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Karlsson T, Winkvist A, Strid A, Lindahl B, Johansson I. Associations of dietary choline and betaine with all-cause mortality: a prospective study in a large Swedish cohort. Eur J Nutr 2024; 63:785-796. [PMID: 38175250 PMCID: PMC10948568 DOI: 10.1007/s00394-023-03300-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE Investigate the association between choline and betaine intake and all-cause mortality in a large Swedish cohort. METHODS Women (52,246) and men (50,485) attending the Västerbotten Intervention Programme 1990-2016 were included. Cox proportional hazard regression models adjusted for energy intake, age, BMI, smoking, education, and physical activity were used to estimate mortality risk according to betaine, total choline, phosphatidylcholine, glycerophosphocholine, phosphocholine, sphingomyelin, and free choline intakes [continuous (per 50 mg increase) and in quintiles]. RESULTS During a median follow-up of 16 years, 3088 and 4214 deaths were registered in women and men, respectively. Total choline intake was not associated with all-cause mortality in women (HR 1.01; 95% CI 0.97, 1.06; P = 0.61) or men (HR 1.01; 95% CI 0.98, 1.04; P = 0.54). Betaine intake was associated with decreased risk of all-cause mortality in women (HR 0.95; 95% CI 0.91, 0.98; P < 0.01) but not in men. Intake of free choline was negatively associated with risk of all-cause mortality in women (HR 0.98; 95% CI 0.96, 1.00; P = 0.01). No other associations were found between intake of the different choline compounds and all-cause mortality. In women aged ≥ 55 years, phosphatidylcholine intake was positively associated with all-cause mortality. In men with higher folate intake, total choline intake was positively associated with all-cause mortality. CONCLUSION Overall, our results do not support that intake of total choline is associated with all-cause mortality. However, some associations were modified by age and with higher folate intake dependent on sex. Higher intake of betaine was associated with lower risk of all-cause mortality in women.
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Affiliation(s)
- Therese Karlsson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, P. O. Box 459, S-405 30, Gothenburg, Sweden.
- Department of Life Sciences, Division of Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden.
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, P. O. Box 459, S-405 30, Gothenburg, Sweden
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden
| | - Anna Strid
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, P. O. Box 459, S-405 30, Gothenburg, Sweden
| | - Bernt Lindahl
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden
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Winkvist A, Johansson I, Ellegård L, Lindqvist HM. Towards objective measurements of habitual dietary intake patterns: comparing NMR metabolomics and food frequency questionnaire data in a population-based cohort. Nutr J 2024; 23:29. [PMID: 38429740 PMCID: PMC10908051 DOI: 10.1186/s12937-024-00929-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/23/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Low-quality, non-diverse diet is a main risk factor for premature death. Accurate measurement of habitual diet is challenging and there is a need for validated objective methods. Blood metabolite patterns reflect direct or enzymatically diet-induced metabolites. Here, we aimed to evaluate associations between blood metabolite patterns and a priori and data-driven food intake patterns. METHODS 1, 895 participants in the Northern Sweden Health and Disease Study, a population-based prospective cohort study, were included. Fasting plasma samples were analyzed with 1H Nuclear Magnetic Resonance. Food intake data from a 64-item validated food frequency questionnaire were summarized into a priori Healthy Diet Score (HDS), relative Mediterranean Diet Score (rMDS) and a set of plant-based diet indices (PDI) as well as data driven clusters from latent class analyses (LCA). Orthogonal projections to latent structures (OPLS) were used to explore clustering patterns of metabolites and their relation to reported dietary intake patterns. RESULTS Age, sex, body mass index, education and year of study participation had significant influence on OPLS metabolite models. OPLS models for healthful PDI and LCA-clusters were not significant, whereas for HDS, rMDS, PDI and unhealthful PDI significant models were obtained (CV-ANOVA p < 0.001). Still, model statistics were weak and the ability of the models to correctly classify participants into highest and lowest quartiles of rMDS, PDI and unhealthful PDI was poor (50%/78%, 42%/75% and 59%/70%, respectively). CONCLUSION Associations between blood metabolite patterns and a priori as well as data-driven food intake patterns were poor. NMR metabolomics may not be sufficiently sensitive to small metabolites that distinguish between complex dietary intake patterns, like lipids.
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Affiliation(s)
- Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Box 459, Gothenburg, SE-405 30, Sweden.
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden.
| | | | - Lars Ellegård
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Box 459, Gothenburg, SE-405 30, Sweden
- Clinical Nutrition Unit, Department of Gastroenterology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helen M Lindqvist
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Box 459, Gothenburg, SE-405 30, Sweden
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Forsby M, Hulander E, Amberntsson A, Brembeck P, Winkvist A, Bärebring L, Augustin H. Nutritional intake and determinants of nutritional quality changes from pregnancy to postpartum-a longitudinal study. Food Sci Nutr 2024; 12:1245-1256. [PMID: 38370042 PMCID: PMC10867539 DOI: 10.1002/fsn3.3838] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 10/27/2023] [Accepted: 11/03/2023] [Indexed: 02/20/2024] Open
Abstract
Nutrient requirements vary across the reproductive cycle, but research on changes in nutritional intake and quality from pregnancy to beyond the lactation period is limited. Thus, we aimed to study nutritional intake and quality changes, among Swedish pregnant participants from late pregnancy to 18 months postpartum and to study the determinants of nutritional quality changes. Participants (n = 72) were studied longitudinally from the third trimester of pregnancy and postpartum (2 weeks 4, 12, and 18 months postpartum). At each visit, participant characteristics and 4-day food diaries were collected. Nutritional quality was assessed by energy adjusted Nutrient Rich Food Index 11.3. Linear mixed models were used to analyze the determinants of change in nutritional quality. Intakes of carbohydrate energy percentage (E%), fiber, vitamin A, vitamin C, and potassium were higher in the third trimester compared to postpartum, whereas intakes of E% protein and monounsaturated fat were lower. Adherence to recommended intakes was low at all study visits for saturated fat (4%-11%), fiber (15%-39%), vitamin D (8%-14%), folate (0%-2%), and iron (6%-21%). Overall, nutritional quality did not differ significantly from third trimester to postpartum. Shorter duration (<4 months) of lactation was negatively related to nutritional quality changes, whereas higher age was positively related to changes. In conclusion, nutritional intake from pregnancy to postpartum changed, whereas quality remained relatively stable, with age and lactation duration as determinants. Identification of people at risk of adverse dietary changes from pregnancy to the postpartum period should be further addressed in future larger and more diverse study populations.
