Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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Dietary supplement use and colorectal cancer risk: A systematic review and meta-analyses of prospective cohort studies
Heine-Bröring, R.C. ; Winkels, R.M. ; Renkema, J.M.S. ; Kragt, L. ; Orten-Luiten, A.C.B. van; Tigchelaar, E.F. ; Chan, D.S.M. ; Norat, T. ; Kampman, E. - \ 2015
International Journal of Cancer 136 (2015)10. - ISSN 0020-7136 - p. 2388 - 2401.
beta-carotene supplementation - base-line characteristics - iowa womens health - combined folic-acid - colon-cancer - vitamin-d - multivitamin use - united-states - life-style - randomized-trial
Use of dietary supplements is rising in countries where colorectal cancer is prevalent. We conducted a systematic literature review and meta-analyses of prospective cohort studies on dietary supplement use and colorectal cancer risk. We identified relevant studies in Medline, Embase and Cochrane up to January 2013. Original and peer-reviewed papers on dietary supplement use and colorectal cancer, colon cancer, or rectal cancer incidence were included. “Use-no use”(U-NU), “highest-lowest”(H-L) and “dose-response”(DR) meta-analyses were performed. Random-effects models were used to estimate summary estimates. In total, 24 papers were included in the meta-analyses. We observed inverse associations for colorectal cancer risk and multivitamin (U-NU: RR¿=¿0.92; 95% CI: 0.87,0.97) and calcium supplements (U-NU: RR¿=¿0.86; 95% CI: 0.79,0.95; H-L: RR¿=¿0.80; 95% CI: 0.70,0.92; DR: for an increase of 100 mg/day, RR¿=¿0.96; 95% CI: 0.94,0.99). Inconsistent associations were found for colon cancer risk and supplemental vitamin A and vitamin C, and for colorectal cancer risk and supplemental vitamin D, vitamin E, garlic and folic acid. Meta-analyses of observational studies suggest a beneficial role for multivitamins and calcium supplements on colorectal cancer risk, while the association with other supplements and colorectal cancer risk is inconsistent. Residual confounding of lifestyle factors might be present. Before recommendations can be made, an extensive assessment of dietary supplement use and a better understanding of underlying mechanisms is needed.
Red and processed meat intake and risk of colorectal adenomas: a systematic review and meta-analysis of epidemiological studies
Aune, D. ; Chan, D.S.M. ; Vieira, A. ; Navarro Rosenblatt, D. ; Vieira, R. ; Greenwood, D.C. ; Kampman, E. ; Norat, T. - \ 2013
Cancer Causes and Control 24 (2013)4. - ISSN 0957-5243 - p. 611 - 627.
dose-response metaanalysis - heterocyclic amines - dietary factors - life-style - hyperplastic polyps - carcinoma sequence - cigarette-smoking - burgundy france - dairy-products - sigmoid colon
Background Current evidence indicates that red and processed meat intake increases the risk of colorectal cancer; however, the association with colorectal adenomas is unclear. Objective To conduct a systematic review and meta-analysis of epidemiological studies of red and processed meat intake and risk of colorectal adenomas as part of the Continuous Update Project of the World Cancer Research Fund. Design PubMed and several other databases were searched for relevant studies from their inception up to 31 December 2011. Summary relative risks (RRs) were estimated using a random effects model. Results Nineteen case–control studies and seven prospective studies were included in the analyses. The summary RR per 100 g/day of red meat was 1.27 (95 % CI 1.16–1.40, I2 = 5 %, n = 16) for all studies combined, 1.20 (95 % CI 1.06–1.36, I2 = 0 %, n = 6) for prospective studies, and 1.34 (95 % CI 1.12–1.59, I2 = 31 %, n = 10) for case–control studies. The summary RR per 50 g/day of processed meat intake was 1.29 (95 % CI 1.10–1.53, I2 = 27 %, n = 10) for all studies combined, 1.45 (95 % CI 1.10–1.90, I2 = 0 %, n = 2) for prospective studies, and 1.23 (95 % CI 0.99–1.52, I2 = 37 %, n = 8) for case–control studies. There was evidence of a nonlinear association between red meat (pnonlinearity <0.001) and processed meat (pnonlinearity = 0.01) intake and colorectal adenoma risk. Conclusion These results indicate an elevated risk of colorectal adenomas with intake of red and processed meat, but further prospective studies are warranted
Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct
Romaguera, D. ; Norat, T. ; Wark, P.A. ; Vergnaud, A.C. ; Schulze, M.B. ; Woudenbergh, G.J. van; Beulens, J.W.J. ; Feskens, E.J.M. ; The InterAct Consortium, A. - \ 2013
Diabetologia 56 (2013)7. - ISSN 0012-186X - p. 1520 - 1530.
