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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Vitamin D-related genes, blood vitamin D levels and colorectal cancer risk in western european populations
Fedirko, Veronika ; Mandle, Hannah B. ; Zhu, Wanzhe ; Hughes, David J. ; Siddiq, Afshan ; Ferrari, Pietro ; Romieu, Isabelle ; Riboli, Elio ; Bueno-de-Mesquita, Bas ; Duijnhoven, Fränzel J.B. Van; Siersema, Peter D. ; Tjønneland, Anne ; Olsen, Anja ; Perduca, Vittorio ; Carbonnel, Franck ; Boutron-Ruault, Marie Christine ; Kühn, Tilman ; Johnson, Theron ; Krasimira, Aleksandrova ; Trichopoulou, Antonia ; Makrythanasis, Periklis ; Thanos, Dimitris ; Panico, Salvatore ; Krogh, Vittorio ; Sacerdote, Carlotta ; Skeie, Guri ; Weiderpass, Elisabete ; Colorado-Yohar, Sandra ; Sala, Núria ; Barricarte, Aurelio ; Sanchez, Maria Jose ; Quirós, Ramón ; Amiano, Pilar ; Gylling, Björn ; Harlid, Sophia ; Perez-Cornago, Aurora ; Heath, Alicia K. ; Tsilidis, Konstantinos K. ; Aune, Dagfinn ; Freisling, Heinz ; Murphy, Neil ; Gunter, Marc J. ; Jenab, Mazda - \ 2019
Nutrients 11 (2019)8. - ISSN 2072-6643
Colorectal neoplasms - Incidence - Single nucleotide polymorphism (SNP) - Vitamin D

Higher circulating 25-hydroxyvitamin D levels (25(OH)D) have been found to be associated with lower risk for colorectal cancer (CRC) in prospective studies. Whether this association is modified by genetic variation in genes related to vitamin D metabolism and action has not been well studied in humans. We investigated 1307 functional and tagging single-nucleotide polymorphisms (SNPs; individually, and by gene/pathway) in 86 vitamin D-related genes in 1420 incident CRC cases matched to controls from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. We also evaluated the association between these SNPs and circulating 25(OH)D in a subset of controls. We confirmed previously reported CRC risk associations between SNPs in the VDR, GC, and CYP27B1 genes. We also identified additional associations with 25(OH)D, as well as CRC risk, and several potentially novel SNPs in genes related to vitamin D transport and action (LRP2, CUBN, NCOA7, and HDAC9). However, none of these SNPs were statistically significant after Benjamini-Hochberg (BH) multiple testing correction. When assessed by a priori defined functional pathways, tumor growth factor β(TGFβ) signaling was associated with CRC risk (P ≤ 0.001), with most statistically significant genes being SMAD7 (PBH = 0.008) and SMAD3 (PBH = 0.008), and 18 SNPs in the vitamin D receptor (VDR) binding sites (P = 0.036). The 25(OH)D-gene pathway analysis suggested that genetic variants in the genes related to VDR complex formation and transcriptional activity are associated with CRC depending on 25(OH)D levels (interaction P = 0.041). Additional studies in large populations and consortia, especially with measured circulating 25(OH)D, are needed to confirm our findings.

One-carbon metabolism biomarkers and risk of urothelial cell carcinoma in the European prospective investigation into cancer and nutrition
Vrieling, Alina ; Bueno-De-Mesquita, H.B. ; Ros, Martine M. ; Kampman, Ellen ; Aben, Katja K. ; Büchner, Frederike L. ; Jansen, Eugène H. ; Roswall, Nina ; Tjønneland, Anne ; Boutron-Ruault, Marie Christine ; Cadeau, Claire ; Chang-Claude, Jenny ; Kaaks, Rudolf ; Weikert, Steffen ; Boeing, Heiner ; Trichopoulou, Antonia ; Lagiou, Pagona ; Trichopoulos, Dimitrios ; Sieri, Sabina ; Palli, Domenico ; Panico, Salvatore ; Peeters, Petra H. ; Weiderpass, Elisabete ; Skeie, Guri ; Jakszyn, Paula ; Chirlaque, María Dolores ; Ardanaz, Eva ; Sánchez, María José ; Ehrnström, Roy ; Malm, Johan ; Ljungberg, Börje ; Khaw, Kay Tee ; Wareham, Nick J. ; Brennan, Paul ; Johansson, Mattias ; Riboli, Elio ; Kiemeney, Lambertus A. - \ 2019
International Journal of Cancer 145 (2019)9. - ISSN 0020-7136 - p. 2349 - 2359.
B-vitamins - biomarker - folate - nested case–control - urothelial cell carcinomas

Published associations between dietary folate and bladder cancer risk are inconsistent. Biomarkers may provide more accurate measures of nutrient status. This nested case–control analysis within the European Prospective Investigation into Cancer and Nutrition (EPIC) investigated associations between pre-diagnostic serum folate, homocysteine, vitamins B6 and B12 and the risk of urothelial cell carcinomas of the bladder (UCC). A total of 824 patients with newly diagnosed UCC were matched with 824 cohort members. Serum folate, homocysteine, and vitamins B6 and B12 were measured. Odds ratios (OR) and 95% confidence intervals (CI) for total, aggressive, and non-aggressive UCC were estimated using conditional logistic regression with adjustment for smoking status, smoking duration and intensity, and other potential confounders. Additionally, statistical interaction with smoking status was assessed. A halving in serum folate concentrations was moderately associated with risk of UCC (OR: 1.18; 95% CI: 0.98–1.43), in particular aggressive UCC (OR: 1.34; 95% CI: 1.02–1.75; p-heterogeneity = 0.19). Compared to never smokers in the highest quartile of folate concentrations, this association seemed only apparent among current smokers in the lowest quartile of folate concentrations (OR: 6.26; 95% CI: 3.62–10.81, p-interaction = 0.07). Dietary folate was not associated with aggressive UCC (OR: 1.26; 95% CI: 0.81–1.95; p-heterogeneity = 0.14). No association was observed between serum homocysteine, vitamins B6 and B12 and risk of UCC. This study suggests that lower serum folate concentrations are associated with increased UCC risk, in particular aggressive UCC. Residual confounding by smoking cannot be ruled out and these findings require confirmation in future studies with multiple measurements.