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Affiliation(s)
- Mathilda Forsby
- Institute of Medicine, University of GothenburgGothenburgSweden
| | - Erik Hulander
- Institute of Medicine, University of GothenburgGothenburgSweden
| | | | - Petra Brembeck
- Institute of Health and Care Sciences, University of GothenburgGothenburgSweden
| | - Anna Winkvist
- Institute of Medicine, University of GothenburgGothenburgSweden
| | | | - Hanna Augustin
- Institute of Medicine, University of GothenburgGothenburgSweden
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Lindqvist HM, Gjertsson I, Hulander E, Bärebring L, Winkvist A. Exploring the differences in serum metabolite profiles after intake of red meat in women with rheumatoid arthritis and a matched control group. Eur J Nutr 2024; 63:221-230. [PMID: 37814020 PMCID: PMC10798910 DOI: 10.1007/s00394-023-03257-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/15/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE Studies have suggested that women with RA tend to avoid red meat more often than women without RA, based on their perception that it exacerbates their symptoms. Therefore, the aim of this study is to investigate and compare the postprandial metabolic response following the consumption of a red meat meal in patients with RA and a matched control group. METHODS Participants were challenged with a meal with red meat and blood samples were collected before and at 0.5, 1, 2, 3 and 5 h after the meal. Serum metabolites were quantified by Nuclear Magnetic Resonance (NMR) analysis. Orthogonal Projections to Latent Structures with Discriminant Analysis (OPLS-DA) was used to evaluate separation by metabolites due to diagnosis of RA or not and to identify changes in metabolites related to RA. Incremental area under the curve was calculated for univariate comparisons for 23 metabolites. RESULTS The matched groups, including 22 women with RA and 22 women without RA, did not differ significantly in age, body mass index, diet quality or reported physical activity. OPLS-DA models had a limited quality indicating that there were no differences in metabolite patterns between the groups. However, phenylalanine was significantly higher in concentration in women with RA compared to controls in both fasting and postprandial samples. CONCLUSION To conclude, this well-controlled postprandial intervention study found a significantly higher concentration of phenylalanine in both fasting and postprandial samples of women with RA compared to matched women without RA. These findings warrant further investigation in larger studies. TRIAL REGISTRATION The PIRA (Postprandial Inflammation in Rheumatoid Arthritis) trial is Registered at Clinicaltrials.gov (NCT04247009).
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Affiliation(s)
- Helen M Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Rheumatology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Erik Hulander
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Forsby M, Winkvist A, Bärebring L, Augustin H. Supplement use in relation to dietary intake in pregnancy: an analysis of the Swedish GraviD cohort. Br J Nutr 2024; 131:256-264. [PMID: 37565530 PMCID: PMC10751946 DOI: 10.1017/s0007114523001794] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/28/2023] [Accepted: 08/07/2023] [Indexed: 08/12/2023]
Abstract
We aimed to study supplement use in relation to dietary intake among pregnant women in Sweden, and adherence to the Nordic Nutrition Recommendations among supplement and non-supplement users. Pregnant women were recruited at registration to antenatal care in 2013–2014. In third trimester, supplement use was collected using a questionnaire, and dietary intake was collected using a FFQ. The majority (64 %) of the 1044 women reported use of one or more supplements. Among all, 0–23 % reported dietary intakes above recommended intake (RI) of vitamin D, folate, Fe and Se. Median dietary intakes of thiamine (1·4 v. 1·3 mg P = 0·013), phosphorus (1482 v. 1440 mg P = 0·007), folate (327 v. 316 µg P = 0·02), Fe (12 v. 11·5 mg P = 0·009), Mg (361 v. 346 mg P < 0·001) and Zn (10·7 v. 10·4 mg P = 0·01) were higher among supplement users compared with non-users. Larger proportions of supplement users than non-users adhered to RI of dietary intakes of thiamine (42 % v. 35 % P = 0·04) and Mg (75 % v. 69 % P = 0·05). Among non-users, a minority had dietary intakes above RI for vitamin D (6 %), folate (10 %) and Fe (21 %). The majority (75–100 %) of supplement users had total intakes above RI for most nutrients. In conclusion, supplement use contributed substantially to reaching RI for vitamin D, folate and Fe. Supplement users had a higher dietary intake of several nutrients than non-users. This highlights that non-supplement users are at risk of inadequate nutrient intakes during pregnancy, suggesting a need for heightened awareness of nutritional adequacy for pregnant women.
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Affiliation(s)
- Mathilda Forsby
- Institute of Medicine, University of Gothenburg, Gothenburg40530, Sweden
| | - Anna Winkvist
- Institute of Medicine, University of Gothenburg, Gothenburg40530, Sweden
| | - Linnea Bärebring
- Institute of Medicine, University of Gothenburg, Gothenburg40530, Sweden
| | - Hanna Augustin
- Institute of Medicine, University of Gothenburg, Gothenburg40530, Sweden
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Bodén S, Zheng R, Ribbenstedt A, Landberg R, Harlid S, Vidman L, Gunter MJ, Winkvist A, Johansson I, Van Guelpen B, Brunius C. Dietary patterns, untargeted metabolite profiles and their association with colorectal cancer risk. Sci Rep 2024; 14:2244. [PMID: 38278865 PMCID: PMC10817924 DOI: 10.1038/s41598-023-50567-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/21/2023] [Indexed: 01/28/2024] Open
Abstract
We investigated data-driven and hypothesis-driven dietary patterns and their association to plasma metabolite profiles and subsequent colorectal cancer (CRC) risk in 680 CRC cases and individually matched controls. Dietary patterns were identified from combined exploratory/confirmatory factor analysis. We assessed association to LC-MS metabolic profiles by random forest regression and to CRC risk by multivariable conditional logistic regression. Principal component analysis was used on metabolite features selected to reflect dietary exposures. Component scores were associated to CRC risk and dietary exposures using partial Spearman correlation. We identified 12 data-driven dietary patterns, of which a breakfast food pattern showed an inverse association with CRC risk (OR per standard deviation increase 0.89, 95% CI 0.80-1.00, p = 0.04). This pattern was also inversely associated with risk of distal colon cancer (0.75, 0.61-0.96, p = 0.01) and was more pronounced in women (0.69, 0.49-0.96, p = 0.03). Associations between meat, fast-food, fruit soup/rice patterns and CRC risk were modified by tumor location in women. Alcohol as well as fruit and vegetables associated with metabolite profiles (Q2 0.22 and 0.26, respectively). One metabolite reflecting alcohol intake associated with increased CRC risk, whereas three metabolites reflecting fiber, wholegrain, and fruit and vegetables associated with decreased CRC risk.
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Affiliation(s)
- Stina Bodén
- Department of Diagnostics and Intervention, Oncology, Umeå University, Umeå, Sweden.
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
| | - Rui Zheng
- Department of Surgical Sciences, The EpiHub, Uppsala University, Uppsala, Sweden
| | - Anton Ribbenstedt
- Department of Life Sciences, Chalmers University of Technology, Gothenburg, Sweden
| | - Rikard Landberg
- Department of Life Sciences, Chalmers University of Technology, Gothenburg, Sweden
| | - Sophia Harlid
- Department of Diagnostics and Intervention, Oncology, Umeå University, Umeå, Sweden
| | - Linda Vidman
- Department of Diagnostics and Intervention, Oncology, Umeå University, Umeå, Sweden
| | - Marc J Gunter
- International Agency for Research On Cancer, Nutrition and Metabolism Section, 69372, Lyon Cedex 08, France
- Cancer Epidemiology and Prevention Research Unit, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Ingegerd Johansson
- Department of Odontology, Section of Cariology, Umeå University, Umeå, Sweden
| | - Bethany Van Guelpen
- Department of Diagnostics and Intervention, Oncology, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - Carl Brunius
- Department of Life Sciences, Chalmers University of Technology, Gothenburg, Sweden.
