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Hayhoe R, Lentjes M, Mulligan A, Luben R, Khaw KT, Welch A. Carotenoid dietary intakes and plasma concentrations are associated with heel bone ultrasound attenuation and osteoporotic fracture risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk cohort - CORRIGENDUM. Br J Nutr 2024; 131:176. [PMID: 37694519 DOI: 10.1017/s0007114523002003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
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Shannon OM, Ranson JM, Gregory S, Macpherson H, Milte C, Lentjes M, Mulligan A, McEvoy C, Griffiths A, Matu J, Hill TR, Adamson A, Siervo M, Minihane AM, Muniz-Tererra G, Ritchie C, Mathers JC, Llewellyn DJ, Stevenson E. Mediterranean diet adherence is associated with lower dementia risk, independent of genetic predisposition: findings from the UK Biobank prospective cohort study. BMC Med 2023; 21:81. [PMID: 36915130 PMCID: PMC10012551 DOI: 10.1186/s12916-023-02772-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 02/07/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND The identification of effective dementia prevention strategies is a major public health priority, due to the enormous and growing societal cost of this condition. Consumption of a Mediterranean diet (MedDiet) has been proposed to reduce dementia risk. However, current evidence is inconclusive and is typically derived from small cohorts with limited dementia cases. Additionally, few studies have explored the interaction between diet and genetic risk of dementia. METHODS We used Cox proportional hazard regression models to explore the associations between MedDiet adherence, defined using two different scores (Mediterranean Diet Adherence Screener [MEDAS] continuous and Mediterranean diet Pyramid [PYRAMID] scores), and incident all-cause dementia risk in 60,298 participants from UK Biobank, followed for an average 9.1 years. The interaction between diet and polygenic risk for dementia was also tested. RESULTS Higher MedDiet adherence was associated with lower dementia risk (MEDAS continuous: HR = 0.77, 95% CI = 0.65-0.91; PYRAMID: HR = 0.86, 95% CI = 0.73-1.02 for highest versus lowest tertiles). There was no significant interaction between MedDiet adherence defined by the MEDAS continuous and PYRAMID scores and polygenic risk for dementia. CONCLUSIONS Higher adherence to a MedDiet was associated with lower dementia risk, independent of genetic risk, underlining the importance of diet in dementia prevention interventions.
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Affiliation(s)
- Oliver M Shannon
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Janice M Ranson
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Helen Macpherson
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Catherine Milte
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Marleen Lentjes
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Angela Mulligan
- Nutrition Measurement Platform, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Claire McEvoy
- Centre for Public Health, The Institute for Global Food Security, Queen's University Belfast, Belfast, UK
| | | | - Jamie Matu
- School of Health, Leeds Beckett University, Leeds, UK
| | - Tom R Hill
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Ashley Adamson
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Mario Siervo
- School of Life Sciences, Queen's Medical Centre, The University of Nottingham Medical School, Nottingham, UK
| | - Anne Marie Minihane
- Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, UK.,Norwich Institute of Health Ageing (NIHA), Norwich, UK
| | - Graciela Muniz-Tererra
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | - Craig Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - John C Mathers
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
| | - David J Llewellyn
- College of Medicine and Health, University of Exeter, Exeter, UK.,Alan Turing Institute, London, UK
| | - Emma Stevenson
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
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Vingeliene S, Hiyoshi A, Lentjes M, Fall K, Montgomery S. Ageing accounts for much of the association between decreasing grip strength and subsequent loneliness: the English Longitudinal Study of Ageing. J Epidemiol Community Health 2023; 77:175-181. [PMID: 35256526 PMCID: PMC9933172 DOI: 10.1136/jech-2021-218635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/19/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Loneliness at older ages has been associated with higher morbidity and mortality. One of the risk factors for loneliness may be age-related decline in skeletal muscle strength, which may limit the possibilities for engagement in usual social activities and maintaining relationships. We aimed to identify if decrease in grip strength is an independent determinant of subsequent change in loneliness. METHODS Prospective cohort study of participants aged 50 years or older living in private households and provided data in the English Longitudinal Study of Ageing waves 2 (2004/2005), 4 (2008/2009) and 6 (2012/2013) (n=6118). We used fixed effects linear models to estimate β coefficients and 95% confidence intervals. RESULTS The adjusted estimates for a 5-kilogramme decrease in grip strength and loneliness score (ranging from 3 to 9) are β 0.04 and 95% CI -0.003 to 0.08 among men and β 0.03 and 95% CI -0.02 to 0.09 among women. In age-stratified analysis, a statistically significant association was observed among men below the age of 80 years (0.04, 0.0001 to 0.08) but not among older men (0.04, -0.28 to 0.35), and among women below the age of 80 years (0.03, -0.002 to 0.09) or above (-0.02, -0.32 to 0.28). CONCLUSION Muscle strength declines with age and may help explain the greater social isolation that occurs at older ages. Decline in strength was only independently associated with modestly increased loneliness among men younger than 80 years of age, indicating its limitation as a potential marker of loneliness risk.