weight-gain - metabolic syndrome - body-weight - risk - project - obesity - cancer - cohort - dietary - women
Aims/hypothesis Consumption of sugar-sweetened beverages has been shown, largely in American populations, to increase type 2 diabetes incidence. We aimed to evaluate the association of consumption of sweet beverages (juices and nectars, sugar-sweetened soft drinks and artificially sweetened soft drinks) with type 2 diabetes incidence in European adults. Methods We established a case–cohort study including 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 participants selected from eight European cohorts participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. After exclusions, the final sample size included 11,684 incident cases and a subcohort of 15,374 participants. Cox proportional hazards regression models (modified for the case–cohort design) and random-effects meta-analyses were used to estimate the association between sweet beverage consumption (obtained from validated dietary questionnaires) and type 2 diabetes incidence. Results In adjusted models, one 336 g (12 oz) daily increment in sugar-sweetened and artificially sweetened soft drink consumption was associated with HRs for type 2 diabetes of 1.22 (95% CI 1.09, 1.38) and 1.52 (95% CI 1.26, 1.83), respectively. After further adjustment for energy intake and BMI, the association of sugar-sweetened soft drinks with type 2 diabetes persisted (HR 1.18, 95% CI 1.06, 1.32), but the association of artificially sweetened soft drinks became statistically not significant (HR 1.11, 95% CI 0.95, 1.31). Juice and nectar consumption was not associated with type 2 diabetes incidence. Conclusions/interpretation This study corroborates the association between increased incidence of type 2 diabetes and high consumption of sugar-sweetened soft drinks in European adults
Nort-South gradients in plasma concentrations of B-vitamins and other components of one-carbon metabolism in Western Europe: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) Study
Eussen, S.J.P.M. ; Nilsen, R.M. ; Midttun, O. ; Hustad, S. ; IJssenagger, N. ; Meyer, K. ; Fredriksen, A. ; Ulvik, A. ; Ueland, P.M. ; Brennan, P. ; Johansson, M. ; Bueno-de-Mesquita, B. ; Vineis, P. ; Chuang, S.C. ; Boutron-Ruault, M.C. ; Dossus, L. ; Perquier, F. ; Overvad, K. ; Teucher, B. ; Grote, V.A. ; Trichopoulou, A. ; Adarakis, G. ; Plada, M. ; Sieri, S. ; Tumino, R. ; Santucci de Magistris, M. ; Ros, M.M. ; Peeters, P.H.M. ; Redondo, M.L. ; Zamora-Ros, R. ; Chirlaque, M.D. ; Ardanaz, E. ; Sonestedt, E. ; Ericson, U. ; Schneede, J. ; Guelpen, B. ; Wark, P.A. ; Gallo, V. ; Norat, T. ; Riboli, E. ; Vollset, S.E. - \ 2013
The British journal of nutrition 110 (2013)2. - ISSN 0007-1145 - p. 363 - 374.
tandem mass-spectrometry - 24-hour dietary recalls - colorectal-cancer - homocysteine metabolism - microbiological assay - alcohol-consumption - nutrient intake - dairy-products - folate intake - 10 countries
Different lifestyle patterns across Europe may influence plasma concentrations of B-vitamins and one-carbon metabolites and their relation to chronic disease. Comparison of published data on one-carbon metabolites in Western European regions is difficult due to differences in sampling procedures and analytical methods between studies. The present study aimed, to compare plasma concentrations of one-carbon metabolites in Western European regions with one laboratory performing all biochemical analyses. We performed the present study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort among 5446 presumptively healthy individuals. Quantile regression was used to compare sex-specific median concentrations between Northern (Denmark and Sweden), Central (France, Germany, The Netherlands and United Kingdom) and Southern (Greece, Spain and Italy) European regions. The lowest folate concentrations were observed in Northern Europe (men, 10·4 nmol/l; women, 10·7 nmol/l) and highest concentrations in Central Europe. Cobalamin concentrations were slightly higher in Northern Europe (men, 330 pmol/l; women, 352 pmol/l) compared with Central and Southern Europe, but did not show a clear north–south gradient. Vitamin B2 concentrations were highest in Northern Europe (men, 22·2 nmol/l; women, 26·0 nmol/l) and decreased towards Southern Europe (P trend <0·001). Vitamin B6 concentrations were highest in Central Europe in men (77·3 nmol/l) and highest in the North among women (70·4 nmol/l), with decreasing concentrations towards Southern Europe in women (P trend <0·001). In men, concentrations of serine, glycine and sarcosine increased from the north to south. In women, sarcosine increased from Northern to Southern Europe. These findings may provide relevant information for the study of regional differences of chronic disease incidence in association with lifestyle.