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Lindroos AK, Hallström E, Moraeus L, Strid A, Winkvist A. Dietary Greenhouse Gas Emissions and Diet Quality in a Cross-Sectional Study of Swedish Adolescents. Am J Clin Nutr 2023; 118:956-965. [PMID: 37678640 DOI: 10.1016/j.ajcnut.2023.09.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/25/2023] [Accepted: 09/02/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Interventions to improve dietary intake and reduce dietary greenhouse gas emissions (dGHGE) are urgently needed. Adolescence presents a unique time in life to promote sustainable diets. Detailed dietary data are needed to inform public health strategies aiming at improving adolescents' diet quality and reducing dGHGE. OBJECTIVE This study aimed to describe dGHGE in Swedish adolescents' diets by socio-demographic characteristics, evaluate how food groups contribute to dGHGE, and examine dGHGE in relation to diet quality. METHODS Data come from the national, school-based, cross-sectional dietary survey Riksmaten Adolescents 2016-17 of 3099 females and males attending school grades 5 (11-12 y old), 8 (14-15 y old) and 11 (17-18 y old). Participants completed 2 web-based 24-h recalls and questionnaires on lifestyle factors. dGHGE was estimated based on life cycle assessment data. Diet quality was estimated using NRF11.3 (Nutrient Rich Food Index) and SHEIA15 (Swedish Healthy Eating Index for Adolescents 2015). RESULTS dGHGE were higher in males than females (medians 4.2 versus 3.8 kg CO2e/10 MJ, P < 0.001). In females, dGHGE were highest in grade 5 (4.0 kg CO2e/10MJ), whereas in males, emissions were highest in grade 11 (4.4 kg CO2e/10MJ), P < 0.001 for the sex/grade interaction. Overweight/obesity was positively associated with CO2e/10MJ, but parental education, birthplace, and degree of urbanization were not. In females, the proportion of dGHGE from animal-based foods was lowest in grade 11, whereas the proportions from plant-based foods and sweet foods/beverages were highest. In males, these proportions were similar across grades. NRF11.3 was not associated with CO2e/10MJ, whereas healthier eating, according to SHEIA15, was inversely associated with CO2e/10MJ. CONCLUSIONS Food choices and dGHGE per calorie differ by sex in adolescents. Thus, intervention strategies to improve dietary sustainability need to be tailored differently to females and males. Diet quality should also be considered when promoting reduced GHGE diets.
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Affiliation(s)
- Anna Karin Lindroos
- Department of Risk Benefit Assessment, Swedish Food Agency, Uppsala, Sweden; Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Elinor Hallström
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Research Institutes of Sweden (RISE), Department of Food and Agriculture, Lund, Sweden
| | - Lotta Moraeus
- Department of Risk Benefit Assessment, Swedish Food Agency, Uppsala, Sweden
| | - Anna Strid
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Sustainable Health, Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
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Strid A, Hallström E, Lindroos AK, Lindahl B, Johansson I, Winkvist A. Adherence to the Swedish dietary guidelines and the impact on mortality and climate in a population-based cohort study. Public Health Nutr 2023; 26:2333-2342. [PMID: 37395057 DOI: 10.1017/s1368980023001295] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To assess the associations between adherence to the Swedish dietary guidelines and all-cause mortality (i.e. assessing the index' ability to predict health outcomes), as well as levels of dietary greenhouse gas emissions (GHGEs). DESIGN A longitudinal study 1990-2016 within the population-based cohort Västerbotten Intervention Programme. Dietary data were based on FFQs. Diet quality was assessed by the Swedish Healthy Eating Index for Adults 2015 (SHEIA15), based on the 2015 Swedish dietary guidelines. Dietary GHGEs were estimated from life cycle assessment data including emissions from farm to industry gate. Hazard ratios (HR) and 95 % CI of all-cause mortality were evaluated with Cox proportional hazards regression, and differences in median GHGEs were tested between quintiles of SHEIA15 score using the Kruskal-Wallis one-way ANOVA test. SETTING Northern Sweden. PARTICIPANTS In total, 49 124 women and 47 651 men, aged 35-65 years. RESULTS Median follow-up times were 16·0 years for women and 14·7 years for men, during which time 3074 women and 4212 men died. A consistent trend of lower all-cause mortality HR for both sexes with higher SHEIA15 scores was demonstrated. For women, the all-cause mortality HR was 0·81 ((95 % CI 0·71, 0·92); P = 0·001) and for men 0·90 ((95 % CI 0·81, 0·996); P = 0·041) between the quintile with the highest SHEIA15 score compared with the quintile with the lowest SHEIA15 score. A consistent trend of lower estimated dietary GHGEs among both sexes with higher SHEIA15 scores was also found. CONCLUSIONS Adherence to Swedish dietary guidelines, estimated by SHEIA15, seems to promote longevity and reduce dietary climate impact.
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Affiliation(s)
- Anna Strid
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, SE-405 30Gothenburg, Sweden
| | - Elinor Hallström
- Department of Agriculture and Food, Research Institutes of Sweden (RISE), Lund, Sweden
| | - Anna Karin Lindroos
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, SE-405 30Gothenburg, Sweden
- Department of Risk and Benefit Assessment, Swedish Food Agency, Uppsala, Sweden
| | - Bernt Lindahl
- Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, SE-405 30Gothenburg, Sweden
- Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Amberntsson A, Bärebring L, Winkvist A, Lissner L, Meltzer HM, Brantsæter AL, Papadopoulou E, Augustin H. Maternal vitamin D status and risk of childhood overweight at 5 years of age in two Nordic cohort studies. Front Nutr 2023; 10:1201171. [PMID: 37565036 PMCID: PMC10410266 DOI: 10.3389/fnut.2023.1201171] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/10/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction Maternal vitamin D status during pregnancy has been suggested to have a role in childhood adiposity development, but results are conflicting. Our aims were to investigate [1] the relationships between maternal 25-hydroxyvitamin D (25OHD) during pregnancy and the child's body mass index (BMI) and risk of overweight at 5 years of age, and [2] maternal pre-pregnancy BMI as effect modifier for these associations. Methods Data sources included a subsample from the Norwegian Mother, Father and Child Cohort Study (MoBa sub-cohort; N = 2,744) and the Swedish GraviD cohort study (N = 891). Maternal 25OHD was analyzed in gestational week 18 in the MoBa sub-cohort and week 10 in the GraviD cohort. In the MoBa sub-cohort, parents reported their child's documented measures of weight and length or height from the health card at routine check-up. In the GraviD cohort, this information was collected directly from medical records. Childhood overweight (including obesity) was identified using the International Obesity Task Force cut-offs. Linear and logistic regression models were used to investigate the association between maternal 25OHD and child's BMI and risk of overweight at 5 years of age in each cohort separately, and in a pooled dataset. Results In the pooled analysis, maternal 25OHD <30 nmol/L was associated with lower BMI in children at 5 years of age, but not with risk of overweight. Interaction analysis showed that the association was predominant among children of mothers with pre-pregnancy BMI ≥25 kg/m2. Conclusion Low maternal vitamin D status, particularly in mothers with overweight or obesity, predicted lower BMI in their five-year-old children. However, there was no evidence of an effect on overweight in these children.
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Affiliation(s)
- Anna Amberntsson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lauren Lissner
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Margrete Meltzer
- Department of Food Safety, Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Lise Brantsæter
- Department of Food Safety, Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Eleni Papadopoulou
- Global Health Cluster, Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Hanna Augustin
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Amberntsson A, Bärebring L, Winkvist A, Lissner L, Meltzer HM, Brantsæter AL, Papadopoulou E, Augustin H. Vitamin D intake and determinants of vitamin D status during pregnancy in The Norwegian Mother, Father and Child Cohort Study. Front Nutr 2023; 10:1111004. [PMID: 37426186 PMCID: PMC10327547 DOI: 10.3389/fnut.2023.1111004] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/24/2023] [Indexed: 07/11/2023] Open
Abstract
Background Norwegian data on vitamin D status among pregnant women indicate a moderate to high prevalence of insufficient vitamin D status (25-hydroxyvitamin D (25OHD) concentrations ≤50 nmol/L). There is a lack of population-based research on vitamin D intake and determinants of 25OHD in pregnant women from northern latitudes. The aims of this study were (1) to evaluate total vitamin D intake from both diet and supplements, (2) to investigate determinants of vitamin D status, and (3) to investigate the predicted response in vitamin D status by total vitamin D intake, in pregnant Norwegian women. Methods In total, 2,960 pregnant women from The Norwegian Environmental Biobank, a sub-study within The Norwegian Mother, Father and Child Cohort Study (MoBa), were included. Total vitamin D intake was estimated from a food frequency questionnaire in gestational week 22. Concentrations of plasma 25OHD was analyzed by automated chemiluminescent microparticle immunoassay method in gestational week 18. Candidate determinant variables of 25OHD were chosen using stepwise backward selection and investigated using multivariable linear regression. Predicted 25OHD by total vitamin D intake, overall and stratified by season and pre-pregnancy BMI, was explored using restricted cubic splines in an adjusted linear regression. Results Overall, about 61% of the women had a total vitamin D intake below the recommended intake. The main contributors to total vitamin D intake were vitamin D supplements, fish, and fortified margarine. Higher 25OHD concentrations were associated with (in descending order of the beta estimates) summer season, use of solarium, higher vitamin D intake from supplements, origin from high income country, lower pre-pregnancy BMI, higher age, higher vitamin D intake from foods, no smoking during pregnancy, higher education and energy intake. During October-May, a vitamin D intake according to the recommended intake was predicted to reach sufficient 25OHD concentrations >50 nmoL/L. Conclusion The findings from this study highlight the importance of the vitamin D intake, as one of few modifiable determinants, to reach sufficient 25OHD concentrations during months when dermal synthesis of vitamin D is absent.