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Affiliation(s)
- Snieguole Vingeliene
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Ayako Hiyoshi
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden,Department of Public Health Sciences, Stockholm University, Stockholm, Sweden,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan,Department of Epidemiology and Public Health, University College London, London, UK
| | - Marleen Lentjes
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Katja Fall
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden,Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden,Department of Epidemiology and Public Health, University College London, London, UK,Clinical Epidemiology Division, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
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Kelly RK, Pollard Z, Young H, Piernas C, Lentjes M, Mulligan A, Huybrechts I, Carter JL, Key TJ, Perez-Cornago A. Evaluation of the New Individual Fatty Acid Dataset for UK Biobank: Analysis of Intakes and Sources in 207,997 Participants. Nutrients 2022; 14:3603. [PMID: 36079862 PMCID: PMC9460581 DOI: 10.3390/nu14173603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
The Oxford WebQ is an online 24 h dietary assessment tool used by several large prospective studies. This study describes the creation of the new individual fatty acid (FA) dataset for the Oxford WebQ and reports intakes and sources of dietary individual FAs in the UK Biobank. Participants who completed ≥1 (maximum of five) 24 h dietary assessments were included (n = 207,997). Nutrient intakes were obtained from the average of all completed 24 h dietary assessments. Nutrient data from the UK McCance and Widdowson's The Composition of Foods and the US Department of Agriculture food composition tables were used to calculate intakes of 21 individual FAs. The individual FA dataset included 10 saturated fatty acids (SFAs), 4 monounsaturated fatty acids (MUFAs), and 7 polyunsaturated fatty acids (PUFAs; including alpha-linolenic (18:3), eicosapentaenoic (20:5), and docosahexaenoic (22:6) acids). Palmitic (16:0; mean ± standard deviation (SD): 13.5 ± 5.7 g/d) and stearic (18:0; 5.2 ± 2.5) acids were the main contributors to SFAs, and the main sources of these were cereals and cereal products (mostly desserts/cakes/pastries), milk and milk products (mostly cheese and milk), and meat and meat products. Oleic acid (18:1; 24.2 ± 9.8) was the main MUFA, derived mainly from cereals and cereal products, and meat and meat products. Linoleic acid (18:2; 9.7 ± 4.3) was the main PUFA, derived mostly from cereals and cereal products, and vegetables (including potatoes) and vegetable dishes. The individual FA dataset for the Oxford WebQ will allow future investigations on individual FAs and disease risk.
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Affiliation(s)
- Rebecca K. Kelly
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Zoe Pollard
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Heather Young
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX3 7LF, UK
| | - Marleen Lentjes
- Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, Cambridge CB1 8RN, UK
- School of Medical Sciences, Clinical Epidemiology and Biostatistics/Nutrient Gut Brain Interaction, Örebro University, 70182 Örebro, Sweden
| | - Angela Mulligan
- Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, Cambridge CB1 8RN, UK
- Nutrition Measurement Platform, MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Inge Huybrechts
- International Agency for Research on Cancer, World Health Organization, 69372 Lyon, France
| | - Jennifer L. Carter
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford OX3 7LF, UK
| | - Timothy J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
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Piernas C, Perez-Cornago A, Gao M, Young H, Pollard Z, Mulligan A, Lentjes M, Carter J, Bradbury K, Key TJ, Jebb SA. Describing a new food group classification system for UK biobank: analysis of food groups and sources of macro- and micronutrients in 208,200 participants. Eur J Nutr 2021; 60:2879-2890. [PMID: 33768317 PMCID: PMC8275520 DOI: 10.1007/s00394-021-02535-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/06/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE The UK Biobank study collected detailed dietary data using a web-based self-administered 24 h assessment tool, the Oxford WebQ. We aimed to describe a comprehensive food grouping system for this questionnaire and to report dietary intakes and key sources of selected nutrients by sex and education. METHODS Participants with at least one valid 24-h questionnaire were included (n = 208,200). Dietary data were grouped based on the presence of nutrients as well as culinary use, processing, and plant/animal origin. For each food group, we calculated the contribution to energy intake, key macronutrients, and micronutrients. We also identified the top contributors to energy intake, free sugars and saturated fat by sex and education. RESULTS From the 93 food groups, the top five contributors to energy intake (in descending order) were: desserts/cakes/pastries; white bread; white pasta/rice; bananas/other fruit; semi-skimmed milk. Wine, beer, and fruit juices were the top beverage contributors to overall energy intake. Biscuits, and desserts/cakes/pastries were the highest contributors to free sugars, total fat, and saturated fat intakes, but also contributed to the calcium and iron intakes. Top contributors to energy, saturated fat, and free sugars were broadly similar by sex and education category, with small differences in average nutrient intakes across the population. CONCLUSION This new food classification system will support the growing interest in the associations between food groups and health outcomes and the development of food-based dietary guidelines. Food group variables will be available to all users of the UK Biobank WebQ questionnaire.
