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Prebiotics are a subtype of dietary fibre selectively fermented by beneficial bacterial in the colon. Preclinical evidence has suggested that prebiotics may be associated with a decreased risk of colorectal cancer. However, the association between dietary intake of prebiotics and colorectal cancer risk has not been investigated prospectively. This study aims to prospectively investigate the association between total prebiotic intake and colorectal cancer risk. Further characterisation of the association by prebiotic sub-type (fructans and galacto-oligosaccharides (GOSs)) and colorectal cancer sub-site (colon cancer and rectal cancer) were secondary objectives.
Material and methods:
A total of 53,700 men and women living in England and Scotland who were enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Oxford study, were included in the analysis and followed up for incident colorectal cancers. Validated semi-quantitative food frequency questionnaires administered at baseline were used to calculate daily fructan, GOS and total prebiotic intake. We used multivariable Cox proportional hazards models to assess associations between prebiotic intake and risk of colorectal cancer.
A total of 574 incident cases of colorectal cancer were identified during a mean of 16.1 years of follow-up. Total prebiotic, fructan and GOS intake were not significantly associated with colorectal cancer risk. The hazard ratios for those in the highest fourths of total prebiotic, fructan and GOS intake compared to those in the lowest fourths were 0.87 (95% confidence intervals (CI) 0.66–1.14; P for trend = 0.3), 0.91 (95% CI 0.70–1.18; P for trend = 0.4), and 0.87 (95% CI 0.66–1.15; P for trend = 0.4) respectively. The associations remained nonsignificant when colorectal cancer sub-sites were investigated separately.
The results from this observational study do not support an association between prebiotic intake and colorectal cancer risk. Given the biological plausibility of a role for prebiotics in reducing colorectal cancer risk and since the non-significant association between prebiotic intake and colorectal cancer risk observed in the current study may be due to the small number of cases and the healthy profile of the cohort, further epidemiological research is needed to characterise the association between dietary prebiotic intake and colorectal cancer incidence.
In the present study, the aim was to investigate the correlation between the acute and habitual dietary intake of flavanones, their main food sources and the concentrations of aglycones naringenin and hesperetin in 24 h urine in a European population. A 24-h dietary recall (24-HDR) and a 24-h urine sample were collected the same day from a subsample of 475 people from four different countries of the European Prospective Investigation into Cancer and Nutrition study. Acute and habitual dietary data were captured through a standardised 24-HDR and a country/centre-specific validated dietary questionnaire (DQ). The intake of dietary flavanones was estimated using the Phenol-Explorer database. Urinary flavanones (naringenin and hesperetin) were analysed using tandem MS with a previous enzymatic hydrolysis. Weak partial correlation coefficients were found between urinary flavanone concentrations and both acute and habitual dietary flavanone intakes (Rpartial = 0·14–0·17). Partial correlations were stronger between urinary excretions and acute intakes of citrus fruit and juices (Rpartial ∼ 0·6) than with habitual intakes of citrus fruit and juices (Rpartial ∼ 0·24). In conclusion, according to our results, urinary excretion of flavanones can be considered a good biomarker of acute citrus intake. However, low associations between habitual flavanone intake and urinary excretion suggest a possible inaccurate estimation of their intake or a too sporadic intake. For assessing habitual exposures, multiple urinary collections may be needed. These results show that none of the approaches tested is ideal, and the use of both DQ and biomarkers can be recommended.
Fish consumption is the major dietary source of EPA and DHA, which according to rodent experiments may reduce body fat mass and prevent obesity. Only a few human studies have investigated the association between fish consumption and body-weight gain. We investigated the association between fish consumption and subsequent change in body weight. Women and men (n 344 757) participating in the European Prospective Investigation into Cancer and Nutrition were followed for a median of 5·0 years. Linear and logistic regression were used to investigate the associations between fish consumption and subsequent change in body weight. Among women, the annual weight change was 5·70 (95 % CI 4·35, 7·06), 2·23 (95 % CI 0·16, 4·31) and 11·12 (95 % CI 8·17, 14·08) g/10 g higher total, lean and fatty fish consumption per d, respectively. The OR of becoming overweight in 5 years among women who were normal weight at enrolment was 1·02 (95 % CI 1·01, 1·02), 1·01 (95 % CI 1·00, 1·02) and 1·02 (95 % CI 1·01, 1·04) g/10 g higher total, lean and fatty consumption per d, respectively. Among men, fish consumption was not statistically significantly associated with weight change. Adjustment for potential over- or underestimation of fish consumption did not systematically change the observed associations, but the 95 % CI became wider. The results in subgroups from analyses stratified by age or BMI at enrolment were not systematically different. In conclusion, the present study suggests that fish consumption has no appreciable association with body-weight gain.
