| 1. |
- Sonestedt, Emily, et al.
(författare)
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Past food habit change is related to obesity, lifestyle and socio-economic factors in the Malmo Diet and Cancer Cohort.
- 2005
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Ingår i: Public Health Nutrition. - 1475-2727. ; 8:7, s. 876-885
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To examine if obesity status and socio-economic and lifestyle factors are associated with self-reported past food habit change, and also whether the level of obesity depends on the reason for change. Design: Cross-sectional analysis within the Malmo Diet and Cancer (MDC) study using data from the baseline examination and the extensive socio-economic and lifestyle questionnaire including questions of past food habit change. The risk of having changed food habits in the past was examined using logistic regression. Mean differences in obesity status across categories of reasons for past food habit change were examined using analysis of variance. Setting: Malmo¨, the third largest city in Sweden. Subjects: A sub-sample (15 282 women and 9867 men) from the MDC cohort recruited from 1992 to 1996. Results: Individuals with body mass index (BMI) .30 kgm22 had an increased risk of having reported past food habit change compared with individuals with BMI ,25 kgm22 (odds ratio (OR) ¼ 1.63, 95% confidence interval (CI) ¼ 1.48–1.83 for women; OR ¼ 1.53, 95% CI ¼ 1.32–1.76 for men). The highest level of obesity was observed among individuals who had changed their diet due to reasons related to the metabolic syndrome. Changers were more likely to be highly educated and to live alone, be retired, ex-smokers and non-drinkers at baseline. Conclusions: Because past food habit change is related to obesity and other lifestyle and socio-economic factors, a complex confounding situation may exist that could seriously influence observed relationships between diet and disease. Studies need to collect information on past food habit change and take this information into account in the analysis and when interpreting study outcomes.
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| 2. |
- Sonestedt, Emily
(författare)
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Plant foods, plasma enterolactone and breast cancer - with a focus on estrogen receptor status and genetic variation
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Diets high in fibre have previously been associated with decreased risk of breast cancer in the Malmö Diet and Cancer cohort. Several potent compounds may exist in high-fibre diets that might protect against breast cancer, for example lignans. Plant lignans are converted to enterolactone by the gut microflora and are similar in structure to estrogens. Enterolactone may interact with the estrogen receptors (ERs) and, therefore, inhibit the effect of estrogens. The aim of this doctoral project was to prospectively examine if plant food intakes and enterolactone blood concentrations were associated with breast cancer, and to examine if the association differed depending on ER status of the tumours or variation in the ER genes. Information (including high validity dietary data) from the Malmö Diet and Cancer cohort with baseline examinations from 1991 to 1996 was used. Among 15,773 women, 45-73 years at baseline, without prevalent cancer, 544 women were diagnosed with breast cancer until 31 December 2004. High intakes of high-fibre bread were associated with decreased risk of breast cancer. When restricting the analyses to individuals with suggested more stable food habits, a decreased breast cancer risk were also observed with high intakes of fruit, berries and vegetables. High-fibre bread and fruit and berries were the main dietary determinants of enterolactone concentration. In addition, obesity and smoking was associated with lower enterolactone concentrations. High enterolactone concentrations (>16 nmol/L) was associated with decreased breast cancer risk. When stratifying for fibre intake, a decreased breast cancer risk with high enterolactone concentration was only observed among individuals with high fibre intakes. Relatively high variation of enterolactone within and between individuals was observed; the association between enterolactone and risk of breast cancer is likely attenuated. The reduced breast cancer risk with high enterolactone concentrations was only observed for ERα-positive and ERβ-negative tumours. Breast cancer risk was not significantly associated with any of the selected polymorphisms in the ERα and ERβ genes. However, the protective effect of high enterolactone concentration was seen in subgroups of the individuals with specific genetic variants, and a tendency towards an interaction between a polymorphism in intron 3 of the ERα gene and enterolactone concentrations was observed. In conclusion, a high-fibre diet including high-fibre bread, fruit, berries and vegetables will likely reduce the risk of breast cancer in middle aged and older women. The protective effect of a high-fibre diet might be due to its content of lignans.
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| 3. |
- Cust, A. E., et al.