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Affiliation(s)
- Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Department of Population Health, University of Oxford, Nuffield, UK
| | - Min Gao
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
- School of Public Health, Peking University, Beijing, China
| | - Heather Young
- Cancer Epidemiology Unit, Department of Population Health, University of Oxford, Nuffield, UK
| | - Zoe Pollard
- Cancer Epidemiology Unit, Department of Population Health, University of Oxford, Nuffield, UK
| | - Angela Mulligan
- Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
- NIHR BRC Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Marleen Lentjes
- Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
- School of Medical Sciences, Clinical Epidemiology & Biostatistics, Örebro University, Örebro, Sweden
| | - Jennifer Carter
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kathryn Bradbury
- School of Population Health, National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Tim J Key
- Cancer Epidemiology Unit, Department of Population Health, University of Oxford, Nuffield, UK
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
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Piernas C, Perez-Cornago A, Gao M, Young H, Pollard Z, Mulligan A, Lentjes M, Carter J, Bradbury K, Key TJ, Jebb SA. Correction to: Describing a new food group classification system for UK biobank: analysis of food groups and sources of macro- and micronutrients in 208,200 participants. Eur J Nutr 2021; 60:2891-2892. [PMID: 34110470 PMCID: PMC8275524 DOI: 10.1007/s00394-021-02591-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2022]
Abstract
A correction to this paper has been published: https://doi.org/10.1007/s00394-021-02591-3
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Affiliation(s)
- Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Department of Population Health, University of Oxford, Nuffield, UK
| | - Min Gao
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
- School of Public Health, Peking University, Beijing, China
| | - Heather Young
- Cancer Epidemiology Unit, Department of Population Health, University of Oxford, Nuffield, UK
| | - Zoe Pollard
- Cancer Epidemiology Unit, Department of Population Health, University of Oxford, Nuffield, UK
| | - Angela Mulligan
- Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
- NIHR BRC Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Marleen Lentjes
- Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
- School of Medical Sciences, Clinical Epidemiology & Biostatistics, Örebro University, Örebro, Sweden
| | - Jennifer Carter
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kathryn Bradbury
- School of Population Health, National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Tim J Key
- Cancer Epidemiology Unit, Department of Population Health, University of Oxford, Nuffield, UK
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
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Perez-Cornago A, Pollard Z, Young H, van Uden M, Andrews C, Piernas C, Key TJ, Mulligan A, Lentjes M. Description of the updated nutrition calculation of the Oxford WebQ questionnaire and comparison with the previous version among 207,144 participants in UK Biobank. Eur J Nutr 2021; 60:4019-4030. [PMID: 33956230 PMCID: PMC8437868 DOI: 10.1007/s00394-021-02558-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/03/2021] [Indexed: 11/27/2022]
Abstract
Purpose The Oxford WebQ is a web-based 24-h dietary assessment method which has been used in UK Biobank and other large prospective studies. The food composition table used to calculate nutrient intakes has recently been replaced with the UK Nutrient Databank, which has food composition data closer in time to when participants completed the questionnaire, and new dietary variables were incorporated. Here we describe the updated version of the Oxford WebQ questionnaire nutrient calculation, and compare nutrient intakes with the previous version used. Methods 207,144 UK Biobank participants completed ≥ 1 Oxford WebQs, and means and standard deviations of nutrient intakes were averaged for all completed 24-h dietary assessments. Spearman correlations and weighted kappa statistics were used to compare the re-classification and agreement of nutrient intakes between the two versions. Results 35 new nutrients were incorporated in the updated version. Compared to the previous version, most nutrients were very similar in the updated version except for a few nutrients which showed a difference of > 10%: lower with the new version for trans-fat (− 20%), and vitamin C (− 15%), but higher for retinol (+ 42%), vitamin D (+ 26%) and vitamin E (+ 20%). Most participants were in the same (> 60%) or adjacent (> 90%) quintile of intake for the two versions. Except for trans-fat (r = 0.58, κ = 0.42), very high correlations were found between the nutrients calculated using the two versions (r > 0.79 and κ > 0.60). Conclusion Small absolute differences in nutrient intakes were observed between the two versions, and the ranking of individuals was minimally affected, except for trans-fat. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02558-4.
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Affiliation(s)
- Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK.
| | - Zoe Pollard
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK
| | - Heather Young
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK
| | - Marloes van Uden
- Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Colm Andrews
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK
| | - Angela Mulligan
- Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
- NIHR BRC Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Marleen Lentjes
- Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
- School of Medical Sciences, Clinical Epidemiology and Biostatistics, Örebro University, Örebro, Sweden
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Vingeliene S, Hiyoshi A, Lentjes M, Fall K, Montgomery S. Longitudinal analysis of loneliness and inflammation at older ages: English longitudinal study of ageing. Psychoneuroendocrinology 2019; 110:104421. [PMID: 31494341 DOI: 10.1016/j.psyneuen.2019.104421] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/16/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
Loneliness has been associated with adverse health outcomes, including age-related diseases with an inflammatory etiology such as cardiovascular disease. We aimed to identify potential biological pathways linking loneliness with morbidity and mortality by examining associations of loneliness with biomarkers. Participants in the English Longitudinal Study of Ageing (n = 3239) aged 50 years or older with an average age of 64 years, provided data in waves 4 (2008/2009) and 6 (2012/2013). Linear regression conditional change models had three outcomes: C reactive protein (CRP) measured in mg/L (log transformed), fibrinogen in g/L and ferritin in g/dL. In men, the onset of loneliness indicated by answering 'no' at wave 4 and 'yes' at wave 6 to question "Much of the time during the past week, you felt lonely?" was associated with a statistically significant increase in levels of CRP (β = 0.36, 95% confidence interval (0.09 to 0.62)), plasma fibrinogen (0.18 (0.04 to 0.31)) and ferritin (41.04 (6.58 to 75.50)), after full adjustment. A statistically significant increase in CRP in men was also observed for onset of loneliness assessed with the question "How often do you feel lonely?" (0.20 (0.03 to 0.38)). These associations were not mediated by depressive symptoms. Persistent loneliness (loneliness experienced at both baseline and follow-up) assessed using the University of California Los Angeles (UCLA) loneliness scale was associated with an increase in CRP (0.11 (0.004 to 0.22)) among men. Associations of the two latter loneliness measures with fibrinogen and ferritin were mainly null. Among women, the only statistically significant association was for persistent loneliness (loneliness at both waves) identified by question "Much of the time during the past week, you felt lonely?" with a reduction in levels of ferritin (-20.62 (-39.78 to -1.46)). Men may be more susceptible to loneliness-associated disease risks signaled by biological changes, including systemic inflammation. Combined social and targeted medical interventions may help to reduce health risks associated with loneliness.