A national FFQ for the Netherlands (the FFQ-NL1.0): development and compatibility with existing Dutch FFQs
Eussen, Simone ; Dongen, M.C.J.M. van; Wijckmans, N.E. ; Meijboom, S. ; Brants, H.A.M. ; Vries, J.H.M. de; Bueno-de-Mesquita, H.B. ; Geelen, M.M.E.E. ; Sluik, D. ; Feskens, E.J.M. ; Ocke, M.C. ; Dagnelie, P.C. - \ 2018
Public Health Nutrition 21 (2018)12. - ISSN 1368-9800 - p. 2221 - 2229.
Objective In the Netherlands, various FFQs have been administered in large cohort studies, which hampers comparison and pooling of dietary data. The present study aimed to describe the development of a standardized Dutch FFQ, FFQ-NL1.0, and assess its compatibility with existing Dutch FFQs. Design Dutch FFQTOOLTM was used to develop the FFQ-NL1.0 by selecting food items with the largest contributions to total intake and explained variance in intake of energy and thirty-nine nutrients in adults aged 25–69 years from the Dutch National Food Consumption Survey (DNFCS) 2007–2010. Compatibility with the Maastricht-FFQ, Wageningen-FFQ and EPICNL-FFQ was assessed by comparing the number of food items, the covered energy and nutrient intake, and the covered variance in intake. Results FFQ-NL1.0 comprised 160 food items, v. 253, 183 and 154 food items for the Maastricht-FFQ, Wageningen-FFQ and EPICNL-FFQ, respectively. FFQ-NL1.0 covered ≥85 % of energy and all nutrients reported in the DNFCS. Covered variance in intake ranged from 57 to 99 % for energy and macronutrients, and from 45 to 93 % for micronutrients. Differences between FFQ-NL1.0 and the other FFQs in covered nutrient intake and covered variance in intake were <5 % for energy and all macronutrients. For micronutrients, differences between FFQ-NL and other FFQs in covered level of intake were <15 %, but differences in covered variance were much larger, the maximum difference being 36 %. Conclusions The FFQ-NL1.0 was compatible with other FFQs regarding energy and macronutrient intake. However, compatibility for covered variance of intake was limited for some of the micronutrients. If implemented in existing cohorts, it is advised to administer the old and the new FFQ in combination to derive calibration factors.
Impact of prediagnostic smoking and smoking cessation on colorectal cancer prognosis : A meta-analysis of individual patient data from cohorts within the CHANCES consortium
Ordóñez-Mena, J.M. ; Walter, V. ; Schöttker, B. ; Jenab, M. ; O'Doherty, M.G. ; Kee, F. ; Bueno-de-Mesquita, B. ; Peeters, P.H.M. ; Stricker, B.H. ; Ruiter, R. ; Hofman, A. ; Söderberg, S. ; Jousilahti, P. ; Kuulasmaa, K. ; Freedman, N.D. ; Wilsgaard, T. ; Wolk, A. ; Nilsson, L.M. ; Tjønneland, A. ; Quirós, J.R. ; Duijnhoven, F.J.B. van; Siersema, P.D. ; Boffetta, P. ; Trichopoulou, A. ; Brenner, H. - \ 2018
Annals of Oncology 29 (2018)2. - ISSN 0923-7534 - p. 472 - 483.
Colorectal neoplasms - Meta-analysis - Smoking - Smoking cessation - Survival
Background: Smoking has been associated with colorectal cancer (CRC) incidence and mortality in previous studies and might also be associated with prognosis after CRC diagnosis. However, current evidence on smoking in association with CRC prognosis is limited. Patients and methods: For this individual patient data meta-analysis, sociodemographic and smoking behavior information of 12 414 incident CRC patients (median age at diagnosis: 64.3 years), recruited within 14 prospective cohort studies among previously cancer-free adults, was collected at baseline and harmonized across studies. Vital status and causes of death were collected for a mean follow-up time of 5.1 years following cancer diagnosis. Associations of smoking behavior with overall and CRC-specific survival were evaluated using Cox regression and standard meta-analysis methodology. Results: A total of 5229 participants died, 3194 from CRC. Cox regression revealed significant associations between former [hazard ratio (HR)=1.12; 95 % confidence interval (CI)=1.04-1.20] and current smoking (HR=1.29; 95% CI=1.04-1.60) and poorer overall survival compared with never smoking. Compared with current smoking, smoking cessation was associated with improved overall (HR<10 years=0.78; 95% CI=0.69-0.88; HR≥10 years=0.78; 95% CI=0.63-0.97) and CRC-specific survival (HR≥10 years=0.76; 95% CI=0.67-0.85). Conclusion: In this large meta-analysis including primary data of incident CRC patients from 14 prospective cohort studies on the association between smoking and CRC prognosis, former and current smoking were associated with poorer CRC prognosis compared with never smoking. Smoking cessation was associated with improved survival when compared with current smokers. Future studies should further quantify the benefits of nonsmoking, both for cancer prevention and for improving survival among CRC patients, in particular also in terms of treatment response.