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Affiliation(s)
- Anna Amberntsson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lauren Lissner
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Margrete Meltzer
- Department of Food Safety, Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Lise Brantsæter
- Department of Food Safety, Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Eleni Papadopoulou
- Global Health Cluster, Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Hanna Augustin
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Wadell AT, Bärebring L, Hulander E, Gjertsson I, Landberg R, Lindqvist H, Winkvist A. Dietary biomarkers and food records indicate compliance to study diets in the ADIRA (Anti-inflammatory Diet In Rheumatoid Arthritis) trial. Front Nutr 2023; 10:1209787. [PMID: 37426179 PMCID: PMC10325030 DOI: 10.3389/fnut.2023.1209787] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Background In the ADIRA (Anti-inflammatory Diet In Rheumatoid arthritis) trial, compliance to the study diets has previously been described primarily with a score based on reported intake of trial foods from telephone interviews. The aim of this study was to evaluate compliance using objective dietary biomarkers for whole grain, fruit and vegetables, margarine and oil, seafood and overall fat quality, as well as reported intake from food records of key components of the study diets. Methods Fifty patients with rheumatoid arthritis were randomized to begin with the intervention diet (rich in whole grain, fruit and vegetables, margarine/oil and seafood) or the control diet (rich in meat and high-fat dairy) for 10 weeks, followed by a ~ 4 months wash-out period, and then switched diet. Compliance was evaluated using plasma alkylresorcinols (AR) as biomarkers for intake of whole grain wheat and rye, serum carotenoids for fruit and vegetables, plasma linoleic acid (LA, 18:2 n-6) and -α-linolenic acid (18:3, n-3) for margarine and cooking oil, plasma eicosapentaenoic acid (EPA, 20:5 n-3), -docosahexaenoic acid (DHA 22:6, n-3) and -docosapentaenoic acid (22:5 n-3) for seafood, and plasma fatty acid pattern for the overall dietary fat quality. Reported intake of whole grain, fruit, berries and vegetables, seafood, red meat, and fat quality was extracted from 3-d food records. Results Plasma AR C21:0 and C23:0, LA, EPA, and DHA were higher while total serum carotenoids were lower after the intervention diet period compared to the control diet period (AR and carotenoids: p = <0.05, fatty acids: p = <0.001). Reported intake of whole grain, fruit, berries and vegetables, and seafood was higher and reported intake of red meat was lower during the intervention diet period compared to the control diet period (p = <0.001). Plasma- and reported fatty acid pattern differed as intended between the diet periods. Conclusion This study indicates that the participants in the ADIRA trial were compliant to the study diets regarding intake of whole grain, cooking fat, seafood, and red meat, and the intended overall dietary fat quality. Compliance to instructions on fruit- and vegetable intake remains uncertain. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT02941055?term=NCT02941055&draw=2&rank=1, NCT02941055.
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Affiliation(s)
- Anna Turesson Wadell
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Erik Hulander
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Gastroenterology and Hepatology, Clinical Nutrition Unit, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Rikard Landberg
- Division of Food and Nutrition Science, Department of Life Sciences, Chalmers University of Technology, Gothenburg, Sweden
| | - Helen Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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12
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Hesselink A, Winkvist A, Lindahl B, Ueland PM, Schneede J, Johansson I, Karlsson T. Healthy Nordic diet and associations with plasma concentrations of metabolites in the choline oxidation pathway: a cross-sectional study from Northern Sweden. Nutr J 2023; 22:26. [PMID: 37198607 DOI: 10.1186/s12937-023-00853-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 05/10/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND The choline oxidation pathway and metabolites involved have been linked to diseases including cardiovascular disease, type 2 diabetes and cancer. A healthy Nordic diet is a recently defined dietary pattern associated with decreased risk for these diseases. Our aim was to explore associations between adherence to a healthy Nordic diet and plasma concentrations of metabolites of the choline oxidation pathway. METHODS The Healthy Nordic Food Index (HNFI) and Baltic Sea Diet Score (BSDS) were applied to cross-sectional data (n = 969) from the Västerbotten Intervention Programme in Northern Sweden to score adherence to a healthy Nordic diet. Data included responses to a dietary questionnaire and blood sample analyses (1991-2008). Associations of diet scores with plasma concentrations of metabolites of the choline oxidation pathway and total homocysteine (tHcy), seven metabolites in total, were evaluated with linear regression, adjusting for age, BMI, education and physical activity. RESULTS HNFI scores showed linear relationships with plasma choline (β = 0.11), betaine (β = 0.46), serine (β = 0.98) and tHcy (β = - 0.38), and BSDS scores with betaine (β = 0.13) and tHcy (β = - 0.13); unstandardized beta coefficients, all significant at P < 0.05. The regression models predicted changes in plasma metabolite concentrations (± 1 SD changes in diet score) in the range of 1-5% for choline, betaine, serine and tHcy. No other statistically significant associations were observed. CONCLUSIONS A healthy Nordic diet was associated with plasma concentrations of several metabolites of the choline oxidation pathway. Although relationships were statistically significant, effect sizes were moderate. Further research is warranted to explore the underlying mechanisms and associations with health outcomes.
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Affiliation(s)
- André Hesselink
- Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Box 459, 405 30, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Box 459, 405 30, Gothenburg, Sweden
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden
| | - Bernt Lindahl
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden
| | - Per M Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Bevital AS, Bergen, Norway
| | - Jörn Schneede
- Department of Clinical Pharmacology, Pharmacology and Clinical Neurosciences, Umeå University, Umeå, Sweden
| | | | - Therese Karlsson
- Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Box 459, 405 30, Gothenburg, Sweden.
- Department of Life Sciences, Chalmers University of Technology, Gothenburg, Sweden.
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13
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Huybrechts I, Rauber F, Nicolas G, Casagrande C, Kliemann N, Wedekind R, Biessy C, Scalbert A, Touvier M, Aleksandrova K, Jakszyn P, Skeie G, Bajracharya R, Boer JMA, Borné Y, Chajes V, Dahm CC, Dansero L, Guevara M, Heath AK, Ibsen DB, Papier K, Katzke V, Kyrø C, Masala G, Molina-Montes E, Robinson OJK, Santiuste de Pablos C, Schulze MB, Simeon V, Sonestedt E, Tjønneland A, Tumino R, van der Schouw YT, Verschuren WMM, Vozar B, Winkvist A, Gunter MJ, Monteiro CA, Millett C, Levy RB. Corrigendum: Characterization of the degree of food processing in the European Prospective Investigation into Cancer and Nutrition: application of the Nova classification and validation using selected biomarkers of food processing. Front Nutr 2023; 10:1207555. [PMID: 37260516 PMCID: PMC10227715 DOI: 10.3389/fnut.2023.1207555] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 06/02/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fnut.2022.1035580.].