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Affiliation(s)
- Snieguole Vingeliene
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
| | - Ayako Hiyoshi
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Public Health Sciences, Stockholm University, Sweden
| | - Marleen Lentjes
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Katja Fall
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; Clinical Epidemiology Division, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, United Kingdom
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9
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Shannon OM, Stephan BCM, Granic A, Lentjes M, Hayat S, Mulligan A, Brayne C, Khaw KT, Bundy R, Aldred S, Hornberger M, Paddick SM, Muniz-Tererra G, Minihane AM, Mathers JC, Siervo M. Mediterranean diet adherence and cognitive function in older UK adults: the European Prospective Investigation into Cancer and Nutrition-Norfolk (EPIC-Norfolk) Study. Am J Clin Nutr 2019; 110:938-948. [PMID: 31204785 DOI: 10.1093/ajcn/nqz114] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 05/06/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In Mediterranean countries, adherence to a traditional Mediterranean dietary pattern (MedDiet) is associated with better cognitive function and reduced dementia risk. It is unclear if similar benefits exist in non-Mediterranean regions. OBJECTIVES The aims of this study were to examine associations between MedDiet adherence and cognitive function in an older UK population and to investigate whether associations differed between individuals with high compared with low cardiovascular disease (CVD) risk. METHODS We conducted an analysis in 8009 older individuals with dietary data at Health Check 1 (1993-1997) and cognitive function data at Health Check 3 (2006-2011) of the European Prospective Investigation into Cancer and Nutrition-Norfolk (EPIC-Norfolk). Associations were explored between MedDiet adherence and global and domain-specific cognitive test scores and risk of poor cognitive performance in the entire cohort, and when stratified according to CVD risk status. RESULTS Higher MedDiet adherence defined by the Pyramid MedDiet score was associated with better global cognition (β ± SE = -0.012 ± 0.002; P < 0.001), verbal episodic memory (β ± SE = -0.009 ± 0.002; P < 0.001), and simple processing speed (β ± SE = -0.002 ± 0.001; P = 0.013). Lower risk of poor verbal episodic memory (OR: 0.784; 95% CI: 0.641, 0.959; P = 0.018), complex processing speed (OR: 0.739; 95% CI: 0.601, 0.907; P = 0.004), and prospective memory (OR: 0.841; 95% CI: 0.724, 0.977; P = 0.023) was also observed for the highest compared with the lowest Pyramid MedDiet tertiles. The effect of a 1-point increase in Pyramid score on global cognitive function was equivalent to 1.7 fewer years of cognitive aging. MedDiet adherence defined by the Mediterranean Diet Adherence Screener (MEDAS) score (mapped through the use of both binary and continuous scoring) showed similar, albeit less consistent, associations. In stratified analyses, associations were evident in individuals at higher CVD risk only (P < 0.05). CONCLUSIONS Higher adherence to the MedDiet is associated with better cognitive function and lower risk of poor cognition in older UK adults. This evidence underpins the development of interventions to enhance MedDiet adherence, particularly in individuals at higher CVD risk, aiming to reduce the risk of age-related cognitive decline in non-Mediterranean populations.
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Affiliation(s)
- Oliver M Shannon
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Blossom C M Stephan
- Institute of Health and Society and Newcastle University Institute of Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Antoneta Granic
- Institute of Health and Society and Newcastle University Institute of Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Marleen Lentjes
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.,School of Medical Sciences and Health, Örebro University, Campus USÖ, Örebro, Sweden
| | - Shabina Hayat
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Angela Mulligan
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Carol Brayne
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Kay-Tee Khaw
- Clinical Gerontology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Rafe Bundy
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Sarah Aldred
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Michael Hornberger
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | - Stella-Maria Paddick
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Graciela Muniz-Tererra
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Anne-Marie Minihane
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Mario Siervo
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.,School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, United Kingdom
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Luben R, Hayat S, Mulligan A, Lentjes M, Wareham N, Pharoah P, Khaw KT. Alcohol consumption and future hospital usage: The EPIC-Norfolk prospective population study. PLoS One 2018; 13:e0200747. [PMID: 30020973 PMCID: PMC6051641 DOI: 10.1371/journal.pone.0200747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 07/01/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Heavy drinkers of alcohol are reported to use hospitals more than non-drinkers, but it is unclear whether light-to-moderate drinkers use hospitals more than non-drinkers. OBJECTIVE We examined the relationship between alcohol consumption in 10,883 men and 12,857 women aged 40-79 years in the general population and subsequent admissions to hospital and time spent in hospital. METHODS Participants from the EPIC-Norfolk prospective population-based study were followed for ten years (1999-2009) using record linkage. RESULTS Compared to current non-drinkers, men who reported any alcohol drinking had a lower risk of spending more than twenty days in hospital multivariable adjusted OR 0.80 (95%CI 0.68-0.94) after adjusting for age, smoking status, education, social class, body mass index and prevalent diseases. Women who were current drinkers were less likely to have any hospital admissions multivariable adjusted OR 0.84 (95%CI 0.74-0.95), seven or more admissions OR 0.77 (95% CI 0.66-0.88) or more than twenty hospital days OR 0.70 (95%CI 0.62-0.80). However, compared to lifelong abstainers, men who were former drinkers had higher risk of any hospital admissions multivariable adjusted OR 2.22 (95%CI 1.51-3.28) and women former drinkers had higher risk of seven or more admissions OR 1.30 (95%CI 1.01-1.67). CONCLUSION Current alcohol consumption was associated with lower risk of future hospital usage compared with non-drinkers in this middle aged and older population. In men, this association may in part be due to whether former drinkers are included in the non-drinker reference group but in women, the association was consistent irrespective of the choice of reference group. In addition, there were few participants in this cohort with very high current alcohol intake. The measurement of past drinking, the separation of non-drinkers into former drinkers and lifelong abstainers and the choice of reference group are all influential in interpreting the risk of alcohol consumption on future hospitalisation.