Circulating concentrations of vitamin D in relation to pancreatic cancer risk in European populations
Duijnhoven, Fränzel J.B. van; Jenab, Mazda ; Hveem, Kristian ; Siersema, Peter D. ; Fedirko, Veronika ; Duell, Eric J. ; Kampman, Ellen ; Halfweeg, Anouk ; Kranen, Henk J. van; Ouweland, Jody M.W. van den; Weiderpass, Elisabete ; Murphy, Neil ; Langhammer, Arnulf ; Ness-Jensen, Eivind ; Olsen, Anja ; Tjønneland, Anne ; Overvad, Kim ; Cadeau, Claire ; Kvaskoff, Marina ; Boutron-Ruault, Marie Christine ; Katzke, Verena A. ; Kühn, Tilman ; Boeing, Heiner ; Trichopoulou, Antonia ; Kotanidou, Anastasia ; Kritikou, Maria ; Palli, Domenico ; Agnoli, Claudia ; Tumino, Rosario ; Panico, Salvatore ; Matullo, Giuseppe ; Peeters, Petra ; Brustad, Magritt ; Olsen, Karina Standahl ; Lasheras, Cristina ; Obón-Santacana, Mireia ; Sánchez, María José ; Dorronsoro, Miren ; Chirlaque, Maria Dolores ; Barricarte, Aurelio ; Manjer, Jonas ; Almquist, Martin ; Renström, Frida ; Ye, Weimin ; Wareham, Nick ; Khaw, Kay Tee ; Bradbury, Kathryn E. ; Freisling, Heinz ; Aune, Dagfinn ; Norat, Teresa ; Riboli, Elio ; Bueno-de-Mesquita, H.B. - \ 2018
International Journal of Cancer 142 (2018)6. - ISSN 0020-7136 - p. 1189 - 1201.
Cancer epidemiology - Nested case-control study - Pancreatic cancer - Vitamin D
Evidence from in vivo, in vitro and ecological studies are suggestive of a protective effect of vitamin D against pancreatic cancer (PC). However, this has not been confirmed by analytical epidemiological studies. We aimed to examine the association between pre-diagnostic circulating vitamin D concentrations and PC incidence in European populations. We conducted a pooled nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) and the Nord-Trøndelag Health Study's second survey (HUNT2) cohorts. In total, 738 primary incident PC cases (EPIC n=626; HUNT2 n=112; median follow-up=6.9 years) were matched to 738 controls. Vitamin D [25(OH)D2 and 25(OH)D3 combined] concentrations were determined using isotope-dilution liquid chromatography-tandem mass spectrometry. Conditional logistic regression models with adjustments for body mass index and smoking habits were used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (95%CI). Compared with a reference category of >50 to 75 nmol/L vitamin D, the IRRs (95% CIs) were 0.71 (0.42-1.20); 0.94 (0.72-1.22); 1.12 (0.82-1.53) and 1.26 (0.79-2.01) for clinically pre-defined categories of ≤25; >25 to 50; >75 to 100; and >100 nmol/L vitamin D, respectively (p for trend=0.09). Corresponding analyses by quintiles of season-standardized vitamin D concentrations also did not reveal associations with PC risk (p for trend=0.23). Although these findings among participants from the largest combination of European cohort studies to date show increasing effect estimates of PC risk with increasing pre-diagnostic concentrations of vitamin D, they are not statistically significant.
Evaluating dietary supply of microminerals as a premix in a complete plant ingredient-based diet to juvenile rainbow trout (Oncorhynchus mykiss)
Prabhu, P.A.J. ; Schrama, J.W. ; Fontagné-Dicharry, S. ; Mariojouls, C. ; Surget, A. ; Bueno de Mesquita, M. ; Geurden, I. ; Kaushik, Sadasivam J. - \ 2018
Aquaculture Nutrition 24 (2018)1. - ISSN 1353-5773 - p. 539 - 547.
Fishmeal replacement - Micro minerals - Premix - Rainbow trout - Requirement - Supplement - Trace minerals
Two basal diets M0 and V0 were formulated with marine and plant based ingredient composition. Seven experimental diets were prepared from the two basal diets namely M0, M100, V0, V30, V60, V100 and V150 by incorporating different levels of a micromineral premix (Cu, Fe, Mn, Se and Zn). Triplicate groups of rainbow trout (initial weight: 20 g) reared at 17°C were fed one of each diet to apparent visual satiation over 12 weeks. Among the V diet fed fish, growth and feed intake exhibited maximal response at V60 level of premix inclusion; Apparent availability coefficient of Fe, Cu and Zn decreased linearly with increasing level of premix whereas apparent availability coefficient of Mn and Se was unaffected. The available dietary concentration in basal V0 diet was for Fe, 20.6; Cu, 2.8; Mn, 6.5; Zn, 17.3 and Se, 0.195 (in mg/kg DM) and in the M0 diet for Fe, 63.3; Cu, 5.2; Mn, 2.9; Zn, 35.2 and Se, 0.87 (in mg/kg DM). In reference to NRC (Nutrient requirements of fish and shrimp. Washington, DC: National Research Council, The National Academies Press, 2011) recommendations, the V0 basal diet accounted for 34.3%, 92.9%, 53.9%, 115% and 130.2% and the contribution from M0 diet for 105.5%, 173.3%, 24.2%, 234.7% and 580% of the minimal dietary inclusion levels of Fe, Cu, Mn, Zn and Se to rainbow trout, respectively. However, data on whole body mineral contents showed that normal levels were maintained only for Cu and Mn through supply from basal V0 diet. For Zn and Se, available supply even from the highest supplemented diet (V150) was not sufficient to maintain normal body mineral levels of rainbow trout in the present study. On the whole, optimal dietary inclusion levels of microminerals are altered while using fishmeal-free diets for rainbow trout.
Self-rated health and all-cause and cause-specific mortality of older adults. Individual data meta-analysis of prospective cohort studies in the CHANCES Consortium
Bamia, Christina ; Orfanos, Philippos ; Juerges, H. ; Schöttker, Ben ; Brenner, Hermann ; Lorbeer, Roberto ; Aadahl, Mette ; Matthews, Charles E. ; Bueno-de Mesquita, H.B. ; Groot, C.P.G.M. de - \ 2017
Maturitas 103 (2017). - ISSN 0378-5122 - p. 37 - 44.
To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as “at-least-good”.

