| 11. |
- Slimani, N, et al.
(författare)
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Diversity of dietary patterns observed in the European Prospective Investigation into Cancer and Nutrition (EPIC) project
- 2002
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Ingår i: Public Health Nutrition. - 1475-2727. ; 5:6B, s. 1311-1328
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Tidskriftsartikel (refereegranskat)abstract
- Objective.. To describe the diversity in dietary patterns existing across centres/regions participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). Design and setting.. Single 24-hour dietary recall measurements were obtained by means of standardised face-to-face interviews using the EPIC-SOFT software. These have been used to present a graphic multi-dimensional comparison of the adjusted mean consumption of 22 food groups. Subjects: In total, 35 955 men and women, aged 35-74 years, participating in the EPIC nested calibration study. Results.. Although wide differences were observed across centres, the countries participating in EPIC are characterised by specific dietary patterns. Overall, Italy and Greece have a dietary pattern characterised by plant foods (except potatoes) and a lower consumption of animal and processed foods, compared with the other EPIC countries. France and particularly Spain have more heterogeneous dietary patterns, with a relatively high consumption of both plant foods and animal products. Apart from characteristics specific to vegetarian groups, the UK 'health-conscious' group shares with the UK general population a relatively high consumption of tea, sauces, cakes, soft drinks (women), margarine and butter. In contrast, the diet in the Nordic countries, The Netherlands, Germany and the UK general population is relatively high in potatoes and animal, processed and sweetened/refined foods, with proportions varying across countries/centres. In these countries, consumption of vegetables and fruit is similar to, or below, the overall EPIC means, and is low for legumes and vegetable oils. Overall, dietary patterns were similar for men and women, although there were large gender differences for certain food groups. Conclusions: There are considerable differences in food group consumption and dietary patterns among the EPIC study populations. This large heterogeneity should be an advantage when investigating the relationship between diet and cancer and formulating new aetiological hypotheses related to dietary patterns and disease.
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| 12. |
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| 13. |
- Wallstrom, P, et al.
(författare)
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Serum concentrations of beta-carotene and alpha-tocopherol are associated with diet, smoking, and general and central adiposity
- 2001
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Ingår i: American Journal of Clinical Nutrition. - 1938-3207. ; 73:4, s. 777-785
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous studies of associations between diet, obesity, and blood concentrations of alpha-tocopherol and beta-carotene have been equivocal. Furthermore, most studies used only body mass index (BMI) as an obesity measure. OBJECTIVES: Our objectives were to examine the associations between energy and nutrient intakes, alcohol consumption, tobacco use, and serum cholesterol and serum concentrations of alpha-tocopherol and beta-carotene, and to examine the associations between different measures of general and central adiposity and serum concentrations of alpha-tocopherol and beta-carotene. DESIGN: This was a cross-sectional, population-based study of 253 men and 276 women aged 46-67 y. Nutrient data were collected by a modified diet history method. Measures of obesity included BMI, percentage of body fat (impedance analysis), waist-to-hip ratio, and waist circumference. The associations between serum nutrient concentrations and the other factors were examined by multiple linear regression. RESULTS: Twenty-one percent of men and 34% of women used antioxidant supplements. The mean BMI was 26.1 in men and 25.4 in women. Serum beta-carotene concentration was positively associated with serum cholesterol concentration, fiber intake, and beta-carotene intake, and negatively associated with smoking and all measures of obesity. In men, serum beta-carotene concentration was not significantly associated with central adiposity after adjustment for body fat. Serum alpha-tocopherol concentration was positively correlated with serum cholesterol, obesity, and vitamin E intake. In women, serum alpha-tocopherol concentration was also positively associated with intakes of ascorbic acid and selenium. Serum alpha-tocopherol concentration was associated with central adiposity after adjustment for body fat. CONCLUSION: Serum beta-carotene and alpha-tocopherol concentrations have different associations with diet, smoking, general adiposity, and central adiposity.
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| 14. |
- Wallström, Peter, et al.
(författare)
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Antibodies against 5-Hydroxymethyl-2'-deoxyuridine Are Associated with Lifestyle Factors and GSTM1 Genotype: A Report from the Malmö Diet and Cancer Cohort.
- 2003
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Ingår i: Cancer Epidemiology Biomarkers & Prevention. - 1538-7755. ; 12:5, s. 444-451
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Tidskriftsartikel (refereegranskat)abstract
- Plasma autoantibodies (aAbs) against the oxidized DNA base derivative 5-hydroxymethyl-2'-deoxyuridine (5-HMdU) are potential biomarkers of cancer risk and oxidative stress. We examined their association with a number of cancer risk factors: smoking, alcohol habits, body fatness, and absence of the glutathione S-transferases M1 and T1 (GSTM1 and GSTT1) in a sample from the population-based Malmö Diet and Cancer cohort (Sweden). This was a cross-sectional study of 264 men and 280 women, 46–67 years of age. Anti-5-HMdU aAb concentration was determined by an ELISA. Data on tobacco exposure were collected through a questionnaire. Alcohol consumption was estimated by a modified diet history method. Body fatness was assessed by a bioimpedance method. The absence or presence of genes coding for GSTM1 and GSTT1 was determined in granulocyte DNA by a multiplex PCR technique. aAb titers were significantly greater in those with high alcohol consumption. Current smokers lacking GSTM1, particularly men, had greater aAb titers compared with nonsmokers or persons expressing GSTM1. Body fatness was inversely associated with antibody titers in men. GSTT1 genotype was not associated with aAb titers. Overall, women had higher aAb titers than men. Adjustment for potential confounders (history of chronic diseases, anti-inflammatory medication, and season of blood sampling) did not change the results. Our study shows that a high alcohol consumption, smoking in combination with lack of GSTM1, and low body fatness (in men) is associated with high titers of anti-5-HMdU aAbs in this population.
