obesity (AO) and related anthropometric measures in a population-based cohort of men and women in Stockholm County. The overall hypothesis was that dietary fat quality assessed by serum and adipose tissue FA composition, and dietary intake of especially carbohydrates is associated with AO. FA composition was assessed by liquid gas chromatography, and AO was measured as waist circumference (WC), waist hip ratio (WHR) and sagittal abdominal diameter (SAD). Dietary intake was assessed by 7-day food records.</p><p>Papers I, II, III, and IV were all observational studies based on a Swedish population in Stockholm County (n=5460). A sub-cohort of only men (n=301) was included in Papers II, III, and IV.</p><p>In Paper I, serum proportions of the polyunsaturated FA (PUFA), linoleic acid (LA) (18:2n6), was inversely associated with AO in both men and women, whereas a positive association was observed between the saturated FA (SFA), palmitic acid (PA) (16:0) and AO measures. These findings support recent interventional studies suggesting that a higher relative intake of PUFA (LA) from vegetable oils as compared with 16:0 is associated with decreased abdominal adiposity.</p><p>In Paper II, we investigated whether biomarkers of dietary fat quality were related to the corresponding FA intake from fat-rich foods reported in a short food frequency questionnaire (FFQ). Serum proportions of the long-chain n-3 PUFAs eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA) were higher among men with higher total fish intake. Serum LA was higher among men who reported a consumption of more than 5 g/d of margarine. Absolute agreement between intakes assessed with FFQ of 60YO and 7-day food record of "Kost och Metabola syndromet"/"Diet and the Metabolic syndrome" (KOMET) was highest for alcohol, total fish, and eggs. Weighted Kappa statistics revealed the strongest agreement for alcohol, margarine, and fruits.</p><p>In Paper III, carbohydrate intake was inversely associated with 16:0 in serum phospholipids (PL). Disaccharide and alcohol intake was positively and non-linearly associated with palmitoleic acid (16:1) and stearoyl-CoA-desaturase (SCD) activity in PL. Alcohol was consistently associated with higher SFA and monounsaturated FA (MUFA).</p><p>Results of Paper IV indicated that total carbohydrate intake was inversely associated with measures of AO and central fat distribution, WHR and SAD, respectively. Likewise, monosaccharide intake was associated with lower AO. In contrast, alcohol intake was associated with AO prevalence and all anthropometric measurements.</p><p>In conclusion, serum SFA (palmitic acid) was positively associated with AO, whereas n-6 PUFA (linoleic acid) was associated with lower AO. High intake of total carbohydrate and monosaccharides were associated with lower AO. Overall, these results support a beneficial role on adiposity of diets that are higher in polyunsaturated fat (vegetable oils) and total carbohydrates compared with saturated fat.</p>
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37.
  • Bakker, Marije F., et al. (författare)
  • Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort
  • 2016
  • Ingår i: American Journal of Clinical Nutrition. - 0002-9165 .- 1938-3207. ; 103:2, s. 454-464
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>Background:</strong> Carotenoids and vitamin C are thought to be associated with reduced cancer risk because of their antioxidative capacity.</p><p><strong>Objective:</strong> This study evaluated the associations of plasma carotenoid, retinol, tocopherol, and vitamin C concentrations and risk of breast cancer.</p><p><strong>Design:</strong> In a nested case-control study within the European Prospective Investigation into Cancer and Nutrition cohort, 1502 female incident breast cancer cases were included, with an oversampling of premenopausal (n = 582) and estrogen receptor-negative (ER-) cases (n = 462). Controls (n = 1502) were individually matched to cases by using incidence density sampling. Prediagnostic samples were analyzed for alpha-carotene, beta-carotene, lycopene, lutein, zeaxanthin, beta-cryptoxanthin, retinol, alpha-tocopherol, gamma-tocopherol, and 454 vitamin C. Breast cancer risk was computed according to hormone receptor status and age at diagnosis (proxy for menopausal status) by using conditional logistic regression and was further stratified by smoking status, alcohol consumption, and body mass index (BMI). All statistical tests were 2-sided.</p><p><strong>Results:</strong> In quintile 5 compared with quintile 1, alpha-carotene (OR: 0.61; 95% CI: 0.39, 0.98) and beta-carotene (OR: 0.41; 95% CI: 0.26, 0.65) were inversely associated with risk of ER- breast tumors. The other analytes were not statistically associated with ER- breast cancer. For estrogen receptor-positive (ER+) tumors, no statistically significant associations were found. The test for heterogeneity between ER- and ER+ tumors was statistically significant only for beta-carotene (P-heterogeneity = 0.03). A higher risk of breast cancer was found for retinol in relation to ER-/progesterone receptor-negative tumors (OR: 2.37; 95% CI: 1.20, 4.67; P-heterogeneity with ER+/progesterone receptor positive = 0.06). We observed no statistically significant interaction between smoking, alcohol, or BMI and all investigated plasma analytes (based on tertile distribution).</p><p><strong>Conclusion:</strong> Our results indicate that higher concentrations of plasma beta-carotene and alpha-carotene are associated with lower breast cancer risk of ER tumors.</p>
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38.
  • Baumeister, Sebastian E., et al. (författare)
  • Association between physical activity and risk of hepatobiliary cancers : A multinational cohort study
  • 2019
  • Ingår i: Journal of Hepatology. - 0168-8278 .- 1600-0641. ; 70:5, s. 885-892
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background &amp; Aims: To date, evidence on the association between physical activity and risk of hepatobiliary cancers has been inconclusive. We examined this association in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC).</p><p>Methods: We identified 275 hepatocellular carcinoma (HCC) cases, 93 intrahepatic bile duct cancers (IHBCs), and 164 non-gallbladder extrahepatic bile duct cancers (NGBCs) among 467,336 EPIC participants (median follow-up 14.9 years). We estimated cause-specific hazard ratios (HRs) for total physical activity and vigorous physical activity and performed mediation analysis and secondary analyses to assess robustness to confounding (<em>e.g.</em> due to hepatitis virus infection).</p><p>Results: In the EPIC cohort, the multivariable-adjusted HR of HCC was 0.55 (95% CI 0.38–0.80) comparing active and inactive individuals. Regarding vigorous physical activity, for those reporting &gt;2 hours/week compared to those with no vigorous activity, the HR for HCC was 0.50 (95% CI 0.33–0.76). Estimates were similar in sensitivity analyses for confounding. Total and vigorous physical activity were unrelated to IHBC and NGBC. In mediation analysis, waist circumference explained about 40% and body mass index 30% of the overall association of total physical activity and HCC.</p><p>Conclusions: These findings suggest an inverse association between physical activity and risk of HCC, which is potentially mediated by obesity.</p><p>Lay summary: In a pan-European study of 467,336 men and women, we found that physical activity is associated with a reduced risk of developing liver cancers over the next decade. This risk was independent of other liver cancer risk factors, and did not vary by age, gender, smoking status, body weight, and alcohol consumption.</p>
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39.
  • Bentham, James, et al. (författare)
  • A century of trends in adult human height
  • 2016
  • Ingår i: eLife. - 2050-084X. ; 5
  • Tidskriftsartikel (refereegranskat)abstract
    • Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5-22.7) and 16.5 cm (13.3- 19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8- 144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
40.
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