Study Design
Individual data on SRH and important covariates were obtained for 424,791 European and Unites States residents, ≥60 years at recruitment (1982-2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses.

Main outcome measures
All-cause, cardiovascular and cancer mortality.

Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH “fair” or “poor” vs. “at-least-good” was associated with increased mortality: HRs 1.46 (95% CI 1·23-1.74) and 2.31 (1.79-2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence).

SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to “feel healthy” and “be healthy”.
Pre-diagnostic meat and fibre intakes in relation to colorectal cancer survival in the European Prospective Investigation into Cancer and Nutrition
Ward, Heather A. ; Norat, Teresa ; Overvad, Kim ; Dahm, Christina C. ; Bueno-de-Mesquita, H.B. ; Jenab, Mazda ; Fedirko, Veronika ; Duijnhoven, Fränzel J.B. Van; Skeie, Guri ; Romaguera-Bosch, Dora ; Tjonneland, Anne ; Olsen, Anja ; Carbonnel, Franck ; Affret, Aurélie ; Boutron-Ruault, Marie Christine ; Katzke, Verena ; Kühn, Tilman ; Aleksandrova, Krassimira ; Boeing, Heiner ; Trichopoulou, Antonia ; Lagiou, Pagona ; Bamia, Christina ; Palli, Domenico ; Sieri, Sabina ; Tumino, Rosario ; Naccarati, Alessio ; Mattiello, Amalia ; Peeters, Petra H. ; Weiderpass, Elisabete ; Åsli, Lene Angell ; Jakszyn, Paula ; Ramón Quirós, J. ; Sánchez, María José ; Dorronsoro, Miren ; Huerta, José María ; Barricarte, Aurelio ; Jirström, Karin ; Ericson, Ulrika ; Johansson, Ingegerd ; Gylling, Björn ; Bradbury, Kathryn E. ; Khaw, Kay Tee ; Wareham, Nicholas J. ; Stepien, Magdalena ; Freisling, Heinz ; Murphy, Neil ; Cross, Amanda J. ; Riboli, Elio - \ 2016
The British journal of nutrition 116 (2016)2. - ISSN 0007-1145 - p. 316 - 325.
Cancer survival - Cohorts - Colorectal cancers - Diets - European Prospective Investigation into Cancer and Nutrition
Improvements in colorectal cancer (CRC) detection and treatment have led to greater numbers of CRC survivors, for whom there is limited evidence on which to provide dietary guidelines to improve survival outcomes. Higher intake of red and processed meat and lower intake of fibre are associated with greater risk of developing CRC, but there is limited evidence regarding associations with survival after CRC diagnosis. Among 3789 CRC cases in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, pre-diagnostic consumption of red meat, processed meat, poultry and dietary fibre was examined in relation to CRC-specific mortality (n 1008) and all-cause mortality (n 1262) using multivariable Cox regression models, adjusted for CRC risk factors. Pre-diagnostic red meat, processed meat or fibre intakes (defined as quartiles and continuous grams per day) were not associated with CRC-specific or all-cause mortality among CRC survivors; however, a marginal trend across quartiles of processed meat in relation to CRC mortality was detected (P 0·053). Pre-diagnostic poultry intake was inversely associated with all-cause mortality among women (hazard ratio (HR)/20 g/d 0·92; 95 % CI 0·84, 1·00), but not among men (HR 1·00; 95 % CI 0·91, 1·09) (P for heterogeneity=0·10). Pre-diagnostic intake of red meat or fibre is not associated with CRC survival in the EPIC cohort. There is suggestive evidence of an association between poultry intake and all-cause mortality among female CRC survivors and between processed meat intake and CRC-specific mortality; however, further research using post-diagnostic dietary data is required to confirm this relationship.
Anthropometry and the risk of lung cancer in EPIC
Dewi, Nikmah Utami ; Boshuizen, Hendriek C. ; Johansson, Mattias ; Vineis, Paolo ; Kampman, Ellen ; Steffen, Annika ; Tjønneland, Anne ; Halkjær, Jytte ; Overvad, Kim ; Severi, Gianluca ; Fagherazzi, Guy ; Boutron-Ruault, Marie Christine ; Kaaks, Rudolf ; Li, Kuanrong ; Boeing, Heiner ; Trichopoulou, Antonia ; Bamia, Christina ; Klinaki, Eleni ; Tumino, Rosario ; Palli, Domenico ; Mattiello, Amalia ; Tagliabue, Giovanna ; Peeters, Petra H. ; Vermeulen, Roel ; Weiderpass, Elisabete ; Gram, Inger Torhild ; Huerta, José María ; Agudo, Antonio ; Sánchez, María José ; Ardanaz, Eva ; Dorronsoro, Miren ; Quirós, José Ramón ; Sonestedt, Emily ; Johansson, Mikael ; Grankvist, Kjell ; Key, Tim ; Khaw, Kay Tee ; Wareham, Nick ; Cross, Amanda J. ; Norat, Teresa ; Riboli, Elio ; Fanidi, Anouar ; Muller, David ; Bueno-De-Mesquita, H.B. - \ 2016
American Journal of Epidemiology 184 (2016)2. - ISSN 0002-9262 - p. 129 - 139.
body mass index - lung cancer - obesity - smoking - waist circumference - waist to hip ratio - waist-to-height ratio

The associations of body mass index (BMI) and other anthropometric measurements with lung cancer were examined in 348,108 participants in the European Investigation Into Cancer and Nutrition (EPIC) between 1992 and 2010. The study population included 2,400 case patients with incident lung cancer, and the average length of follow-up was 11 years. Hazard ratios were calculated using Cox proportional hazard models in which we modeled smoking variables with cubic splines. Overall, there was a significant inverse association between BMI (weight (kg)/height (m)2) and the risk of lung cancer after adjustment for smoking and other confounders (for BMI of 30.0-34.9 versus 18.5-25.0, hazard ratio = 0.72, 95% confidence interval: 0.62, 0.84). The strength of the association declined with increasing follow-up time. Conversely, after adjustment for BMI, waist circumference and waist-to-height ratio were significantly positively associated with lung cancer risk (for the highest category of waist circumference vs. the lowest, hazard ratio = 1.25, 95% confidence interval: 1.05, 1.50). Given the decline of the inverse association between BMI and lung cancer over time, the association is likely at least partly due to weight loss resulting from preclinical lung cancer that was present at baseline. Residual confounding by smoking could also have influenced our findings.