Dietary Fibre Intake and Risks of Cancers of the Colon and Rectum in the European Prospective Investigation into Cancer and Nutrition (EPIC)
Murphy, N. ; Norat, T. ; Ferrari, P. ; Jenab, M. ; Bueno-de-Mesquita, B. ; Skeie, G. ; Dahm, C.C. ; Overvad, K. ; Olsen, A. ; Tjonneland, A. ; Clavel-Chapelon, F. ; Boutron-Ruault, M.C. ; Racine, A. ; Kaaks, R. ; Teucher, B. ; Boeing, H. ; Bergmann, M.M. ; Trichopoulou, A. ; Trichopoulos, D. ; Lagiou, P. ; Palli, D. ; Pala, V. ; Panico, S. ; Tumino, R. ; Vineis, P. ; Siersema, P. ; Duijnhoven, F.J.B. van; Peeters, P.H.M. ; Hjartaker, A. ; Engeset, D. ; Gonzalez, C.A. ; Sanchez, M.J. ; Dorronsoro, M. ; Navarro, C. ; Ardanaz, E. ; Quiros, J.R. ; Sonestedt, E. ; Ericson, U. ; Nilsson, L. ; Palmqvist, R. ; Khaw, K.T. ; Wareham, N. ; Key, T.J. ; Crowe, F.L. ; Fedirko, V. ; Wark, P.A. ; Chuang, S.C. ; Riboli, E. - \ 2012
PLoS ONE 7 (2012)6. - ISSN 1932-6203
colorectal-cancer - nonstarch polysaccharides - epidemiologic evidence - measurement error - glycemic index - cohort - project - carbohydrate - calibration - protection
Background: 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. Methodology/Principal Findings: 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. Conclusions/Significance: Our results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.
Prediagnostic 25-hydroxyvitamin D, VDR and CASR polymorphisms, and survival in patients with colorectal cancer in western European populations
Fedirko, V. ; Riboli, E. ; Tjonneland, A. ; Ferrari, P. ; Olsen, A. ; Bueno de Mesquita, H.B. ; Duijnhoven, F.J.B. van; Norat, T. ; Jansen, E.H. ; Dahm, C.C. ; Overvad, K. - \ 2012
Cancer Epidemiology Biomarkers and Prevention 21 (2012)4. - ISSN 1055-9965 - p. 582 - 593.
vitamin-d-receptor - cell lung-cancer - colon-cancer - serum 25-hydroxyvitamin-d - prostate-cancer - 1,25-dihydroxyvitamin d-3 - physical-activity - supplement use - risk - calcium
Background: Individuals with higher blood 25-hydroxyvitamin D [25(OH)D] levels have a lower risk of developing colorectal cancer (CRC), but the influence of 25(OH)D on mortality after CRC diagnosis is unknown. Methods: The association between prediagnostic 25(OH)D levels and CRC-specific (N = 444) and overall mortality (N = 541) was prospectively examined among 1,202 participants diagnosed with CRC between 1992 and 2003 in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Multivariable Cox proportional hazards models were used to calculate HRs and corresponding 95% CIs according to 25(OH)D quintiles and genetic variation within the VDR and CASR genes. Potential dietary, lifestyle, and metabolic effect modifiers were also investigated. Results: There were 541 deaths, 444 (82%) due to CRC. Mean follow-up was 73 months. In multivariable analysis, higher 25(OH)D levels were associated with a statistically significant reduction in CRC-specific (Ptrend = 0.04) and overall mortality (Ptrend = 0.01). Participants with 25(OH)D levels in the highest quintile had an adjusted HR of 0.69 (95% CI: 0.50–0.93) for CRC-specific mortality and 0.67 (95% CI: 0.50–0.88) for overall mortality, compared with the lowest quintile. Except for a possible interaction by prediagnostic dietary calcium intake (Pinteraction = 0.01), no other potential modifying factors related to CRC survival were noted. The VDR (FokI and BsmI) and CASR (rs1801725) genotypes were not associated with survival. Conclusions: High prediagnostic 25(OH)D levels are associated with improved survival of patients with CRC.