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Affiliation(s)
- Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Fernanda Rauber
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Geneviève Nicolas
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Corinne Casagrande
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Nathalie Kliemann
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Roland Wedekind
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Carine Biessy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Augustin Scalbert
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University Paris Cité (CRESS), Paris, France
| | - Krasimira Aleksandrova
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology (BIPS), Bremen, Germany
- Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Paula Jakszyn
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
- Blanquerna School of Health Sciences, Ramon Llull University, Barcelona, Spain
| | - Guri Skeie
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | | | - Jolanda M. A. Boer
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Yan Borné
- Department of Clinical Sciences Malmö, Faculty of Medicine, Nutritional Epidemiology, Lund University, Lund, Sweden
| | - Veronique Chajes
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Lucia Dansero
- Department of Clinical and Biological Sciences, Centre for Biostatistics, Epidemiology, and Public Health (C-BEPH), University of Turin, Turin, Italy
| | - Marcela Guevara
- Instituto de Salud Pública de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Alicia K. Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Daniel B. Ibsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus, Denmark
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Verena Katzke
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Cecilie Kyrø
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Giovanna Masala
- Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Esther Molina-Montes
- Department of Nutrition and Food Science, Campus of Cartuja, University of Granada, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Biomedical Research Centre, Institute of Nutrition and Food Technology (INYTA) “José Mataix”, University of Granada, Granada, Spain
| | - Oliver J. K. Robinson
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Carmen Santiuste de Pablos
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Vittorio Simeon
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Vanvitelli University, Naples, Italy
| | - Emily Sonestedt
- Department of Clinical Sciences Malmö, Faculty of Medicine, Nutritional Epidemiology, Lund University, Lund, Sweden
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research, AIRE ONLUS, Ragusa, Italy
| | - Yvonne T. van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - W. M. Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Beatrice Vozar
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Anna Winkvist
- Sustainable Health, Department Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marc J. Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Carlos A. Monteiro
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Christopher Millett
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
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14
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Lindqvist HM, Winkvist A, Gjertsson I, Calder PC, Armando AM, Quehenberger O, Coras R, Guma M. Influence of Dietary n-3 Long Chain Polyunsaturated Fatty Acid Intake on Oxylipins in Erythrocytes of Women with Rheumatoid Arthritis. Molecules 2023; 28:molecules28020717. [PMID: 36677774 PMCID: PMC9863541 DOI: 10.3390/molecules28020717] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
Oxylipins derived from n-3 fatty acids are suggested as the link between these fatty acids and reduced inflammation. The aim of the present study was to explore the effect of a randomized controlled cross-over intervention on oxylipin patterns in erythrocytes. Twenty-three women with rheumatoid arthritis completed 2 × 11-weeks exchanging one cooked meal per day, 5 days a week, for a meal including 75 g blue mussels (source for n-3 fatty acids) or 75 g meat. Erythrocyte oxylipins were quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The results were analyzed with multivariate data analysis. Orthogonal projections to latent structures (OPLS) with effect projections and with discriminant analysis were performed to compare the two diets' effects on oxylipins. Wilcoxon signed rank test was used to test pre and post values for each dietary period as well as post blue-mussel vs. post meat. The blue-mussel diet led to significant changes in a few oxylipins from the precursor fatty acids arachidonic acid and dihomo-ɣ-linolenic acid. Despite significant changes in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and free EPA in erythrocytes in the mussel group, no concurrent changes in their oxylipins were seen. Further research is needed to study the link between n-3 fatty-acid intake, blood oxylipins, and inflammation.
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Affiliation(s)
- Helen M. Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Correspondence: (H.M.L.); (P.C.C.)
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Philip C. Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
- Correspondence: (H.M.L.); (P.C.C.)
| | - Aaron M. Armando
- Department of Pharmacology, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Oswald Quehenberger
- Department of Pharmacology, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Roxana Coras
- Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Monica Guma
- Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
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15
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Strid A, Johansson I, Lindahl B, Hallström E, Winkvist A. Toward a More Climate-Sustainable Diet: Possible Deleterious Impacts on Health When Diet Quality Is Ignored. J Nutr 2023; 153:242-252. [PMID: 36913458 DOI: 10.1016/j.tjnut.2022.10.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 10/13/2022] [Accepted: 10/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Nutritional quality, and health and climate impacts are important considerations in the design of sustainable diets. OBJECTIVES To investigate the association between diets varying in nutrient density and climate impact and MI and stroke HRs. METHODS Dietary data of 41,194 women and 39,141 men (35-65 y) who participated in a Swedish population-based cohort study were employed. Nutrient density was calculated using the Sweden-adapted Nutrient Rich Foods 11.3 index. Dietary climate impact was calculated with data from life cycle assessments, including greenhouse gas emissions from primary production to industry gate. HRs and 95% CIs for MI and stroke were assessed with multivariable Cox proportional hazards regression, comparing a least-desirable diet scenario reference group (lower nutrient density, higher climate impact) with three diet groups that varied with respect to higher/lower nutrient density and higher/lower climate impact. RESULTS Median follow-up time from the baseline study visit to MI or stroke diagnosis was 15.7 y for women and 12.8 y for men. The MI hazard was significantly higher for the men with diets of lower nutrient density and lower climate impact (HR: 1.19; 95% CI: 1.06, 1.33; P = 0.004), compared with the reference group. No significant association with MI was observed for any of the diet groups of women. No significant association with stroke was observed among any of the diet groups of women or men. CONCLUSIONS The results among men suggest some adverse health effects for men when diet quality is not considered in the pursuit of more climate-sustainable diets. For women, no significant associations were detected. The mechanism underlying this association for men needs further investigation.