A national FFQ for the Netherlands (the FFQ-NL 1.0): validation of a comprehensive FFQ for adults
Sluik, D. ; Geelen, M.M.E.E. ; Vries, J.H.M. de; Eussen, S.J.P.M. ; Brants, H.A.M. ; Meijboom, S. ; Dongen, Martien C.J.M. van; Bueno-de Mesquita, H.B. ; Veer, P. van 't; Feskens, E.J.M. - \ 2016
The British journal of nutrition 116 (2016)5. - ISSN 0007-1145 - p. 913 - 923.
A standardised, national, 160-item FFQ, the FFQ-NL 1.0, was recently developed for Dutch epidemiological studies. The objective was tovalidate the FFQ-NL 1.0 against multiple 24-h recalls (24hR) and recovery and concentration biomarkers. The FFQ-NL 1.0 was filled out by383 participants (25–69 years) from the Nutrition Questionnaires plus study. For each participant, one to two urinary and blood samples andone to five (mean 2·7) telephone-based 24hR were available. Group-level bias, correlation coefficients, attenuation factors, de-attenuatedcorrelation coefficients and ranking agreement were assessed. Compared with the 24hR, the FFQ-NL 1.0 estimated the intake of energy andmacronutrients well. However, it underestimated intakes of SFA and trans-fatty acids and alcohol and overestimated intakes of most vitaminsby >5%. The median correlation coefficient was 0·39 for energy and macronutrients, 0·30 for micronutrients and 0·30 for food groups. TheFFQ underestimated protein intake by an average of 16% and K by 5 %, relative to their urinary recovery biomarkers. Attenuation factors were0·44 and 0·46 for protein and K, respectively. Correlation coefficients were 0·43–0·47 between (fatty) fish intake and plasma EPA and DHA and0·24–0·43 between fruit and vegetable intakes and plasma carotenoids. In conclusion, the overall validity of the newly developed FFQ-NL 1.0was acceptable to good. The FFQ-NL 1.0 is well suited for future use within Dutch cohort studies among adults.
Quantification of the smoking-associated cancer risk with rate advancement periods : Meta-analysis of individual participant data from cohorts of the CHANCES consortium
Ordóñez-Mena, José Manuel ; Schöttker, Ben ; Mons, Ute ; Jenab, Mazda ; Freisling, Heinz ; Bueno-de-Mesquita, Bas ; O'Doherty, Mark G. ; Scott, Angela ; Kee, Frank ; Stricker, Bruno H. ; Hofman, Albert ; Keyser, Catherine E. de; Ruiter, Rikje ; Söderberg, Stefan ; Jousilahti, Pekka ; Kuulasmaa, Kari ; Freedman, Neal D. ; Wilsgaard, Tom ; Groot, Lisette C.P.G.M. de; Kampman, Ellen ; Håkansson, Niclas ; Orsini, Nicola ; Wolk, Alicja ; Nilsson, Lena Maria ; Tjønneland, Anne ; Pajak, Andrzej ; Malyutina, Sofia ; Kubínová, Růžena ; Tamosiunas, Abdonas ; Bobak, Martin ; Katsoulis, Michail ; Orfanos, Philippos ; Boffetta, Paolo ; Trichopoulou, Antonia ; Brenner, Hermann - \ 2016
BMC Medicine 14 (2016)1. - ISSN 1741-7015
Cancer - Cohort - Incidence - Meta-analysis - Mortality - Smoking

Background: Smoking is the most important individual risk factor for many cancer sites but its association with breast and prostate cancer is not entirely clear. Rate advancement periods (RAPs) may enhance communication of smoking related risk to the general population. Thus, we estimated RAPs for the association of smoking exposure (smoking status, time since smoking cessation, smoking intensity, and duration) with total and site-specific (lung, breast, colorectal, prostate, gastric, head and neck, and pancreatic) cancer incidence and mortality. Methods: This is a meta-analysis of 19 population-based prospective cohort studies with individual participant data for 897,021 European and American adults. For each cohort we calculated hazard ratios (HRs) for the association of smoking exposure with cancer outcomes using Cox regression adjusted for a common set of the most important potential confounding variables. RAPs (in years) were calculated as the ratio of the logarithms of the HRs for a given smoking exposure variable and age. Meta-analyses were employed to summarize cohort-specific HRs and RAPs. Results: Overall, 140,205 subjects had a first incident cancer, and 53,164 died from cancer, during an average follow-up of 12 years. Current smoking advanced the overall risk of developing and dying from cancer by eight and ten years, respectively, compared with never smokers. The greatest advancements in cancer risk and mortality were seen for lung cancer and the least for breast cancer. Smoking cessation was statistically significantly associated with delays in the risk of cancer development and mortality compared with continued smoking. Conclusions: This investigation shows that smoking, even among older adults, considerably advances, and cessation delays, the risk of developing and dying from cancer. These findings may be helpful in more effectively communicating the harmful effects of smoking and the beneficial effect of smoking cessation.

Pre-diagnostic vitamin D concentrations and cancer risks in older individuals: an analysis of cohorts participating in the CHANCES consortium
Ordonez-Mena, J.M. ; Schöttker, B. ; Fedirko, V. ; Jenab, M. ; Olsen, A. ; Halkjaer, J. ; Kampman, E. ; Groot, C.P.G.M. de; Jansen, E. ; Bueno-de-Mesquita, H.B. ; Peeters, P.H. - \ 2016
European Journal of Epidemiology 31 (2016)3. - ISSN 0393-2990 - p. 311 - 323.