Variety in vegetable and fruit consumption and the risk of gastric and esophageal cancer in the European prospective investigation into cancer and nutrition
Jeurnink, S.M. ; Büchner, F.L. ; Bueno-de Mesquita, H.B. ; Siersema, P.D. ; Boshuizen, H.C. ; Numans, M.E. ; Dahm, C.C. ; Overvad, K. ; Tjonneland, A. ; Roswall, N. ; Clavel-Chapelon, F. ; Boutron-Ruault, M.C. ; Morois, S. ; Kaaks, R. ; Teucher, B. ; Boeing, H. ; Buijsse, B. ; Trichopoulou, A. ; Benetou, V. ; Zylis, D. ; Palli, D. ; Sieri, S. ; Vineis, P. ; Tumino, R. ; Panico, S. ; Ocké, M.C. ; Peeters, P.H. ; Skeie, G. ; Brustad, M. ; Lund, E. ; Sanchez-Cantalejo, E. ; Navarro, C. ; Amiano, P. ; Ardanaz, E. ; Ramón Quirós, J. ; Hallmans, G. ; Johansson, I. ; Lindkvist, B. ; Regnér, S. ; Khaw, K.T. ; Wareham, N. ; Key, T.J. ; Slimani, N. ; Norat, T. ; Vergnaud, A.C. ; Romaguera, D. ; Gonzalez, C.A. - \ 2012
International Journal of Cancer 131 (2012)6. - ISSN 0020-7136 - p. E963 - E973.
epic-eurgast - epidemiologic evidence - helicobacter-pylori - physical-activity - diet diversity - cereal fiber - vitamin-c - stomach - adenocarcinomas - metaanalysis
Diets high in vegetables and fruits have been suggested to be inversely associated with risk of gastric cancer. However, the evidence of the effect of variety of consumption is limited. We therefore investigated whether consumption of a variety of vegetables and fruit is associated with gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition study. Data on food consumption and follow-up on cancer incidence were available for 452,269 participants from 10 European countries. After a mean follow-up of 8.4 years, 475 cases of gastric and esophageal adenocarcinomas (180 noncardia, 185 cardia, gastric esophageal junction and esophagus, 110 not specified) and 98 esophageal squamous cell carcinomas were observed. Diet Diversity Scores were used to quantify the variety in vegetable and fruit consumption. We used multivariable Cox proportional hazard models to calculate risk ratios. Independent from quantity of consumption, variety in the consumption of vegetables and fruit combined and of fruit consumption alone were statistically significantly inversely associated with the risk of esophageal squamous cell carcinoma (continuous hazard ratio per 2 products increment 0.88; 95% CI 0.79–0.97 and 0.76; 95% CI 0.62–0.94, respectively) with the latter particularly seen in ever smokers. Variety in vegetable and/or fruit consumption was not associated with risk of gastric and esophageal adenocarcinomas. Independent from quantity of consumption, more variety in vegetable and fruit consumption combined and in fruit consumption alone may decrease the risk of esophageal squamous cell carcinoma. However, residual confounding by lifestyle factors cannot be excluded
Dairy products and colorectal cancer risk : a systematic review and meta-analysis of cohort studies
Aune, D. ; Lau, R. ; Chan, D.S.M. ; Vieira, R. ; Greenwood, D.C. ; Kampman, E. ; Norat, T. - \ 2012
Annals of Oncology 23 (2012)1. - ISSN 0923-7534 - p. 37 - 45.
vitamin-d intake - epithelial-cell proliferation - food frequency questionnaire - japan collaborative cohort - dose-response data - colon-cancer - dietary calcium - womens health - milk consumption - united-states
Background: Previous studies of the association between intake of dairy products and colorectal cancer risk have indicated an inverse association with milk, however, the evidence for cheese or other dairy products is inconsistent. Methods: We conducted a systematic review and meta-analysis to clarify the shape of the dose–response relationship between dairy products and colorectal cancer risk. We searched the PubMed database for prospective studies published up to May 2010. Summary relative risks (RRs) were estimated using a random effects model. Results: Nineteen cohort studies were included. The summary RR was 0.83 (95% CI [confidence interval]: 0.78–0.88, I2 = 25%) per 400 g/day of total dairy products, 0.91 (95% CI: 0.85–0.94, I2 = 0%) per 200 g/day of milk intake and 0.96 (95% CI: 0.83–1.12, I2 = 28%) per 50 g/day of cheese. Inverse associations were observed in both men and women but were restricted to colon cancer. There was evidence of a nonlinear association between milk and total dairy products and colorectal cancer risk, P <0.001, and the inverse associations appeared to be the strongest at the higher range of intake. Conclusion: This meta-analysis shows that milk and total dairy products, but not cheese or other dairy products, are associated with a reduction in colorectal cancer risk
Carbohydrates, glycemic index, glycemic load, and colorectal cancer risk : a systematic review and meta-analysis of cohort studies
Aune, D. ; Chan, D.S.M. ; Lau, R. ; Vieira, R. ; Greenwood, D.C. ; Kampman, E. ; Norat, T. - \ 2012
Cancer Causes and Control 23 (2012)4. - ISSN 0957-5243 - p. 521 - 535.