Epidemiological studies show that adherence to a Mediterranean diet (MD) increases longevity; however, few studies are restricted to Mediterranean populations or explore the effect of a MD pattern that directly incorporates olive oil. Therefore the relationship between adherence to the MD and mortality was studied within the the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). The EPIC-Spain analysis included 40 622 participants (37·7 % males) aged 29–69 years who were recruited from five Spanish regions in 1992–1996. During a mean follow-up of 13·4 years, 1855 deaths were documented: 913 from cancer, 399 from CVD, 425 from other causes and 118 from unknown causes of death. Risk of all-cause and cause-specific mortality was assessed according to the level of adherence to a relative MD (rMED) score, measured using an 18-unit scale incorporating nine selected dietary components. A high compared with a low rMED score was associated with a significant reduction in mortality from all causes (hazard ratio (HR) 0·79; 95 % CI 0·69, 0·91), from CVD (HR 0·66; 95 % CI 0·49, 0·89), but not from overall cancer (HR 0·92; 95 % CI 0·75, 1·12). A 2-unit increase in rMED score was associated with a 6 % (P < 0·001) decreased risk of all-cause mortality. A high olive oil intake and moderate alcohol consumption contributed most to this association. In this Spanish cohort, following an olive oil-rich MD was related to a significant reduction in all-cause mortality, and reduced the risk of mortality from CVD. These results support the important role that the MD pattern has on reducing mortality in Mediterranean countries.
In this paper, we present an approach to solve the drawbacks of manual composition of software components. Our approach is applied within the jcolibri framework for building case-based reasoning (CBR) applications. We propose a system design process based on reusing templates obtained from previously designed CBR systems. Templates store the control flow of the CBR applications and include semantic annotations conceptualizing its behavior and expertise. We use CBR ontology to formalize syntactical, semantical and pragmatical aspects of the reusable components of the framework. The ontology vocabulary facilitates an annotation process of the components and allows to reason about their composition, facilitating the semi-automatic configuration of complex systems from their composing pieces.
In contrast to some extensively examined food mutagens, for example, aflatoxins, N-nitrosamines and heterocyclic amines, some other food contaminants, in particular polycyclic aromatic hydrocarbons (PAH) and other aromatic compounds, have received less attention. Therefore, exploring the relationships between dietary habits and the levels of biomarkers related to exposure to aromatic compounds is highly relevant. We have investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort the association between dietary items (food groups and nutrients) and aromatic DNA adducts and 4-aminobiphenyl-Hb adducts. Both types of adducts are biomarkers of carcinogen exposure and possibly of cancer risk, and were measured, respectively, in leucocytes and erythrocytes of 1086 (DNA adducts) and 190 (Hb adducts) non-smokers. An inverse, statistically significant, association has been found between DNA adduct levels and dietary fibre intake (P = 0·02), vitamin E (P = 0·04) and alcohol (P = 0·03) but not with other nutrients or food groups. Also, an inverse association between fibre and fruit intake, and BMI and 4-aminobiphenyl-Hb adducts (P = 0·03, 0·04, and 0·03 respectively) was observed. After multivariate regression analysis these inverse correlations remained statistically significant, except for the correlation adducts v. fruit intake. The present study suggests that fibre intake in the usual range can modify the level of DNA or Hb aromatic adducts, but such role seems to be quantitatively modest. Fibres could reduce the formation of DNA adducts in different manners, by diluting potential food mutagens and carcinogens in the gastrointestinal tract, by speeding their transit through the colon and by binding carcinogenic substances.
Although the fatty acid fractions provide similar metabolizable energy, the type of dietary fat consumed could be relevant to the development of obesity.
To investigate the relationship between body mass index (BMI), obesity and the consumption of different types of fat and olive oil in a Mediterranean country with high prevalence of obesity, and high intake of monounsaturated fatty acids (MUFA) and olive oil.
The study was carried out in Spain among 23 289 women and 14 374 men, aged 29–69 years, who were participants of a large European prospective cohort.
Information on usual food intake was collected by interviewers by means of a dietary history questionnaire. The association between obesity (BMI ≥ 30 kg m2), dietary fat, other dietary patterns and other non-dietary factors were tested using multilinear regression analysis. The ratio of reported energy intake to energy requirement was used as an estimation of dietary underreporting.