(författare)
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Total dietary carbohydrate, sugar, starch and fibre intakes in the European Prospective Investigation into Cancer and Nutrition
- 2009
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Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 1476-5640 .- 0954-3007. ; 63:4s, s. 37-60
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe dietary carbohydrate intakes and their food sources among 27 centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Between 1995 and 2000, 36 034 subjects, aged between 35-74 years, were administered a standardized, 24-h dietary recall using a computerized interview software programme (EPIC-SOFT). Intakes (g/day) of total carbohydrate, sugars, starch and fibre were estimated using the standardized EPIC Nutrient Database (ENDB). Mean intakes were adjusted for age, total energy intake, height and weight, and were weighted by season and day of recall. Results: Adjusted mean total carbohydrate intakes were highest in Italy and in the UK health-conscious cohort, and were lowest in Spain, Greece and France. Total fibre intakes were highest in the UK health-conscious cohort and lowest in Sweden and the UK general population. Bread contributed the highest proportion of carbohydrates (mainly starches) in every centre. Fruit consumption contributed a greater proportion of total carbohydrates (mainly sugars) among women than among men, and in southern centres compared with northern centres. Bread, fruits and vegetables represented the largest sources of fibre, but food sources varied considerably between centres. In stratified analyses, carbohydrate intakes tended to be higher among subjects who were physically active, never-smokers or non-drinkers of alcohol. Conclusions: Dietary carbohydrate intakes and in particular their food sources varied considerably between these 10 European countries. Intakes also varied according to gender and lifestyle factors. These data will form the basis for future aetiological analyses of the role of dietary carbohydrates in influencing health and disease. European Journal of Clinical Nutrition (2009) 63, S37-S60; doi: 10.1038/ejcn.2009.74
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| 4. |
- Ericson, Ulrika, et al.
(författare)
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Folate intake, methylenetetrahydrofolate reductase polymorphisms, and breast cancer risk in women from the Malmö Diet and Cancer cohort.
- 2009
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Ingår i: Cancer Epidemiology Biomarkers & Prevention. - 1538-7755. ; 18:4, s. 1101-1110
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Single nucleotide polymorphisms (SNP) of the folate-metabolizing enzyme methylenetetrahydrofolate reductase (MTHFR) may modify associations between folate intake and breast cancer. We examined if the association between tertiles of dietary folate equivalents (DFE) and breast cancer was different in subgroups according to genotypes of the MTHFR 677 C>T (rs1801133) and 1298A>C (rs1801131) SNPs and if the polymorphisms per se were associated with breast cancer. METHODS: This nested case-control study included 544 incident cases with invasive breast cancer and 1,088 controls matched on age and blood sampling date from the population-based Malmö Diet and Cancer cohort. Genotyping of the MTHFR SNPs was done with PCR-based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Odds ratios (OR) were obtained by unconditional logistic regression. RESULTS: DFE was positively associated with breast cancer in MTHFR 677CT/TT-1298AA women (P for trend = 0.01) but inversely associated in compound heterozygous women (P for trend = 0.01). Interaction was observed between DFE and the 1298C allele (P = 0.03). The 677T allele was associated with increased breast cancer risk in women above 55 years [multivariate adjusted OR, 1.34; 95% confidence interval (95% CI), 1.01-1.76] and an interaction was observed between the T allele and age (P = 0.03). Homozygosis for the 1298C allele was associated with increased risk in women between 45 and 55 years (multivariate adjusted OR, 1.89; 95% CI, 1.09-3.29). CONCLUSION: In conclusion, a positive association between DFE and breast cancer was observed in MTHFR 677CT/TT-1298AA women but an inverse association was observed in 677CT-1298AC women. The 677T allele was associated with higher breast cancer risk in women above 55 years of age.
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| 5. |
- Ericson, Ulrika, et al.
(författare)
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High folate intake is associated with lower breast cancer incidence in postmenopausal women in the Malmö Diet and Cancer cohort
- 2007
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Ingår i: American Journal of Clinical Nutrition. - 0002-9165 .- 1938-3207. ; 86:2, s. 43-434
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Epidemiologic studies of associations between folate intake and breast cancer are inconclusive, but folate and other plant food nutrients appear protective in women at elevated risk.OBJECTIVE: The objective was to examine the association between folate intake and the incidence of postmenopausal breast cancer.DESIGN: This prospective study included all women aged >or=50 y (n = 11699) from the Malmö Diet and Cancer cohort. The mean follow-up time was 9.5 y. We used a modified diet-history method to collect nutrient intake data. At the end of follow-up, 392 incident invasive breast cancer cases were verified. We used proportional hazard regression to calculate hazard ratios (HRs).RESULTS: Compared with the lowest quintile, the incidence of invasive breast cancer was reduced in the highest quintile of dietary folate intake (HR: 0.56; 95% CI: 0.35, 0.90; P for trend = 0.02); total folate intake, including supplements (HR: 0.56; 95% CI: 0.34, 0.91; P for trend = 0.006); and dietary folate equivalents (HR: 0.59; 95% CI: 0.36, 0.97; P for trend = 0.01).CONCLUSION: A high folate intake was associated with a lower incidence of postmenopausal breast cancer in this cohort.
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| 6. |
- Ericson, Ulrika, et al.
(författare)
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Increased breast cancer risk at high plasma folate concentrations among women with the MTHFR 677T allele.