growth-factor-i - plasma c-peptide - dietary carbohydrate - womens health - adenomatous polyps - binding-proteins - insulin index - large-bowel - men - colon
Background Dietary carbohydrate, glycemic index, and glycemic load are thought to influence colorectal cancer risk through hyperinsulinemia. We review and quantitatively summarize in a meta-analysis the evidence from prospective cohort studies. Methods We searched the PubMed database for prospective studies of carbohydrate, glycemic index, and glycemic load and colorectal cancer risk, up to October 2011. Summary relative risks were estimated by the use of a random effects model. Results We identified 14 cohort studies that could be included in the meta-analysis of carbohydrate, glycemic index, and glycemic load and colorectal cancer risk. The summary RR for high versus low intake was 1.00 (95% CI: 0.87–1.14, I 2 = 31%) for carbohydrate, 1.07 (95% CI: 0.99–1.16, I 2 = 28%) for glycemic index, and 1.00 (95% CI: 0.91–1.10, I 2 = 39%) for glycemic load. In the dose–response analysis, the summary RR was 0.95 (95% CI: 0.84–1.07, I 2 = 58%) per 100 grams of carbohydrate per day, 1.07 (95% CI: 0.99–1.15, I 2 = 39%) per 10 glycemic index units, and 1.01 (95% CI: 0.95–1.08, I 2 = 47%) per 50 glycemic load units. Exclusion of one or two outlying studies reduced the heterogeneity, but the results were similar. Conclusion This meta-analysis of cohort studies does not support an independent association between diets high in carbohydrate, glycemic index, or glycemic load and colorectal cancer risk
Magnesium intake and colorectal tumor risk : a case-control study and meta-analysis
Wark, P.A. ; Lau, R. ; Norat, T. ; Kampman, E. - \ 2012
American Journal of Clinical Nutrition 96 (2012)3. - ISSN 0002-9165 - p. 622 - 631.
food frequency questionnaire - large-bowel carcinogenesis - colon-cancer - united-states - double-blind - nondiabetic subjects - insulin sensitivity - prospective cohort - relative validity - randomized-trial
Background: Dietary magnesium might be related to colorectal tumor risk through the pivotal roles of magnesium in cellular metabolism, insulin resistance, and systemic inflammation. Objective: We evaluated the hypothesis of whether higher dietary magnesium intake is associated with reduced colorectal tumor risk. Design: A case-control study on colorectal adenomas (768 cases; 709 polyp-free control subjects) and a meta-analysis of colorectal adenomas (3 case-control studies) and carcinomas (6 prospective cohort studies) were conducted. Dietary magnesium was estimated from food-frequency questionnaires in the case-control study and most studies in the meta-analyses. Data analysis comprised multiple logistic regression analysis (case-control study) and fixed- and random-effects meta-analyses. Results: The case-control study showed a nonsignificant inverse association between dietary magnesium intake and risk of colorectal adenomas (OR for every 100-mg/d increase: 0.81; 95% CI: 0.62, 1.06). However, inverse associations were observed only in subjects with BMI (in kg/m2) =25, in subjects aged =55 y, and for advanced adenomas. Associations did not vary by the calcium-to-magnesium intake ratio. In the meta-analysis, every 100-mg/d increase in magnesium intake was associated with 13% lower risk of colorectal adenomas (OR: 0.87; 95% CI: 0.75, 1.00) and 12% lower risk of colorectal cancer (RR: 0.88; 95% CI: 0.81, 0.97). Conclusions: Our findings support the hypothesis that higher intakes of dietary magnesium are associated with lower risk of colorectal tumors. The consumption of magnesium-rich foods may be a new avenue to explore further in the search for cancer-prevention strategies
Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies
Aune, D. ; Chan, D.S.M. ; Lau, R. ; Vieira, R. ; Greenwood, D.C. ; Kampman, E. ; Norat, T. - \ 2011
BMJ: British Medical Journal 343 (2011). - ISSN 0959-8138
iowa womens health - nih-aarp diet - colon-cancer - singapore chinese - magnesium intake - united-states - finnish men - vitamin-d - prospective cohort - physical-activity
Objective To investigate the association between intake of dietary fibre and whole grains and risk of colorectal cancer. Design Systematic review and meta-analysis of prospective observational studies. Data sources PubMed and several other databases up to December 2010 and the reference lists of studies included in the analysis as well as those listed in published meta-analyses. Study selection Prospective cohort and nested case-control studies of dietary fibre or whole grain intake and incidence of colorectal cancer. Results 25 prospective studies were included in the analysis. The summary relative risk of developing colorectal cancer for 10 g daily of total dietary fibre (16 studies) was 0.90 (95% confidence interval 0.86 to 0.94, I(2)=0%), for fruit fibre (n=9) was 0.93 (0.82 to 1.05, I(2)=23%), for vegetable fibre (n=9) was 0.98 (0.91 to 1.06, I(2)=0%), for legume fibre (n=4) was 0.62 (0.27 to 1.42, I(2)=58%), and for cereal fibre (n=8) was 0.90 (0.83 to 0.97, I(2)=0%). The summary relative risk for an increment of three servings daily of whole grains (n=6) was 0.83 (0.78 to 0.89, I(2)=18%). Conclusion A high intake of dietary fibre, in particular cereal fibre and whole grains, was associated with a reduced risk of colorectal cancer. Further studies should report more detailed results, including those for subtypes of fibre and be stratified by other risk factors to rule out residual confounding. Further assessment of the impact of measurement errors on the risk estimates is also warranted.