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Affiliation(s)
- Robert Luben
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Shabina Hayat
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Angela Mulligan
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Marleen Lentjes
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Nicholas Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge United Kingdom
| | - Paul Pharoah
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
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11
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Landais E, Moskal A, Mullee A, Nicolas G, Gunter MJ, Huybrechts I, Overvad K, Roswall N, Affret A, Fagherazzi G, Mahamat-Saleh Y, Katzke V, Kühn T, La Vecchia C, Trichopoulou A, Valanou E, Saieva C, Santucci de Magistris M, Sieri S, Braaten T, Skeie G, Weiderpass E, Ardanaz E, Chirlaque MD, Garcia JR, Jakszyn P, Rodríguez-Barranco M, Brunkwall L, Huseinovic E, Nilsson L, Wallström P, Bueno-de-Mesquita B, Peeters PH, Aune D, Key T, Lentjes M, Riboli E, Slimani N, Freisling H. Coffee and Tea Consumption and the Contribution of Their Added Ingredients to Total Energy and Nutrient Intakes in 10 European Countries: Benchmark Data from the Late 1990s. Nutrients 2018; 10:E725. [PMID: 29874819 PMCID: PMC6024313 DOI: 10.3390/nu10060725] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 05/31/2018] [Accepted: 06/01/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Coffee and tea are among the most commonly consumed nonalcoholic beverages worldwide, but methodological differences in assessing intake often hamper comparisons across populations. We aimed to (i) describe coffee and tea intakes and (ii) assess their contribution to intakes of selected nutrients in adults across 10 European countries. METHOD Between 1995 and 2000, a standardized 24-h dietary recall was conducted among 36,018 men and women from 27 European Prospective Investigation into Cancer and Nutrition (EPIC) study centres. Adjusted arithmetic means of intakes were estimated in grams (=volume) per day by sex and centre. Means of intake across centres were compared by sociodemographic characteristics and lifestyle factors. RESULTS In women, the mean daily intake of coffee ranged from 94 g/day (~0.6 cups) in Greece to 781 g/day (~4.4 cups) in Aarhus (Denmark), and tea from 14 g/day (~0.1 cups) in Navarra (Spain) to 788 g/day (~4.3 cups) in the UK general population. Similar geographical patterns for mean daily intakes of both coffee and tea were observed in men. Current smokers as compared with those who reported never smoking tended to drink on average up to 500 g/day more coffee and tea combined, but with substantial variation across centres. Other individuals' characteristics such as educational attainment or age were less predictive. In all centres, coffee and tea contributed to less than 10% of the energy intake. The greatest contribution to total sugar intakes was observed in Southern European centres (up to ~20%). CONCLUSION Coffee and tea intake and their contribution to energy and sugar intake differed greatly among European adults. Variation in consumption was mostly driven by geographical region.
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Affiliation(s)
- Edwige Landais
- UMR Nutripass, IRD-UM-Sup'Agro, 34394 Montpellier, France.
| | - Aurélie Moskal
- Nutrition and Metabolism Section, International Agency for Research on Cancer, 69372 Lyon, France.
| | - Amy Mullee
- Nutrition and Metabolism Section, International Agency for Research on Cancer, 69372 Lyon, France.
- School of Public Health, Physiotherapy and Sports Science, Woodview House, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Geneviève Nicolas
- Nutrition and Metabolism Section, International Agency for Research on Cancer, 69372 Lyon, France.
| | - Marc J Gunter
- Nutrition and Metabolism Section, International Agency for Research on Cancer, 69372 Lyon, France.
| | - Inge Huybrechts
- Nutrition and Metabolism Section, International Agency for Research on Cancer, 69372 Lyon, France.
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Bartholins Alle 2, room 2.26, DK-8000 Aarhus, Denmark.
| | - Nina Roswall
- Danish Cancer Society Research Center, Diet, Genes and Environment, Strandboulevarden 49, DK-2100 Copenhagen, Denmark.
| | - Aurélie Affret
- Inserm CESP U1018, Gustave Roussy, Université Paris-Sud, Paris-Saclay, 94800 Villejuif, France.
| | - Guy Fagherazzi
- Inserm CESP U1018, Gustave Roussy, Université Paris-Sud, Paris-Saclay, 94800 Villejuif, France.
| | - Yahya Mahamat-Saleh
- Inserm CESP U1018, Gustave Roussy, Université Paris-Sud, Paris-Saclay, 94800 Villejuif, France.
| | - Verena Katzke
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, 69120 Heidelberg, Germany.
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, 69120 Heidelberg, Germany.
| | - Carlo La Vecchia
- Hellenic Health Foundation, 115 27 Athens, Greece.