The association between fatty acid fractions intake (saturated fatty acids (SFA) in women, and MUFA and polyunsaturated fatty acids (PUFA) in both sexes) and BMI was very weak, accounting for less than 1% of variance. All dietary and non-dietary variables accounted for 21% of variance in the measurement of BMI in women and only 6.7% of variance in men. Estimated underreporting of energy intake was 17.5% in obese women and 5.5% in obese men.
The association between consumption of specific types of dietary fat, olive oil and obesity in Spain is not very important. However, because of the cross-sectional design and some level of underreporting of energy intake observed in overweight subjects and overreporting in underweight subjects, systematic bias cannot be completely discarded.
To evaluate the association of vegetable and fruit intake with several demographic, anthropometric, lifestyle and dietary factors.
Design and setting
Cross-sectional analysis. Information on habitual diet was collected by means of the diet history method. Association of vegetable and fruit intakes with other factors was assessed separately by means of multiple lineal regression and the cumulative odds model.
39 622 healthy subjects aged 29–69 years from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort in Spain.
Fruit intake increased with age, education and physical activity and decreased with intake of saturated fatty acids and cholesterol; smoking and alcohol consumption were also negatively associated with fruit, with a very low consumption for current smokers and heavy drinkers. Vegetable intake increased with education and physical activity and with intake of unsaturated fatty acids, mainly mono-unsaturated. Former smokers consumed more vegetables than never or current smokers and non-consumers of alcohol ate less vegetables than consumers, among whom no differences were observed. All these estimates were adjusted by energy and body mass index (BMI).
When assessing the association of fruit and vegetables with chronic diseases it is important to take into account confounding factors. Furthermore, it would be useful to study dietary patterns including several interrelated factors.
To conduct a comprehensive assessment of dietary intakes of nitrites and N-nitrosodimethylamine (NDMA).
Subjects and setting
A study was conducted within the Spanish cohort of the European Prospective Investigation in Cancer and Nutrition (EPIC) to assess the intake and food sources of these compounds in Spanish adults. The study included 41 446 health volunteers, aged 29–69 years, from Northern and Southern regions. Usual food intake was estimated by in-person interviews using a computerised dietary questionnaire.
The estimated geometric mean was 0.994 mg day−1 for nitrites and 0.114 μg day−1 for NDMA. For both compounds a positive trend in consumption with increasing energy intake was observed. Dietary NDMA was related to age and sex after energy adjustment, while nitrite consumption increased with higher intakes of vitamin C (P < 0.001). The food groups that contributed most to intakes were meat products, cereals, vegetables and fruits for nitrites, and processed meat, beer, cheese and broiled fish for NDMA. Current and past smokers, who had high levels of NDMA from tobacco exposure, were also identified as the highest consumers of dietary NDMA. Furthermore, smokers had low intakes of vitamin C (an inhibitor of endogenous nitrosation).
Intake levels of NDMA and nitrites in a Mediterranean cohort are currently relatively lower than those previously reported, although processed meat, beer and cured cheese still are the most important contributors to NDMA intake.
A cross-sectional study was conducted within the Spanish cohort of the European Prospective Investigation in Cancer and Nutrition to assess the principal food sources of vitamin C, vitamin E, α-carotene, β-carotene, lycopene, lutein, β-cryptoxanthin and zeaxanthin in an adult Spanish population. The study included 41 446 healthy volunteers (25 812 women and 15 634 men), aged 29–69 years, from three Spanish regions in the north (Asturias, Navarra and Guipúzcoa) and two in the south (Murcia and Granada). Usual food intake was estimated by personal interview through a computerized version of a dietary history questionnaire. Foods that provided at least two-thirds of the studied nutrients were: fruits (mainly oranges) (51 %) and fruiting vegetables (mainly tomato and sweet pepper) (20 %) for vitamin C; vegetable oils (sunflower and olive) (40 %), non-citrus fruits (10 %), and nuts and seeds (8 %) for vitamin E; root vegetables (carrots) (82 %) for α-carotene; green leafy (28 %), root (24 %) and fruiting vegetables (22 %) for β-carotene; fruiting vegetables (fresh tomato) (72 %) for lycopene; green leafy vegetables (64 %) for lutein; citrus fruits (68 %) for β-cryptoxanthin; citrus fruits (43 %) and green leafy vegetables (20 %) for zeaxanthin. In conclusion, the main food sources of nutrients with redox properties have been identified in a Mediterranean country. This could provide an insight into the interpretation of epidemiological studies investigating the role of diet in health and disease.
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