- 2009
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Ingår i: The American journal of clinical nutrition. - : Elsevier BV. - 1938-3207 .- 0002-9165. ; 90, s. 1380-1389
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Folate is involved in DNA synthesis and methylation and may thereby influence carcinogenesis. OBJECTIVES: We examined plasma folate (P-folate) concentration in relation to genotypes of the folate-metabolizing enzyme methylenetetrahydrofolate reductase [MTHFR 677C<--T (rs1801133) and 1298A<--C (rs1801131)]. We also explored whether P-folate was associated with risk of postmenopausal breast cancer overall and in subgroups with genetic variants of the MTHFR single nucleotide polymorphisms (SNPs). DESIGN: This nested case-control study included 313 cases (age 55-73 y at baseline) with invasive breast cancer and 626 control subjects, matched on age and blood-sample date, from the population-based Malmö Diet and Cancer cohort. P-folate and MTHFR genotypes were determined for 310 cases and 611 controls. P-folate according to genotype was calculated by using analysis of variance. Odds ratios were obtained by using logistic regression. All tests were 2-sided. RESULTS: The variant 677T allele was associated with lower P-folate. In women with the 677T allele, a high P-folate concentration was associated with increased breast cancer risk (P for trend across P-folate tertiles = 0.03). Interaction was seen between the 677C<--T SNP and P-folate (P = 0.002). A positive association, which was seen between P-folate and breast cancer risk in 1298AA women (P = 0.01), was probably due to linkage between the 2 SNPs. Overall, and in women with other genotypes, no significant associations were observed. CONCLUSIONS: Our results suggest an association of high P-folate concentration with increased risk of postmenopausal breast cancer in carriers of the 677T allele. The findings underline the importance of genetic variation of MTHFR in the complex relation between folate and cancer.
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| 7. |
- Linseisen, J., et al.
(författare)
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Dietary fat intake in the European Prospective Investigation into Cancer and Nutrition: results from the 24-h dietary recalls
- 2009
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Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 1476-5640 .- 0954-3007. ; 63:4s, s. 61-80
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This paper describes the dietary intake of total fat, saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA) and cholesterol of participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) in 27 centres across 10 countries. Methods: Between 1995 and 2000, a stratified random sample of 36 034 participants (age range 35-74 years) completed a standardized 24-h dietary recall, assessed by means of the computer software EPIC-SOFT. Lipid intake data were calculated using a standardized nutrient database. Results: On average, the contribution of fat to total energy intake was >= 34% of energy intake (% en) in women and >= 36% en in men for most EPIC centres, except for the British, Dutch and most Italian cohorts. Total fat (> 40% en) and MUFA intakes (21% en, mainly from olive oil) were highest in Greece. Except for the Greek, Spanish and Italian centres, the average MUFA intake ranged between 10 and 13% en, with a high proportion derived from animal sources. SFA intake in women and men was lowest in the Greek, Spanish, Italian and UK cohorts with an average of <= 13% en (down to 9% en), and highest in the Swedish centres (16% en). The mean PUFA intake was in the range of 4-8% en, being highest in the UK health-conscious cohort. The average cholesterol intake across EPIC varied from 140 to 384 mg/d in women and 215-583 mg/d in men. Conclusions: The presented data show differences and similarities in lipid intake across the European EPIC cohorts and also show differences in food sources of dietary lipids. European Journal of Clinical Nutrition (2009) 63, S61-S80; doi: 10.1038/ejcn.2009.75
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| 8. |
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| 9. |
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| 10. |
- Sonestedt, Emily, et al.
(författare)
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Both food habit change in the past and obesity status may influence the association between dietary factors and postmenopausal breast cancer
- 2007
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Ingår i: Public Health Nutrition. - 1475-2727. ; 10:8, s. 769-779
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Valid dietary data are essential when trying to identify whether or not one or more dietary exposures are responsible for disease. We examined diet composition in women who reported dietary change in the past compared with non-changers, and how the associations between dietary factors and postmenopausal breast cancer are influenced by dietary change, obesity status and misreporting of energy. Design: A population-based prospective cohort Study. Data were obtained by a diet history method, anthropometrical measurements and an extensive lifestyle questionnaire including items on past food habit change. Setting: The Malmo Diet and Cancer (MDC) study, conducted in Malmo, Sweden. Subjects: A subsample of 12 781 women from the MDC cohort recruited from 1991 to 1996. A total of 428 postmenopausal women were diagnosed with incident breast cancer, during 9.2 years of follow-up. Results: Past food habit changers reported healthier food habits and lower energy intake compared with non-changers, a finding that raises issues regarding possible reporting biases. When excluding diet changers, the trend of increased breast cancer risk across omega-6 fatty acid quintiles was stronger, and a tendency of decreased risk emerged for 'fruit, berries and vegetables'. When excluding individuals with non-adequate reports of energy intake, risk estimates were similar to that of the whole sample. In women with body mass index < 27kg m(-2) significant trends of increased breast cancer risk were seen for total fat and omega-6 fatty acids, and of decreased risk for 'fruit, berries and vegetables. Conclusions: This study indicates that both obesity and self-reported past food habit change may be important confounders of diet-breast cancer relationships. The study demonstrates that sensitivity analysis, through stratification, may facilitate interpretation of risk relationships and study results.
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