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milano, Italy.
| | | | | | - Calogero Saieva
- Molecular and Nutritional Epidemiology Unit, ISPO Cancer Prevention and Research Institute, 50139 Florence, Italy.
| | | | - Sabina Sieri
- Epidemiology and Prevention Unit Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
| | - Tonje Braaten
- Department of Community Medicine UiT, The Arctic University of Norway, 9037 Tromsø, Norway.
| | - Guri Skeie
- Department of Community Medicine UiT, The Arctic University of Norway, 9037 Tromsø, Norway.
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, 9037 Tromsø, Norway.
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, NO-0304 Oslo, Norway.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
- Genetic Epidemiology Group, Folkhälsan Research Center and Faculty of Medicine, University of Helsinki, 00014 Helsinkiv, Finland.
| | - Eva Ardanaz
- Navarra Public Health Institute, Pamplona, Spain IdiSNA, Navarra Institute for Health Research, 31003 Pamplona, Spain.
- CIBER Epidemiology and Public Health CIBERESP, 28029 Madrid, Spain.
| | - Maria-Dolores Chirlaque
- CIBER Epidemiology and Public Health CIBERESP, 28029 Madrid, Spain.
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, 30008 Murcia, Spain.
- Department of Health and Social Sciences, Universidad de Murcia, 30008 Murcia, Spain.
| | - Jose Ramon Garcia
- EPIC Asturias, Public Health Directorate, Asturias, 33006 Oviedo, Spain.
| | - Paula Jakszyn
- Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology, 08908 Barcelona, Spain.
| | - Miguel Rodríguez-Barranco
- CIBER Epidemiology and Public Health CIBERESP, 28029 Madrid, Spain.
- Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs, 18011 Granada, Spain.
- Hospitales Universitarios de Granada, Universidad de Granada, 18014 Granada, Spain.
| | | | - Ena Huseinovic
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden.
| | - Lena Nilsson
- Public Health and Clinical Medicine, Nutritional Research, Umeå University, and Arctic Research Centre at Umeå University, SE-901 85 Umeå, Sweden.
| | | | - Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London W2 1PG, UK.
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Petra H Peeters
- University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London W2 1PG, UK.
| | - Tim Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK.
| | - Marleen Lentjes
- Strangeways Research Laboratories, Department of Public Health & Primary Care, University of Cambridge, Cambridge CB1 8RN, UK.
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London W2 1PG, UK.
| | - Nadia Slimani
- Nutrition and Metabolism Section, International Agency for Research on Cancer, 69372 Lyon, France.
| | - Heinz Freisling
- Nutrition and Metabolism Section, International Agency for Research on Cancer, 69372 Lyon, France.
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Khaw KT, Sharp SJ, Finikarides L, Afzal I, Lentjes M, Luben R, Forouhi NG. Randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women. BMJ Open 2018; 8:e020167. [PMID: 29511019 PMCID: PMC5855206 DOI: 10.1136/bmjopen-2017-020167] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION High dietary saturated fat intake is associated with higher blood concentrations of low-density lipoprotein cholesterol (LDL-C), an established risk factor for coronary heart disease. However, there is increasing interest in whether various dietary oils or fats with different fatty acid profiles such as extra virgin coconut oil may have different metabolic effects but trials have reported inconsistent results. We aimed to compare changes in blood lipid profile, weight, fat distribution and metabolic markers after four weeks consumption of 50 g daily of one of three different dietary fats, extra virgin coconut oil, butter or extra virgin olive oil, in healthy men and women in the general population. DESIGN Randomised clinical trial conducted over June and July 2017. SETTING General community in Cambridgeshire, UK. PARTICIPANTS Volunteer adults were recruited by the British Broadcasting Corporation through their websites. Eligibility criteria were men and women aged 50-75 years, with no known history of cancer, cardiovascular disease or diabetes, not on lipid lowering medication, no contraindications to a high-fat diet and willingness to be randomised to consume one of the three dietary fats for 4 weeks. Of 160 individuals initially expressing an interest and assessed for eligibility, 96 were randomised to one of three interventions; 2 individuals subsequently withdrew and 94 men and women attended a baseline assessment. Their mean age was 60 years, 67% were women and 98% were European Caucasian. Of these, 91 men and women attended a follow-up assessment 4 weeks later. INTERVENTION Participants were randomised to extra virgin coconut oil, extra virgin olive oil or unsalted butter and asked to consume 50 g daily of one of these fats for 4 weeks, which they could incorporate into their usual diet or consume as a supplement. MAIN OUTCOMES AND MEASURES The primary outcome was change in serum LDL-C; secondary outcomes were change in total and high-density lipoprotein cholesterol (TC and HDL-C), TC/HDL-C ratio and non-HDL-C; change in weight, body mass index (BMI), waist circumference, per cent body fat, systolic and diastolic blood pressure, fasting plasma glucose and C reactive protein. RESULTS LDL-C concentrations were significantly increased on butter compared with coconut oil (+0.42, 95% CI 0.19 to 0.65 mmol/L, P<0.0001) and with olive oil (+0.38, 95% CI 0.16 to 0.60 mmol/L, P<0.0001), with no differences in change of LDL-C in coconut oil compared with olive oil (-0.04, 95% CI -0.27 to 0.19 mmol/L, P=0.74). Coconut oil significantly increased HDL-C compared with butter (+0.18, 95% CI 0.06 to 0.30 mmol/L) or olive oil (+0.16, 95% CI 0.03 to 0.28 mmol/L). Butter significantly increased TC/HDL-C ratio and non-HDL-C compared with coconut oil but coconut oil did not significantly differ from olive oil for TC/HDL-C and non-HDL-C. There were no significant differences in changes in weight, BMI, central adiposity, fasting blood glucose, systolic or diastolic blood pressure among any of the three intervention groups. CONCLUSIONS AND RELEVANCE Two different dietary fats (butter and coconut oil) which are predominantly saturated fats, appear to have different effects on blood lipids compared with olive oil, a predominantly monounsaturated fat with coconut oil more comparable to olive oil with respect to LDL-C. The effects of different dietary fats on lipid profiles, metabolic markers and health outcomes may vary not just according to the general classification of their main component fatty acids as saturated or unsaturated but possibly according to different profiles in individual fatty acids, processing methods as well as the foods in which they are consumed or dietary patterns. These findings do not alter current dietary recommendations to reduce saturated fat intake in general but highlight the need for further elucidation of the more nuanced relationships between different dietary fats and health. TRIAL REGISTRATION NUMBER NCT03105947; Results.