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Affiliation(s)
- Anna Strid
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Bernt Lindahl
- Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Elinor Hallström
- Department of Agriculture and Food, RISE - Research Institutes of Sweden, Lund, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
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16
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Huybrechts I, Rauber F, Nicolas G, Casagrande C, Kliemann N, Wedekind R, Biessy C, Scalbert A, Touvier M, Aleksandrova K, Jakszyn P, Skeie G, Bajracharya R, Boer JMA, Borné Y, Chajes V, Dahm CC, Dansero L, Guevara M, Heath AK, Ibsen DB, Papier K, Katzke V, Kyrø C, Masala G, Molina-Montes E, Robinson OJK, Santiuste de Pablos C, Schulze MB, Simeon V, Sonestedt E, Tjønneland A, Tumino R, van der Schouw YT, Verschuren WMM, Vozar B, Winkvist A, Gunter MJ, Monteiro CA, Millett C, Levy RB. Characterization of the degree of food processing in the European Prospective Investigation into Cancer and Nutrition: Application of the Nova classification and validation using selected biomarkers of food processing. Front Nutr 2022; 9:1035580. [PMID: 36590209 PMCID: PMC9800919 DOI: 10.3389/fnut.2022.1035580] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022] Open
Abstract
Background Epidemiological studies have demonstrated an association between the degree of food processing in our diet and the risk of various chronic diseases. Much of this evidence is based on the international Nova classification system, which classifies food into four groups based on the type of processing: (1) Unprocessed and minimally processed foods, (2) Processed culinary ingredients, (3) Processed foods, and (4) "Ultra-processed" foods (UPF). The ability of the Nova classification to accurately characterise the degree of food processing across consumption patterns in various European populations has not been investigated so far. Therefore, we applied the Nova coding to data from the European Prospective Investigation into Cancer and Nutrition (EPIC) in order to characterize the degree of food processing in our diet across European populations with diverse cultural and socio-economic backgrounds and to validate this Nova classification through comparison with objective biomarker measurements. Methods After grouping foods in the EPIC dataset according to the Nova classification, a total of 476,768 participants in the EPIC cohort (71.5% women; mean age 51 [standard deviation (SD) 9.93]; median age 52 [percentile (p)25-p75: 58-66] years) were included in the cross-sectional analysis that characterised consumption patterns based on the Nova classification. The consumption of food products classified as different Nova categories were compared to relevant circulating biomarkers denoting food processing, measured in various subsamples (N between 417 and 9,460) within the EPIC cohort via (partial) correlation analyses (unadjusted and adjusted by sex, age, BMI and country). These biomarkers included an industrial transfatty acid (ITFA) isomer (elaidic acid; exogenous fatty acid generated during oil hydrogenation and heating) and urinary 4-methyl syringol sulfate (an indicator for the consumption of smoked food and a component of liquid smoke used in UPF). Results Contributions of UPF intake to the overall diet in % grams/day varied across countries from 7% (France) to 23% (Norway) and their contributions to overall % energy intake from 16% (Spain and Italy) to >45% (in the UK and Norway). Differences were also found between sociodemographic groups; participants in the highest fourth of UPF consumption tended to be younger, taller, less educated, current smokers, more physically active, have a higher reported intake of energy and lower reported intake of alcohol. The UPF pattern as defined based on the Nova classification (group 4;% kcal/day) was positively associated with blood levels of industrial elaidic acid (r = 0.54) and 4-methyl syringol sulfate (r = 0.43). Associations for the other 3 Nova groups with these food processing biomarkers were either inverse or non-significant (e.g., for unprocessed and minimally processed foods these correlations were -0.07 and -0.37 for elaidic acid and 4-methyl syringol sulfate, respectively). Conclusion These results, based on a large pan-European cohort, demonstrate sociodemographic and geographical differences in the consumption of UPF. Furthermore, these results suggest that the Nova classification can accurately capture consumption of UPF, reflected by stronger correlations with circulating levels of industrial elaidic acid and a syringol metabolite compared to diets high in minimally processed foods.
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Affiliation(s)
- Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Fernanda Rauber
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Geneviève Nicolas
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Corinne Casagrande
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Nathalie Kliemann
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Roland Wedekind
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Carine Biessy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Augustin Scalbert
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center, University Paris Cité (CRESS), Paris, France
| | - Krasimira Aleksandrova
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology (BIPS), Bremen, Germany
- Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Paula Jakszyn
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
- Blanquerna School of Health Sciences, Ramon Llull University, Barcelona, Spain
| | - Guri Skeie
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | | | - Jolanda M. A. Boer
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Yan Borné
- Department of Clinical Sciences Malmö, Faculty of Medicine, Nutritional Epidemiology, Lund University, Lund, Sweden
| | - Veronique Chajes
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Lucia Dansero
- Department of Clinical and Biological Sciences, Centre for Biostatistics, Epidemiology, and Public Health (C-BEPH), University of Turin, Turin, Italy
| | - Marcela Guevara
- Instituto de Salud Pública de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Alicia K. Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Daniel B. Ibsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus, Denmark
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Verena Katzke
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Cecilie Kyrø
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Giovanna Masala
- Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Esther Molina-Montes
- Department of Nutrition and Food Science, Campus of Cartuja, University of Granada, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Biomedical Research Centre, Institute of Nutrition and Food Technology (INYTA) “José Mataix”, University of Granada, Granada, Spain
| | - Oliver J. K. Robinson
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Carmen Santiuste de Pablos
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Vittorio Simeon
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Vanvitelli University, Naples, Italy
| | - Emily Sonestedt
- Department of Clinical Sciences Malmö, Faculty of Medicine, Nutritional Epidemiology, Lund University, Lund, Sweden
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research, AIRE ONLUS, Ragusa, Italy
| | - Yvonne T. van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - W. M. Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Beatrice Vozar
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Anna Winkvist
- Sustainable Health, Department Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marc J. Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Carlos A. Monteiro
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Christopher Millett
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
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17
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Mayén AL, Viallon V, Botteri E, Proust-Lima C, Bagnardi V, Batista V, Cross AJ, Laouali N, MacDonald CJ, Severi G, Katzke V, Bergmann MM, Schulze MB, Tjønneland A, Eriksen AK, Dahm CC, Antoniussen CS, Jakszyn P, Sánchez MJ, Amiano P, Colorado-Yohar SM, Ardanaz E, Travis R, Palli D, Sabina S, Tumino R, Ricceri F, Panico S, Bueno-de-Mesquita B, Derksen JWG, Sonestedt E, Winkvist A, Harlid S, Braaten T, Gram IT, Lukic M, Jenab M, Riboli E, Freisling H, Weiderpass E, Gunter MJ, Ferrari P. A longitudinal evaluation of alcohol intake throughout adulthood and colorectal cancer risk. Eur J Epidemiol 2022; 37:915-929. [PMID: 36063305 DOI: 10.1007/s10654-022-00900-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 07/15/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND Alcohol intake is an established risk factor for colorectal cancer (CRC); however, there is limited knowledge on whether changing alcohol drinking habits during adulthood modifies CRC risk. OBJECTIVE Leveraging longitudinal exposure assessments on alcohol intake at different ages, we examined the relationship between change in alcohol intake and subsequent CRC risk. METHODS Within the European Prospective Investigation into Cancer and Nutrition, changes in alcohol intake comparing follow-up with baseline assessments were investigated in relation to CRC risk. The analysis included 191,180, participants and 1530 incident CRC cases, with exclusion of the first three years of follow-up to minimize reverse causation. Trajectory profiles of alcohol intake, assessed at ages 20, 30, 40, 50 years, at baseline and during follow-up, were estimated using latent class mixed models and related to CRC risk, including 407,605 participants and 5,008 incident CRC cases. RESULTS Mean age at baseline was 50.2 years and the follow-up assessment occurred on average 7.1 years later. Compared to stable intake, a 12 g/day increase in alcohol intake during follow-up was positively associated with CRC risk (HR = 1.15, 95%CI 1.04, 1.25), while a 12 g/day reduction was inversely associated with CRC risk (HR = 0.86, 95%CI 0.78, 0.95). Trajectory analysis showed that compared to low alcohol intake, men who increased their alcohol intake from early- to mid- and late-adulthood by up to 30 g/day on average had significantly increased CRC risk (HR = 1.24; 95%CI 1.08, 1.42), while no associations were observed in women. Results were consistent by anatomical subsite. CONCLUSIONS Increasing alcohol intake during mid-to-late adulthood raised CRC risk, while reduction lowered risk.