The associations of circulating 25-hydroxyvitamin D [25(OH)D] concentrations with total and site-specific cancer incidence have been examined in several epidemiological studies with overall inconclusive findings. Very little is known about the association of vitamin D with cancer incidence in older populations. We assessed the association of pre-diagnostic serum 25(OH)D levels with incidence of all cancers combined and incidence of lung, colorectal, breast, prostate and lymphoid malignancies among older adults. Pre-diagnostic 25(OH)D concentrations and cancer incidence were available in total for 15,486 older adults (mean age 63, range 50–84 years) participating in two cohort studies: ESTHER (Germany) and TROMSØ (Norway); and a subset of previously published nested-case control data from a another cohort study: EPIC-Elderly (Greece, Denmark, Netherlands, Spain and Sweden) from the CHANCES consortium on health and aging. Cox proportional hazards or logistic regression were used to derive multivariable adjusted hazard and odds ratios, respectively, and their 95 % confidence intervals across 25(OH)D categories. Meta-analyses with random effects models were used to pool study-specific risk estimates. Overall, lower 25(OH)D concentrations were not significantly associated with increased incidence of most of the cancers assessed. However, there was some evidence of increased breast cancer and decreased lymphoma risk with higher 25(OH)D concentrations. Our meta-analyses with individual participant data from three large European population-based cohort studies provide at best limited support for the hypothesis that vitamin D may have a major role in cancer development and prevention among European older adults.
WHO guidelines for a healty diet and mortality from cardiovascular disease in European and American elderly: the CHANCES project
Jankovic, N. ; Geelen, A. ; Streppel, M.T. ; Groot, C.P.G.M. de; Kiefte-de Jong, J.C. ; Bueno-de Mesquita, H.B. ; Kampman, E. ; Feskens, E.J.M. - \ 2015
American Journal of Clinical Nutrition 102 (2015)4. - ISSN 0002-9165 - p. 745 - 756.
Background: Cardiovascular disease (CVD) represents a leading cause of mortality worldwide, especially in the elderly. Lowering the number of CVD deaths requires preventive strategies targeted on the elderly. Objective: The objective was to generate evidence on the association between WHO dietary recommendations and mortality from CVD, coronary artery disease (CAD), and stroke in the elderly aged =60 y. Design: We analyzed data from 10 prospective cohort studies from Europe and the United States comprising a total sample of 281,874 men and women free from chronic diseases at baseline. Components of the Healthy Diet Indicator (HDI) included saturated fatty acids, polyunsaturated fatty acids, mono- and disaccharides, protein, cholesterol, dietary fiber, and fruit and vegetables. Cohort-specific HRs adjusted for sex, education, smoking, physical activity, and energy and alcohol intakes were pooled by using a random-effects model. Results: During 3,322,768 person-years of follow-up, 12,492 people died of CVD. An increase of 10 HDI points (complete adherence to an additional WHO guideline) was, on average, not associated with CVD mortality (HR: 0.94; 95% CI: 0.86, 1.03), CAD mortality (HR: 0.99; 95% CI: 0.85, 1.14), or stroke mortality (HR: 0.95; 95% CI: 0.88, 1.03). However, after stratification of the data by geographic region, adherence to the HDI was associated with reduced CVD mortality in the southern European cohorts (HR: 0.87; 95% CI: 0.79, 0.96; I2 = 0%) and in the US cohort (HR: 0.85; 95% CI: 0.83, 0.87; I2 = not applicable). Conclusion: Overall, greater adherence to the WHO dietary guidelines was not significantly associated with CVD mortality, but the results varied across regions. Clear inverse associations were observed in elderly populations in southern Europe and the United States.
The relationship between fermented food intake and mortality risk in the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort
Praagman, J. ; Dalmeijer, G.W. ; Schouw, Y.T. van der; Soedamah-Muthu, S.S. ; Verschuren, W.M.M. ; Bueno-de Mesquita, H.B. ; Geleijnse, J.M. ; Beulens, J.W.J. - \ 2015
The British journal of nutrition 113 (2015). - ISSN 0007-1145 - p. 498 - 506.
coronary-heart-disease - lactic-acid bacteria - dairy-products - colorectal-cancer - consumption - stroke - metaanalysis - questionnaire - menaquinone - men
The objective of the present study was to investigate the relationship between total and subtypes of bacterial fermented food intake (dairy products, cheese, vegetables and meat) and mortality due to all causes, total cancer and CVD. From the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort, 34 409 Dutch men and women, aged 20–70 years who were free from CVD or cancer at baseline, were included. Baseline intakes of total and subtypes of fermented foods were measured with a validated FFQ. Data on the incidence and causes of death were obtained from the national mortality register. Cox proportional hazards models were used to analyse mortality in relation to the quartiles of fermented food intake. After a mean follow-up of 15 (sd 2·5) years, 2436 deaths occurred (1216 from cancer and 727 from CVD). After adjustment for age, sex, total energy intake, physical activity, education level, hypertension, smoking habit, BMI, and intakes of fruit, vegetables and alcohol, total fermented food intake was not found to be associated with mortality due to all causes (hazard ratio upper v. lowest quartile (HRQ4 v. Q1) 1·00, 95 % CI 0·88, 1·13), cancer (HRQ4 v. Q1 1·02, 95 % CI 0·86, 1·21) or CVD (HRQ4 v. Q1 1·04, 95 % CI 0·83, 1·30). Bacterial fermented foods mainly consisted of fermented dairy foods (78 %) and cheese (16 %). None of the subtypes of fermented foods was consistently related to mortality, except for cheese which was moderately inversely associated with CVD mortality, and particularly stroke mortality (HRQ4 v. Q1 0·59, 95 % CI 0·38, 0·92, Ptrend= 0·046). In conclusion, the present study provides no strong evidence that intake of fermented foods, particularly fermented dairy foods, is associated with mortality.