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Affiliation(s)
- Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Stephen J Sharp
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Leila Finikarides
- BBC Television ‘Trust Me I’m a Doctor’, BBC Glasgow, Glasgow, UK
- Winton Centre for Evidence Communication, University of Cambridge, Cambridge, UK
| | - Islam Afzal
- Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, UK
| | - Marleen Lentjes
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Robert Luben
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
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13
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Mytton OT, Forouhi NG, Scarborough P, Lentjes M, Luben R, Rayner M, Khaw KT, Wareham NJ, Monsivais P. Association between intake of less-healthy foods defined by the United Kingdom's nutrient profile model and cardiovascular disease: A population-based cohort study. PLoS Med 2018; 15:e1002484. [PMID: 29300725 PMCID: PMC5754044 DOI: 10.1371/journal.pmed.1002484] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 11/29/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In the United Kingdom, the Food Standards Agency-Ofcom nutrient profiling model (FSA-Ofcom model) is used to define less-healthy foods that cannot be advertised to children. However, there has been limited investigation of whether less-healthy foods defined by this model are associated with prospective health outcomes. The objective of this study was to test whether consumption of less-healthy food as defined by the FSA-Ofcom model is associated with cardiovascular disease (CVD). METHODS AND FINDINGS We used data from the European Prospective Investigation of Cancer (EPIC)-Norfolk cohort study in adults (n = 25,639) aged 40-79 years who completed a 7-day diet diary between 1993 and 1997. Incident CVD (primary outcome), cardiovascular mortality, and all-cause mortality (secondary outcomes) were identified using record linkage to hospital admissions data and death certificates up to 31 March 2015. Each food and beverage item reported was coded and given a continuous score, using the FSA-Ofcom model, based on the consumption of energy; saturated fat; total sugar; sodium; nonsoluble fibre; protein; and fruits, vegetables, and nuts. Items were classified as less-healthy using Ofcom regulation thresholds. We used Cox proportional hazards regression to test for an association between consumption of less-healthy food and incident CVD. Sensitivity analyses explored whether the results differed based on the definition of the exposure. Analyses were adjusted for age, sex, behavioural risk factors, clinical risk factors, and socioeconomic status. Participants were followed up for a mean of 16.4 years. During follow-up, there were 4,965 incident cases of CVD (1,524 fatal within 30 days). In the unadjusted analyses, we observed an association between consumption of less-healthy food and incident CVD (test for linear trend over quintile groups, p < 0.01). After adjustment for covariates (sociodemographic, behavioural, and indices of cardiovascular risk), we found no association between consumption of less-healthy food and incident CVD (p = 0.84) or cardiovascular mortality (p = 0.90), but there was an association between consumption of less-healthy food and all-cause mortality (test for linear trend, p = 0.006; quintile group 5, highest consumption of less-healthy food, versus quintile group 1, HR = 1.11, 95% CI 1.02-1.20). Sensitivity analyses produced similar results. The study is observational and relies on self-report of dietary consumption. Despite adjustment for known and reported confounders, residual confounding is possible. CONCLUSIONS After adjustment for potential confounding factors, no significant association between consumption of less-healthy food (as classified by the FSA-Ofcom model) and CVD was observed in this study. This suggests, in the UK setting, that the FSA-Ofcom model is not consistently discriminating among foods with respect to their association with CVD. More studies are needed to understand better the relationship between consumption of less-healthy food, defined by the FSA-Ofcom model, and indices of health.