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Affiliation(s)
- Ana-Lucia Mayén
- International Agency for Research On Cancer (IARC), World Health Organization, 150, cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - Vivian Viallon
- International Agency for Research On Cancer (IARC), World Health Organization, 150, cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - Edoardo Botteri
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway, Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Cecile Proust-Lima
- Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, U1219, 33000, Bordeaux, France
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Veronica Batista
- International Agency for Research On Cancer (IARC), World Health Organization, 150, cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - Amanda J Cross
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Nasser Laouali
- Université Paris-Saclay, UVSQ, Gustave Roussy, CESP U1018 Inserm, "Exposome and Heredity" Group, Villejuif, France
| | - Conor J MacDonald
- Université Paris-Saclay, UVSQ, Gustave Roussy, CESP U1018 Inserm, "Exposome and Heredity" Group, Villejuif, France
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, Gustave Roussy, CESP U1018 Inserm, "Exposome and Heredity" Group, Villejuif, France
- Department of Statistics, Computer Science, Applications "G. Parenti" (DISIA), University of Florence, Florence, Italy
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Manuela M Bergmann
- German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany
| | - Mattias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Diet, Genes and Environment, Copenhagen, Denmark
| | - Anne Kirstine Eriksen
- Danish Cancer Society Research Center, Diet, Genes and Environment, Copenhagen, Denmark
| | | | | | - Paula Jakszyn
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
- Blanquerna School of Health Sciences, Ramon Llull University, Barcelona, Spain
| | - Maria-Jose Sánchez
- Escuela Andaluza de Salud Pública (EASP), 18011, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, 18012, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología Y Salud Pública (CIBERESP), 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, 18071, Granada, Spain
| | - Pilar Amiano
- Centro de Investigación Biomédica en Red de Epidemiología Y Salud Pública (CIBERESP), 28029, Madrid, Spain
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain
- Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain
- Instituto de Salud Carlos III, Madrid, Spain
| | - Sandra M Colorado-Yohar
- Centro de Investigación Biomédica en Red de Epidemiología Y Salud Pública (CIBERESP), 28029, Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Research Group On Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Eva Ardanaz
- Centro de Investigación Biomédica en Red de Epidemiología Y Salud Pública (CIBERESP), 28029, Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Ruth Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Oxford, OX3 7LF, UK
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Sieri Sabina
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research AIRE-ONLUS Ragusa, Milan, Italy
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, Orbassano, TO, Italy
| | - Salvatore Panico
- Dipartimento Di Medicina Clinica E Chirurgia, Federico II University, Naples, Italy
| | - Bas Bueno-de-Mesquita
- Former Senior Scientist, Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Jeroen W G Derksen
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Emily Sonestedt
- Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, 21428, Malmö, Sweden
| | - Anna Winkvist
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, 901 85, Umeå, Sweden
| | - Sophia Harlid
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Tonje Braaten
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Inger Torhild Gram
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marko Lukic
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Mazda Jenab
- International Agency for Research On Cancer (IARC), World Health Organization, 150, cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Heinz Freisling
- International Agency for Research On Cancer (IARC), World Health Organization, 150, cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - Elisabete Weiderpass
- International Agency for Research On Cancer (IARC), World Health Organization, 150, cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - Marc J Gunter
- International Agency for Research On Cancer (IARC), World Health Organization, 150, cours Albert Thomas, 69372, Lyon CEDEX 08, France
| | - Pietro Ferrari
- International Agency for Research On Cancer (IARC), World Health Organization, 150, cours Albert Thomas, 69372, Lyon CEDEX 08, France.
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18
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Grenville ZS, Noor U, His M, Viallon V, Rinaldi S, Aglago EK, Amiano P, Brunkwall L, Chirlaque MD, Drake I, Eichelmann F, Freisling H, Grioni S, Heath AK, Kaaks R, Katzke V, Mayén-Chacon AL, Milani L, Moreno-Iribas C, Pala V, Olsen A, Sánchez MJ, Schulze MB, Tjønneland A, Tsilidis KK, Weiderpass E, Winkvist A, Zamora-Ros R, Key TJ, Smith-Byrne K, Travis RC, Schmidt JA. Diet and BMI Correlate with Metabolite Patterns Associated with Aggressive Prostate Cancer. Nutrients 2022; 14:3306. [PMID: 36014812 PMCID: PMC9415102 DOI: 10.3390/nu14163306] [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: 07/19/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
Three metabolite patterns have previously shown prospective inverse associations with the risk of aggressive prostate cancer within the European Prospective Investigation into Cancer and Nutrition (EPIC). Here, we investigated dietary and lifestyle correlates of these three prostate cancer-related metabolite patterns, which included: 64 phosphatidylcholines and three hydroxysphingomyelins (Pattern 1), acylcarnitines C18:1 and C18:2, glutamate, ornithine, and taurine (Pattern 2), and 8 lysophosphatidylcholines (Pattern 3). In a two-stage cross-sectional discovery (n = 2524) and validation (n = 518) design containing 3042 men free of cancer in EPIC, we estimated the associations of 24 dietary and lifestyle variables with each pattern and the contributing individual metabolites. Associations statistically significant after both correction for multiple testing (False Discovery Rate = 0.05) in the discovery set and at p < 0.05 in the validation set were considered robust. Intakes of alcohol, total fish products, and its subsets total fish and lean fish were positively associated with Pattern 1. Body mass index (BMI) was positively associated with Pattern 2, which appeared to be driven by a strong positive BMI-glutamate association. Finally, both BMI and fatty fish were inversely associated with Pattern 3. In conclusion, these results indicate associations of fish and its subtypes, alcohol, and BMI with metabolite patterns that are inversely associated with risk of aggressive prostate cancer.
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Affiliation(s)
- Zoe S. Grenville
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Urwah Noor
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Mathilde His
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, 69008 Lyon, France
| | - Vivian Viallon
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, 69008 Lyon, France
| | - Sabina Rinaldi
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, 69008 Lyon, France
| | - Elom K. Aglago
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK
| | - Pilar Amiano
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, 20013 San Sebastian, Spain
- Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, 20014 San Sebastián, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Louise Brunkwall
- Department of Clinical Sciences, Lund University, 221 84 Malmö, Sweden
| | - María Dolores Chirlaque
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, 30008 Murcia, Spain
| | - Isabel Drake
- Department of Clinical Sciences, Lund University, 221 84 Malmö, Sweden
- Skåne University Hospital, 214 28 Malmö, Sweden
| | - Fabian Eichelmann
- Department of Molecular Epidemiology, German Institute of Human Nutrition, 14558 Nuthetal, Germany
| | - Heinz Freisling
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, 69008 Lyon, France
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Alicia K. Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK
| | - Rudolf Kaaks
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Verena Katzke
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Ana-Lucia Mayén-Chacon
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, 69008 Lyon, France
| | - Lorenzo Milani
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | - Conchi Moreno-Iribas
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Navarra Public Health Institute, 31003 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Anja Olsen
- Danish Cancer Society Research Center, DK-2100 Copenhagen, Denmark
- Department of Public Health, Aarhus University, DK-8000 Aarhus, Denmark
| | - Maria-Jose Sánchez
- Escuela Andaluza de Salud Pública (EASP), 18011 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, 18071 Granada, Spain
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition, 14558 Nuthetal, Germany
| | - Anne Tjønneland
- Danish Cancer Society Research Center, DK-2100 Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, DK-1353 Copenhagen, Denmark
| | - Konstantinos K. Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, 45110 Ioannina, Greece
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, 69008 Lyon, France
| | - Anna Winkvist
- Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Timothy J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Karl Smith-Byrne
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Ruth C. Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Julie A. Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
- Department of Clinical Epidemiology, Department of Clinical Medicine, University Hospital, Aarhus University and Aarhus, DK-8200 Aarhus N, Denmark
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19
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Wedekind R, Rothwell JA, Viallon V, Keski-Rahkonen P, Schmidt JA, Chajes V, Katzke V, Johnson T, Santucci de Magistris M, Krogh V, Amiano P, Sacerdote C, Redondo-Sánchez D, Huerta JM, Tjønneland A, Pokharel P, Jakszyn P, Tumino R, Ardanaz E, Sandanger TM, Winkvist A, Hultdin J, Schulze MB, Weiderpass E, Gunter MJ, Huybrechts I, Scalbert A. Determinants of blood acylcarnitine concentrations in healthy individuals of the European Prospective Investigation into Cancer and Nutrition. Clin Nutr 2022; 41:1735-1745. [PMID: 35779425 PMCID: PMC9358353 DOI: 10.1016/j.clnu.2022.05.020] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/07/2022] [Accepted: 05/28/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND & AIMS Circulating levels of acylcarnitines (ACs) have been associated with the risk of various diseases such as cancer and type 2 diabetes. Diet and lifestyle factors have been shown to influence AC concentrations but a better understanding of their biological, lifestyle and metabolic determinants is needed. METHODS Circulating ACs were measured in blood by targeted (15 ACs) and untargeted metabolomics (50 ACs) in 7770 and 395 healthy participants of the European Prospective Investigation into Cancer and Nutrition (EPIC), respectively. Associations with biological and lifestyle characteristics, dietary patterns, self-reported intake of individual foods, estimated intake of carnitine and fatty acids, and fatty acids in plasma phospholipid fraction and amino acids in blood were assessed. RESULTS Age, sex and fasting status were associated with the largest proportion of AC variability (partial-r up to 0.19, 0.18 and 0.16, respectively). Some AC species of medium or long-chain fatty acid moiety were associated with the corresponding fatty acids in plasma (partial-r = 0.24) or with intake of specific foods such as dairy foods containing the same fatty acid. ACs of short-chain fatty acid moiety (propionylcarnitine and valerylcarnitine) were moderately associated with concentrations of branched-chain amino acids (partial-r = 0.5). Intake of most other foods and of carnitine showed little association with AC levels. CONCLUSIONS Our results show that determinants of ACs in blood vary according to their fatty acid moiety, and that their concentrations are related to age, sex, diet, and fasting status. Knowledge on their potential determinants may help interpret associations of ACs with disease risk and inform on potential dietary and lifestyle factors that might be modified for disease prevention.