Conflictos y gestión del agua en America Latina
Bueno de Mesquita, M. ; Boelens, R.A. - \ 2014
Boletín (In) Justicia Hídrica, conflictos y resistencias en América Latina 2014 (2014)1.
Adherence to dietary guidelines and cardiovascular disease risk in the EPIC-NL cohort
Struijk, E.A. ; May, A.M. ; Wezenbeek, N.L.W.J. ; Fransen, H. ; Soedamah-Muthu, S.S. ; Geelen, A. ; Boer, J. ; Schouw, Y.T. van der; Bueno de Mesquita, H.B. ; Beulens, J.W.J. - \ 2014
International Journal of Cardiology 176 (2014)2. - ISSN 0167-5273 - p. 354 - 359.
coronary-heart-disease - major chronic disease - systematic analysis - for-americans - global burden - style diet - 21 regions - women - men - questionnaire
Background Global and national dietary guidelines have been created to lower chronic disease risk. The aim of this study was to assess whether greater adherence to the WHO guidelines (Healthy Diet Indicator (HDI)); the Dutch guidelines for a healthy diet (Dutch Healthy Diet-index (DHD-index)); and the Dietary Approaches to Stop Hypertension (DASH) diet was associated with a lower risk of cardiovascular disease (CVD), coronary heart disease (CHD) or stroke. Methods A prospective cohort study was conducted among 33,671 healthy Dutch men and women aged 20–70 years recruited into the EPIC-NL study during 1993–1997. We used Cox regression adjusted for relevant confounders to estimate the hazard ratios per standard deviation increase in score and 95% confidence intervals (CI) of the associations between the dietary guidelines and CVD, CHD and stroke risk. Results After an average follow-up of 12.2 years, 2752 CVD cases were documented, including 1630 CHD cases and 527 stroke cases. We found no association between the HDI (0.98, 95% CI 0.94; 1.02) or DHD-index (0.96, 95% CI 0.92; 1.00) and CVD incidence. Similar results were found for these guidelines and CHD or stroke incidence. Higher adherence to the DASH diet was significantly associated with a lower CVD (0.92, 95% CI 0.89; 0.96), CHD (0.91, 95% CI 0.86; 0.95), and stroke (0.90, 95% CI 0.82; 0.99) risk. Conclusion The HDI and the DHD-index were not associated with CVD risk, while the DASH diet was significantly associated with a lower risk of developing CVD, CHD and stroke.
Biomarker patterns of inflammatory and metabolic pathways are associated with risk of colorectal cancer: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)
Aleksandrova, K. ; Jenab, M. ; Bueno-de-Mesquita, H.B. ; Fedirko, V. ; Kaaks, R. ; Lukanova, A. ; Duijnhoven, F.J.B. van - \ 2014
European Journal of Epidemiology 29 (2014)4. - ISSN 0393-2990 - p. 261 - 275.
soluble leptin receptor - density-lipoprotein cholesterol - c-reactive protein - insulin-resistance - oxidative stress - hdl-cholesterol - multiple imputation - plasma adiponectin - binding-proteins - adipose-tissue
A number of biomarkers of inflammatory and metabolic pathways are individually related to higher risk of colorectal cancer (CRC); however, the association between biomarker patterns and CRC incidence has not been previously evaluated. Our study investigates the association of biomarker patterns with CRC in a prospective nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC). During median follow-up time of 7.0 (3.7-9.4) years, 1,260 incident CRC cases occurred and were matched to 1,260 controls using risk-set sampling. Pre-diagnostic measurements of C-peptide, glycated hemoglobin, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP), reactive oxygen metabolites (ROM), insulin-like growth factor 1, adiponectin, leptin and soluble leptin receptor (sOB-R) were used to derive biomarker patterns from principal component analysis (PCA). The relation with CRC incidence was assessed using conditional logistic regression models. We identified four biomarker patterns 'HDL-C/Adiponectin fractions', 'ROM/CRP', 'TG/C-peptide' and 'leptin/sOB-R' to explain 60 % of the overall biomarker variance. In multivariable-adjusted logistic regression, the 'HDL-C/Adiponectin fractions', 'ROM/CRP' and 'leptin/sOB-R' patterns were associated with CRC risk [for the highest quartile vs the lowest, incidence rate ratio (IRR) = 0.69, 95 % CI 0.51-0.93, P-trend = 0.01; IRR = 1.70, 95 % CI 1.30-2.23, P-trend = 0.002; and IRR = 0.79, 95 % CI 0.58-1.07; P-trend = 0.05, respectively]. In contrast, the 'TG/C-peptide' pattern was not associated with CRC risk (IRR = 0.75, 95 % CI 0.56-1.00, P-trend = 0.24). After cases within the first 2 follow-up years were excluded, the 'ROM/CRP' pattern was no longer associated with CRC risk, suggesting potential influence of preclinical disease on these associations. By application of PCA, the study identified 'HDL-C/Adiponectin fractions', 'ROM/CRP' and 'leptin/sOB-R' as biomarker patterns representing potentially important pathways for CRC development.