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Affiliation(s)
- Oliver T. Mytton
- UKCRC Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nita G. Forouhi
- UKCRC Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Peter Scarborough
- Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Marleen Lentjes
- Strangeways Research Laboratories, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Robert Luben
- Strangeways Research Laboratories, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Mike Rayner
- Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Kay Tee Khaw
- Strangeways Research Laboratories, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Nicholas J. Wareham
- UKCRC Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Pablo Monsivais
- UKCRC Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
- Department of Nutrition and Exercise Physiology, Washington State University, Spokane, Washington, United States of America
- * E-mail:
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14
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Lahiri M, Morgan C, Luben R, Lentjes M, Bunn D, Lunt M, Verstappen S, Symmons D, Khaw KT, Wareham N, Bruce I. FRI0067 The relationship between fructose intake, alcohol consumption and serum URIC acid levels and the risk of inflammatory polyarthritis. Results from the european prospective investigation of cancer and the norfolk arthritis register: The EPIC-2-noar study:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Gay LJ, Mitrou PN, Keen J, Bowman R, Naguib A, Cooke J, Kuhnle GG, Burns PA, Luben R, Lentjes M, Khaw KT, Ball RY, Ibrahim AE, Arends MJ. Dietary, lifestyle and clinicopathological factors associated with APC mutations and promoter methylation in colorectal cancers from the EPIC-Norfolk study. J Pathol 2012; 228:405-15. [PMID: 22864938 DOI: 10.1002/path.4085] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 07/27/2012] [Accepted: 07/29/2012] [Indexed: 12/21/2022]
Abstract
The tumour suppressor APC is the most commonly altered gene in colorectal cancer (CRC). Genetic and epigenetic alterations of APC may therefore be associated with dietary and lifestyle risk factors for CRC. Analysis of APC mutations in the extended mutation cluster region (codons 1276-1556) and APC promoter 1A methylation was performed on 185 archival CRC samples collected from participants of the European Prospective Investigation into Cancer (EPIC)-Norfolk study, with the aim of relating these to high-quality seven-day dietary and lifestyle data collected prospectively. Truncating APC mutations (APC(+) ) and promoter 1A methylation (PM(+) ) were identified in 43% and 23% of CRCs analysed, respectively. Distal CRCs were more likely than proximal CRCs to be APC(+) or PM(+) (p = 0.04). APC(+) CRCs were more likely to be moderately/well differentiated and microsatellite stable than APC(-) CRCs (p = 0.05 and 0.03). APC(+) CRC cases consumed more alcohol than their counterparts (p = 0.01) and PM(+) CRC cases consumed lower levels of folate and fibre (p = 0.01 and 0.004). APC(+) or PM(+) CRC cases consumed higher levels of processed meat and iron from red meat and red meat products (p = 0.007 and 0.006). Specifically, CRC cases harbouring GC-to-AT transition mutations consumed higher levels of processed meat (35 versus 24 g/day, p = 0.04) and iron from red meat and red meat products (0.8 versus 0.6 mg/day, p = 0.05). In a logistic regression model adjusted for age, sex and cigarette-smoking status, each 19 g/day (1SD) increment increase in processed meat consumption was associated with cases with GC-to-AT mutations (OR 1.68, 95% CI 1.03-2.75). In conclusion, APC(+) and PM(+) CRCs may be influenced by diet and GC-to-AT mutations in APC are associated with processed meat consumption, suggesting a mechanistic link with dietary alkylating agents, such as N-nitroso compounds.
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Affiliation(s)
- Laura J Gay
- Medical Research Council Dunn Human Nutrition Unit, Cambridge, UK
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Hutchinson J, Lentjes M, Greenwood D, Burley V, Cade J, Cleghorn C, Threapleton D, Key T, Cairns B, Keogh R, Dahm C, Brunner E, Shipley M, Kuh D, Mishra G, Stephen A, Bhaniani A, Borgulya G, Khaw KT, Rodwell S. P2-118 Vitamin C intake from diary recordings and risk of breast cancer in the UK dietary cohort consortium. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976i.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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17
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Welch AA, Fransen H, Jenab M, Boutron-Ruault MC, Tumino R, Agnoli C, Ericson U, Johansson I, Ferrari P, Engeset D, Lund E, Lentjes M, Key T, Touvier M, Niravong M, Larrañaga N, Rodríguez L, Ocké MC, Peeters PHM, Tjønneland A, Bjerregaard L, Vasilopoulou E, Dilis V, Linseisen J, Nöthlings U, Riboli E, Slimani N, Bingham S. Variation in intakes of calcium, phosphorus, magnesium, iron and potassium in 10 countries in the European Prospective Investigation into Cancer and Nutrition study. Eur J Clin Nutr 2010; 63 Suppl 4:S101-21. [PMID: 19888269 DOI: 10.1038/ejcn.2009.77] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVES Adequate mineral intake is important for the maintenance of bone health, cellular function and general metabolism, and possibly in the aetiology of cancer and other chronic diseases. This study aimed at investigating variation in intakes of selected minerals across 10 European countries participating in the EPIC (European Prospective Investigation into Cancer and Nutrition) study. METHODS Nutrient intakes for 36 034 subjects, aged between 35 and 74 years, in 27 centres were obtained using standardized 24-h dietary recall software (EPIC-SOFT). Mean intakes of calcium, phosphorus, magnesium, iron and potassium were calculated by centre and weighted by season and day of the week and were also stratified by age group. The contribution of food groups to total nutrient intake was calculated. RESULTS There was clear geographical variability in intakes, with differences ranging from 35% for magnesium to 90% for iron in men and 36% for potassium to 75% for calcium in women, and a twofold difference in sources of haem iron (meat and fish). There was a geographical gradient in iron intake, with higher intakes in Southern than in Northern Europe and also around a twofold north-south gradient in the contribution of fruits and vegetables to potassium intake. Compared with reference intakes, the majority of age groups and centres had intakes above the recommended levels. Dairy foods and products contributed the most to calcium and phosphorus intake in almost all centres. Cereals and cereal products contributed the most to magnesium and iron intakes, except in Greece and Germany. CONCLUSIONS Intakes of minerals vary substantially throughout Europe, with some geographical variability in their food sources.
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Affiliation(s)
- A A Welch
- Department of Public Health and Primary Care, MRC Centre for Nutritional Epidemiology in Cancer Prevention and Survival, University of Cambridge, Cambridge, UK.
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