Meta-Analyses of Vitamin D Intake, 25-Hydroxyvitamin D Status, Vitamin D Receptor Polymorphisms, and Colorectal Cancer Risk
Touvier, M. ; Chan, D.S.M. ; Lau, R. ; Aune, D. ; Vieira, R. ; Greenwood, D.C. ; Kampman, E. ; Riboli, E. ; Hercberg, S. ; Norat, T. - \ 2011
Cancer Epidemiology Biomarkers and Prevention 20 (2011)5. - ISSN 1055-9965 - p. 1003 - 1016.
vdr gene polymorphisms - normal colon mucosa - nested case-control - dietary calcium - rectal-cancer - united-states - d supplementation - dairy-products - multiethnic cohort - singapore chinese
Background: Our objective was to conduct a systematic review and meta-analysis of prospective studies on colorectal cancer (CRC) and vitamin D intake and 25-hydroxyvitamin D status, as part of the World Cancer Research Fund Continuous Update Project. We also aimed at conducting meta-analysis of all studies on CRC and vitamin D receptor (VDR) single-nucleotide polymorphisms. Methods: Relevant studies were identified in PubMed (up to June 2010). Inclusion criteria were original and peer-reviewed publications with a prospective design (for studies on vitamin D intake or status). Random effects of dose-response meta-analyses were performed on cancer incidence. Results: We observed inverse associations of CRC risk with dietary vitamin D [summary relative risk (RR) per 100 IU/day = 0.95, 95% CI: 0.93-0.98; 10 studies; range of intake (midpoints) = 39-719 IU/day] and serum/plasma 25-hydroxyvitamin D (RR per 100 IU/L = 0.96, 0.94-0.97; 6 studies; range = 200-1,800 IU/L), but not with total vitamin D (5 studies). Supplemental (2 studies; range = 0-600 IU/day) and total (4 studies; range = 79-732 IU/day) vitamin D intake and 25-hydroxyvitamin D status (6 studies; range = 200-1,800 IU/L) were inversely associated with colon cancer risk. We did not observe statistically significant associations between FokI, PolyA, TaqI, Cdx2, and ApaI VDR polymorphisms and CRC risk. The BsmI polymorphism was associated with a lower CRC risk (RR = 0.57, 0.36-0.89 for BB versus bb, 8 studies). Conclusions: These meta-analyses support the evidence of an inverse association between vitamin D intake, 25-hydroxyvitamin D status, and the BsmI VDR polymorphism and CRC risk. Impact: Improving vitamin D status could be potentially beneficial against CRC incidence. Cancer Epidemiol Biomarkers Prev; 20(5); 1003-16. (C) 2011 AACR.
Cigarette smoking and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition study.
Leufkens, A.M. ; Duijnhoven, F.J.B. van; Siersema, P.D. ; Boshuizen, H.C. ; Vrieling, A. ; Agudo, A. ; Gram, I.T. ; Weiderpass, E. ; Dahm, C. ; Overvad, K. ; Tjonneland, A. ; Olsen, A. ; Boutron-Ruault, M.C. ; Clavel-Chapelon, F. ; Morois, S. ; Palli, D. ; Grioni, S. ; Tumino, R. ; Sacerdote, C. ; Mattiello, A. ; Herman, S. ; Kaaks, R. ; Steffen, A. ; Boeing, H. ; Trichopoulou, A. ; Lagiou, P. ; Trichopoulos, D. ; Peeters, P.H. ; Gils, C.H. van; Kranen, H. van; Lund, E. ; Dumeaux, V. ; Engeset, D. ; Rodriguez, L. ; Sanchez, M.J. ; Chirlaque, M.D. ; Barricarte, A. ; Manjer, J. ; Almquist, M. ; Guelpen, B. ; Hallmans, G. ; Khaw, K.T. ; Wareham, N. ; Tsilidis, K.K. ; Straif, K. ; Leon-Roux, M. ; Vineis, P. ; Norat, T. ; Riboli, E. ; Bueno-de-Mesquita, H.B. - \ 2011
Clinical Gastroenterology and Hepatology 9 (2011)2. - ISSN 1542-3565 - p. 137 - 144.