Active and passive cigarette smoking and breast cancer risk: results from the EPIC cohort
Dossus, L. ; Boutron-Ruault, M.C. ; Kaaks, R. ; Gram, I.T. ; Vilier, A. ; Fervers, B. ; Manjer, J. ; Tjonneland, A. ; Olsen, A. ; Overvad, K. ; Chang-Claude, J. ; Boeing, H. ; Steffen, A. ; Trichopoulou, A. ; Lagiou, P. ; Sarantopoulou, M. ; Palli, D. ; Berrino, F. ; Tumino, R. ; Vineis, P. ; Mattiello, A. ; Bueno-de-Mesquita, H.B. ; Duijnhoven, F.J.B. van - \ 2014
International Journal of Cancer 134 (2014)8. - ISSN 0020-7136 - p. 1871 - 1888.
environmental tobacco-smoke - postmenopausal women - california teachers - 1st childbirth - never smokers - exposure - metaanalysis - association - carcinogens - reanalysis
Recent cohort studies suggest that increased breast cancer risks were associated with longer smoking duration, higher pack-years and a dose-response relationship with increasing pack-years of smoking between menarche and first full-term pregnancy (FFTP). Studies with comprehensive quantitative life-time measures of passive smoking suggest an association between passive smoking dose and breast cancer risk. We conducted a study within the European Prospective Investigation into Cancer and Nutrition to examine the association between passive and active smoking and risk of invasive breast cancer and possible effect modification by known breast cancer risk factors. Among the 322,988 women eligible for the study, 9,822 developed breast cancer (183,608 women with passive smoking information including 6,264 cases). When compared to women who never smoked and were not being exposed to passive smoking at home or work at the time of study registration, current, former and currently exposed passive smokers were at increased risk of breast cancer (hazard ratios (HR) [95% confidence interval (CI)] 1.16 [1.05–1.28], 1.14 [1.04–1.25] and 1.10 [1.01–1.20], respectively). Analyses exploring associations in different periods of life showed the most important increase in risk with pack-years from menarche to FFTP (1.73 [1.29–2.32] for every increase of 20 pack-years) while pack-years smoked after menopause were associated with a significant decrease in breast cancer risk (HR = 0.53, 95% CI: 0.34–0.82 for every increase of 20 pack-years). Our results provide an important replication, in the largest cohort to date, that smoking (passively or actively) increases breast cancer risk and that smoking between menarche and FFTP is particularly deleterious.
Coffee and tea consumption, genotype-based CYP1A2 and NAT2 activity and colorectal cancer risk—Results from the EPIC cohort study
Dik, V.K. ; Bueno-de-Mesquita, H.B. ; Oijen, M.G.C.T. van; Siersema, P.D. ; Uiterwaal, C.S.P.M. ; Gils, C.H. van; Duijnhoven, F.J.B. van - \ 2014
International Journal of Cancer 135 (2014)2. - ISSN 0020-7136 - p. 401 - 412.
colonic aberrant crypts - green tea - components kahweol - black tea - caffeine - cafestol - polyphenols - health - cells - rat
Coffee and tea contain numerous antimutagenic and antioxidant components and high levels of caffeine that may protect against colorectal cancer (CRC). We investigated the association between coffee and tea consumption and CRC risk and studied potential effect modification by CYP1A2 and NAT2 genotypes, enzymes involved in the metabolization of caffeine. Data from 477,071 participants (70.2% female) of the European Investigation into Cancer and Nutrition (EPIC) cohort study were analyzed. At baseline (1992–2000) habitual (total, caffeinated and decaffeinated) coffee and tea consumption was assessed with dietary questionnaires. Cox proportional hazards models were used to estimate adjusted hazard ratio's (HR) and 95% confidence intervals (95% CI). Potential effect modification by genotype-based CYP1A2 and NAT2 activity was studied in a nested case–control set of 1,252 cases and 2,175 controls. After a median follow-up of 11.6 years, 4,234 participants developed CRC (mean age 64.7¿±¿8.3 years). Total coffee consumption (high vs. non/low) was not associated with CRC risk (HR 1.06, 95% CI 0.95–1.18) or subsite cancers, and no significant associations were found for caffeinated (HR 1.10, 95% CI 0.97–1.26) and decaffeinated coffee (HR 0.96, 95% CI 0.84–1.11) and tea (HR 0.97, 95% CI 0.86–1.09). High coffee and tea consuming subjects with slow CYP1A2 or NAT2 activity had a similar CRC risk compared to non/low coffee and tea consuming subjects with a fast CYP1A2 or NAT2 activity, which suggests that caffeine metabolism does not affect the link between coffee and tea consumption and CRC risk. This study shows that coffee and tea consumption is not likely to be associated with overall CRC.
Adherence to a healthy diet according to the World Health Organization guidelines and all-cause mortality in elderly adults from Europe and the United States
Jankovic, N. ; Geelen, A. ; Streppel, M.T. ; Groot, C.P.G.M. de; Kampman, E. ; Feskens, E.J.M. ; Trichopoulou, A. ; Bueno-de Mesquita, H.B. ; Franco, O.H. - \ 2014
American Journal of Epidemiology 180 (2014)10. - ISSN 0002-9262 - p. 978 - 988.
cardiovascular-disease - epic project - design - prevention - cohort - risk - determinants - rationale - quality - scores
The World Health Organization (WHO) has formulated guidelines for a healthy diet to prevent chronic diseases and postpone death worldwide. Our objective was to investigate the association between the WHO guidelines, measured using the Healthy Diet Indicator (HDI), and all-cause mortality in elderly men and women from Europe and the United States. We analyzed data from 396,391 participants (42% women) in 11 prospective cohort studies who were 60 years of age or older at enrollment (in 1988–2005). HDI scores were based on 6 nutrients and 1 food group and ranged from 0 (least healthy diet) to 70 (healthiest diet). Adjusted cohort-specific hazard ratios were derived by using Cox proportional hazards regression and subsequently pooled using random-effects meta-analysis. During 4,497,957 person-years of follow-up, 84,978 deaths occurred. Median HDI scores ranged from 40 to 54 points across cohorts. For a 10-point increase in HDI score (representing adherence to an additional WHO guideline), the pooled adjusted hazard ratios were 0.90 (95% confidence interval (CI): 0.87, 0.93) for men and women combined, 0.89 (95% CI: 0.85, 0.92) for men, and 0.90 (95% CI: 0.85, 0.95) for women. These estimates translate to an increased life expectancy of 2 years at the age of 60 years. Greater adherence to the WHO guidelines is associated with greater longevity in elderly men and women in Europe and the United States.
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