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| 15. |
- 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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| 16. |
- 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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| 17. |
- 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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| 18. |
- Wirfält, Elisabet, et al.
(författare)
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Food patterns and components of the metabolic syndrome in men and women: a cross-sectional study within the Malmo Diet and Cancer cohort
- 2001
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Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 154:12, s. 1150-1159
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Tidskriftsartikel (refereegranskat)abstract
- This study examined the relations between food patterns and five components of the metabolic syndrome in a sample of Swedish men (n = 2,040) and women (n = 2,959) aged 45-68 years who joined the Malmo Diet and Cancer study from November 1991 to February 1994. Baseline examinations included an interview-administered diet history, a self-administered questionnaire, blood pressure and anthropologic measurements, and blood samples donated after an overnight fast. Cluster analysis identified six food patterns for which 43 food group variables were used. Logistic regression analysis was used to examine the risk of each component (hyperinsulinemia, hyperglycemia, hypertension, dyslipidemia, and central obesity) and food patterns, controlling for potential confounders. The study demonstrated relations, independent of specific nutrients, between food patterns and hyperglycemia and central obesity in men and hyperinsulinemia in women. Food patterns dominated by fiber bread provided favorable effects, while food patterns high in refined bread or in cheese, cake, and alcoholic beverages contributed adverse effects. In women, food patterns dominated by milk-fat-based spread showed protective relations with hyperinsulinemia. Relations between risk factors and food patterns may partly depend on gender differences in metabolism or food consumption and on variations in confounders across food patterns.
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| 19. |
- Wirfält, Elisabet, et al.
(författare)
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Food patterns defined by cluster analysis and their utility as dietary exposure variables: a report from the Malmo Diet and Cancer Study
- 2000
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Ingår i: Public Health Nutrition. - 1475-2727. ; 3:2, s. 159-173
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore the utility of cluster analysis in defining complex dietary exposures, separately with two types of variables. DESIGN:: A modified diet history method, combining a 7-day menu book and a 168-item questionnaire, assessed dietary habits. A standardized questionnaire collected information on sociodemographics, lifestyle and health history. Anthropometric information was obtained through direct measurements. The dietary information was collapsed into 43 generic food groups, and converted into variables indicating the per cent contribution of specific food groups to total energy intake. Food patterns were identified by the QUICK CLUSTER procedure in SPSS, in two separate analytical steps using unstandardized and standardized (Z-scores) clustering variables. SETTING:: The Malmo Diet and Cancer (MDC) Study, a prospective study in the third largest city of Sweden, with baseline examinations from March 1991 to October 1996. SUBJECTS: A random sample of 2206 men and 3151 women from the MDC cohort (n = 28 098). RESULTS: Both variable types produced conceptually well separated clusters, confirmed with discriminant analysis. 'Healthy' and 'less healthy' food patterns were also identified with both types of variables. However, nutrient intake differences across clusters were greater, and the distribution of the number of individuals more even, with the unstandardized variables. Logistic regression indicated higher risks of past food habit change, underreporting of energy and higher body mass index (BMI) for individuals falling into 'healthy' food pattern clusters. CONCLUSIONS: The utility in discriminating dietary exposures appears greater for unstandardized food group variables. Future studies on diet and cancer need to recognize the confounding factors associated with 'healthy' food patterns.
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| 20. |
- Wirfält, Elisabet, et al.
(författare)
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Food sources of carbohydrates in a European cohort of adults.
- 2002
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Ingår i: Public Health Nutrition. - 1475-2727. ; 5:6B, s. 1197-1215
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe the average consumption of carbohydrate-providing food groups among study centres of the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Of the 27 redefined EPIC study centres, 19 contributed subjects of both genders and eight centres female participants only (men, n=13 031; women, n=22 924, after exclusion of subjects under 35 and over 74 years of age from the original 36 900 total). Dietary data were obtained using the 24-hour recall methodology using the EPIC-SOFT software. The major sources of dietary carbohydrate were identified, and 16 food groups were examined. Results: The 10 food groups contributing most carbohydrate were bread; fruit; milk and milk products; sweet buns, cakes and pies; potato; sugar and jam; pasta and rice; vegetables and legumes; crispbread; and fruit and vegetable juices. Consumption of fruits as well as vegetables and legumes was higher in southern compared with northern centres, while soft drinks consumption was higher in the north. Italian centres had high pasta and rice consumption, but breakfast cereal, potato, and sweet buns, cakes and pies were higher in northern centres. In Sweden, lower bread consumption was balanced with a higher consumption of crispbread, and with sweet buns, cakes and pies. Overall, men consumed higher amounts of vegetables and legumes, bread, soft drinks, potatoes, pasta and rice, breakfast cereal and sugar and jam than women, but fruit consumption appeared more frequent in women. Conclusion: The study supports the established idea that carbohydrate-rich foods chosen in northern Europe are different from those in the Mediterranean region. When comparing and interpreting diet-disease relationships across populations, researchers need to consider all types of foods.
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