tumor microsatellite instability - life-style factors - alcohol-consumption - rectal-cancer - colon tumors - cohort - women - polymorphisms - associations - metaanalysis
BACKGROUND & AIMS: There has been consistent evidence for a relationship between smoking and colorectal cancer (CRC), although it is not clear whether the colon or rectum is more sensitive to the effects of smoking. We investigated the relationships between cigarette smoking and risk of CRC and tumor location. METHODS: We analyzed data from 465,879 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study; 2741 developed CRC during the follow-up period (mean, 8.7 years). Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: The risk of colon carcinoma was increased among ever smokers (HR, 1.18; 95% CI, 1.06-1.32) and former cigarette smokers (HR, 1.21; 95% CI, 1.08-1.36), compared with never smokers; the increased risk for current smokers was of borderline significance (HR, 1.13; 95% CI, 0.98-1.31). When stratified for tumor location, the risk of proximal colon cancer was increased for former (HR, 1.25; 95% CI, 1.04-1.50) and current smokers (HR, 1.31; 95% CI, 1.06-1.64), but the risks for cancers in the distal colon or rectum were not. Subsite analyses showed a nonsignificant difference between the proximal and distal colon (P = .45) for former smokers and a significant difference for current smokers (P = .02). For smokers who had stopped smoking for at least 20 years, the risk of developing colon cancer was similar to that of never smokers. CONCLUSIONS: Ever smokers have an increased risk of colon cancer, which appeared to be more pronounced in the proximal than the distal colon location.
Red and Processed Meat and Colorectal Cancer Incidence: Meta-Analysis of Prospective Studies
Chan, D.S.M. ; Lau, R. ; Aune, D. ; Vieira, R. ; Greenwood, D.C. ; Kampman, E. ; Norat, T. - \ 2011
PLoS ONE 6 (2011)6. - ISSN 1932-6203
dose-response data - colon-cancer - risk-factors - prospective cohort - rectal-cancer - united-states - nat2 polymorphisms - netherlands cohort - dietary patterns - womens health
Background: The evidence that red and processed meat influences colorectal carcinogenesis was judged convincing in the 2007 World Cancer Research Fund/American Institute of Cancer Research report. Since then, ten prospective studies have published new results. Here we update the evidence from prospective studies and explore whether there is a non-linear association of red and processed meats with colorectal cancer risk. Methods and Findings: Relevant prospective studies were identified in PubMed until March 2011. For each study, relative risks and 95% confidence intervals (CI) were extracted and pooled with a random-effects model, weighting for the inverse of the variance, in highest versus lowest intake comparison, and dose-response meta-analyses. Red and processed meats intake was associated with increased colorectal cancer risk. The summary relative risk (RR) of colorectal cancer for the highest versus the lowest intake was 1.22 (95% CI = 1.11-1.34) and the RR for every 100 g/day increase was 1.14 (95% CI = 1.04-1.24). Non-linear dose-response meta-analyses revealed that colorectal cancer risk increases approximately linearly with increasing intake of red and processed meats up to approximately 140 g/day, where the curve approaches its plateau. The associations were similar for colon and rectal cancer risk. When analyzed separately, colorectal cancer risk was related to intake of fresh red meat (RR (for 100 g/day increase) = 1.17, 95% CI = 1.05-1.31) and processed meat (RR (for 50 g/day increase) = 1.18, 95% CI = 1.10-1.28). Similar results were observed for colon cancer, but for rectal cancer, no significant associations were observed. Conclusions: High intake of red and processed meat is associated with significant increased risk of colorectal, colon and rectal cancers. The overall evidence of prospective studies supports limiting red and processed meat consumption as one of the dietary recommendations for the prevention of colorectal cancer.
Nonlinear Reduction in Risk for Colorectal Cancer by Fruit and Vegetable Intake Based on Meta-analysis of Prospective Studies
Aune, D. ; Lau, R. ; Chan, D.S.M. ; Vieira, R. ; Greenwood, D.C. ; Kampman, E. ; Norat, T. - \ 2011
Gastroenterology 141 (2011)1. - ISSN 0016-5085 - p. 106 - 118.
dose-response data - prospective cohort - colon-cancer - womens health - dietary patterns - rectal-cancer - united-states - life-style - vitamin-c - consumption
BACKGROUND & AIMS: The association between fruit and vegetable intake and colorectal cancer risk has been investigated by many studies but is controversial because of inconsistent results and weak observed associations. We summarized the evidence from cohort studies in categorical, linear, and nonlinear, dose-response meta-analyses. METHODS: We searched PubMed for studies of fruit and vegetable intake and colorectal cancer risk that were published until the end of May 2010. We included 19 prospective studies that reported relative risk estimates and 95% confidence intervals (CIs) of colorectal cancer-associated with fruit and vegetable intake. Random effects models were used to estimate summary relative risks. RESULTS: The summary relative risk for the highest vs the lowest intake was 0.92 (95% CI: 0.86-0.99) for fruit and vegetables combined, 0.90 (95% CI: 0.83-0.98) for fruit, and 0.91 (95% CI: 0.86-0.96) for vegetables (P for heterogeneity = .24, .05, and .54, respectively). The inverse associations appeared to be restricted to colon cancer. In linear dose-response analysis, only intake of vegetables was significantly associated with colorectal cancer risk (summary relative risk = 0.98; 95% CI: 0.97-0.99), per 100 g/d. However, significant inverse associations emerged in nonlinear models for fruits (P(nonlinearity) <.001) and vegetables (P(nonlinearity) = .001). The greatest risk reduction was observed when intake increased from very low levels of intake. There was generally little evidence of heterogeneity in the analyses and there was no evidence of small-study bias. CONCLUSIONS: Based on meta-analysis of prospective studies, there is a weak but statistically significant nonlinear inverse association between fruit and vegetable intake and colorectal cancer risk.
EPIC-Heart: The cardiovascular component of a prospective study of nutritional, lifestyle and biological factors in 520,000 middle-aged participants from 10 European countries
Danesh, J. ; Saracci, R. ; Berglund, G. ; Feskens, E.J.M. ; Overvad, K. ; Panico, S. ; Thompson, S. ; Fournier, A. ; Clavel-Chapelon, F. ; Canonico, M. ; Kaaks, R. ; Linseisen, J. ; Boeing, H. ; Pischon, T. ; Weikert, C. ; Olsen, A. ; Tjonneland, A. ; Johnsen, S.P. ; Jensen, M.K. ; Quiros, J.R. ; Gonzalez-Svatetz, C.A. ; Sanchez-Perez, M.J. ; Larranaga, N. ; Navarro Sanchez, C. ; Moreno Iribas, C. ; Bingham, S. ; Khaw, K.T. ; Wareham, N. ; Key, T. ; Roddam, A. ; Trichopoulou, A. ; Benetou, V. ; Trichopoulous, D. ; Masala, G. ; Sieri, S. ; Tumino, R. ; Sacerdote, C. ; Mattiello, A. ; Verschuren, W.M.M. ; Bueno de Mesquita, H.B. ; Grobbee, D.E. ; Schouw, Y.T. van der; Melander, O. ; Hallmans, G. ; Wennberg, P. ; Lund, E. ; Kumle, M. ; Skeie, G. ; Ferrari, P. ; Slimani, N. ; Norat, T. ; Riboli, E. - \ 2007
European Journal of Epidemiology 22 (2007)2. - ISSN 0393-2990 - p. 129 - 141.
coronary-artery-disease - dietary assessment methods - high blood-pressure - fat distribution - norfolk cohort - plasma-levels - cancer - risk - women - population
EPIC-Heart is the cardiovascular component of the European Prospective Investigation into Cancer and Nutrition (EPIC), a multi-centre prospective cohort study investigating the relationship between nutrition and major chronic disease outcomes. Its objective is to advance understanding about the separate and combined influences of lifestyle (especially dietary), environmental, metabolic and genetic factors in the development of cardiovascular diseases by making best possible use of the unusually informative database and biological samples in EPIC. Between 1992 and 2000, 519,978 participants (366,521 women and 153,457 men, mostly aged 35¿70 years) in 23 centres in 10 European countries commenced follow-up for cause- specific mortality, cancer incidence and major cardiovascular morbidity. Dietary information was collected with quantitative questionnaires or semi-quantitative food frequency questionnaires, including a 24-h dietary recall sub-study to help calibrate the dietary measurements. Information was collected on physical activity, tobacco smoking, alcohol consumption, occupational history, socio-economic status, and history of previous illnesses. Anthropometric measurements and blood pressure recordings were made in the majority of participants. Blood samples were taken from 385,747 individuals, from which plasma, serum, red cells, and buffy coat fractions were separated and aliquoted for long-term storage. By 2004, an estimated 10,000 incident fatal and non-fatal coronary and stroke events had been recorded. The first cycle of EPIC-Heart analyses will assess associations of coronary mortality with several prominent dietary hypotheses and with established cardiovascular risk factors. Subsequent analyses will extend this approach to non-fatal cardiovascular outcomes¿and to further dietary, biochemical and genetic factors.
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