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Affiliation(s)
- Roland Wedekind
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, France.
| | - Joseph A Rothwell
- (CESP), Faculté de Medicine, Université Paris-Saclay, Inserm, Villejuif, France; Institut Gustave Roussy, Villejuif, France
| | - Vivian Viallon
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, France
| | - Pekka Keski-Rahkonen
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, France
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Veronique Chajes
- International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, France
| | - Vna Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Theron Johnson
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori di Milano, Milan, Italy
| | - Pilar Amiano
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain; Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città Della Salute e Della Scienza University-Hospital, Via Santena 7, 10126 Turin, Italy
| | - Daniel Redondo-Sánchez
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; Escuela Andaluza de Salud Pública (EASP), 18011 Granada, Spain; Instituto de Investigación Biosanitaria Ibs.GRANADA, 18012 Granada, Spain
| | - José María Huerta
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Pratik Pokharel
- Danish Cancer Society Research Center, Copenhagen, Denmark; Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Paula Jakszyn
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain; Blanquerna School of Health Sciences, Ramon Llull University, Barcelona, Spain
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research AIRE - ONLUS, Ragusa, Italy
| | - Eva Ardanaz
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Torkjel M Sandanger
- Department of Community Medicine, UiT - the Arctic University of Norway, Langnes, Tromsø, Norway
| | - Anna Winkvist
- Sustainable Health, Dept Epidemiology and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Johan Hultdin
- Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, France
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, France
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, France
| | - Augustin Scalbert
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, France
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Turesson Wadell A, Bärebring L, Hulander E, Gjertsson I, Lindqvist HM, Winkvist A. Inadequate Dietary Nutrient Intake in Patients With Rheumatoid Arthritis in Southwestern Sweden: A Cross-Sectional Study. Front Nutr 2022; 9:915064. [PMID: 35799579 PMCID: PMC9255550 DOI: 10.3389/fnut.2022.915064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 04/07/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPatients with rheumatoid arthritis (RA), who suffer from impaired physical function and fatigue, may have difficulties with grocery shopping and preparing meals. Also, to improve symptoms, patients often experiment with diets but seldom consult a dietitian. Although this could lead to a nutritiously deprived diet, an up-to-date, thorough description of the nutrient intake in Swedish patients with RA is absent. Here, we investigated the habitual dietary energy and nutrient intake in patients with RA living in southwestern Sweden.Materials and MethodsThree-day food records performed at two time points during the ADIRA (Anti-inflammatory Diet In Rheumatoid Arthritis) trial, were used. The intake of energy and nutrients was analyzed using The Swedish Food Composition Database.ResultsA total of 62 participants (50 females, 12 males) were included in the study, where 18 participants completed one 3-day food record and 44 participants completed two 3-day food records. Median (IQR) intake of total fat was above or in the upper range of recommendations (females: 37.1 [32.5, 41.7] energy percent (E%), and males: 40.3 [37.5, 42.9] E%). Median (IQR) intake of saturated fatty acids exceeded recommendations (females: 14.9 [12.5, 17.0] E% and males: 15.4 [12.2, 17.0] E%), while median (IQR) carbohydrate and fiber intakes were below recommendations (females: 41.7 [36.3, 45.4] E% and 17.2 [12.8, 20.9] g, respectively, and males: 38.8 [35.2, 40,3] E% and 18.5 [15.7, 21.0] g, respectively). The reported intake of other macronutrients was in line with recommendations. For several micronutrients, e.g., vitamin A and D, folate, and calcium, median intake was below recommended intake. Vitamin A intake was especially low and did not reach lower intake level (LI) for 14 and 17% of females and males, respectively. For females, about 10% did not reach LI for vitamin D, calcium, and riboflavin.ConclusionWe found that patients with RA residing in southwestern Sweden reported a high intake of saturated fatty acids and low intake of fiber and several micronutrients.Clinical Trial Registration[https://clinicaltrials.gov/ct2/show/NCT02941055?term=NCT02941055&draw=2&rank=1], identifier [NCT02941055].
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Affiliation(s)
- Anna Turesson Wadell
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- *Correspondence: Anna Turesson Wadell,
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Erik Hulander
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helen M. Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Strid A, Hallström E, Lindroos AK, Lindahl B, Johansson I, Winkvist A. Adherence to the Swedish Dietary Guidelines and the Impact on Mortality and Climate in a Population-Based Cohort Study. Curr Dev Nutr 2022. [PMCID: PMC9193821 DOI: 10.1093/cdn/nzac067.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objectives To assess 1) the association between adherence to the Swedish dietary guidelines and all-cause mortality, and 2) the difference in greenhouse gas emissions (GHGE) from diets of participants with higher and lower adherence to the Swedish dietary guidelines. Methods Dietary data from the Swedish population-based cohort Västerbotten Intervention Programme (49,124 women and 47,651 men, 35–65 years at baseline), collected between the years 1990–2016, were used. Diet quality was assessed by the Swedish Healthy Eating Index for Adults 2015 (SHEIA15). SHEIA15 is based on the Swedish dietary guidelines from 2015, and includes assessments of intakes of vegetables and fruits, seafood, whole grains, fiber, monounsaturated fatty acids, polyunsaturated fatty acids, saturated fatty acids, red and processed meat and added sugar. GHGE of diets were estimated from life cycle assessment data, including CO2e from primary production to industry gate. Information on all-cause mortality was acquired from registers at the National Board of Health and Welfare in Sweden using personal identification numbers. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards regression, comparing the lowest and highest quintile of SHEIA15 score. Potential confounders were adjusted for. Difference in GHGE of diets was compared between the lowest and highest quintile of SHEIA15 score, using the Mann Whitney U test. Results Median follow-up times were for women 16.0 years and for men 14.7 years, during which time 3074 women and 4212 men died. For women the highest SHEIA15 score was associated with lower mortality compared with the lowest score (HR: 0.87; 95% CI: 0.77, 0.98; P = 0.027). No statistically significant difference in HR of mortality was found for the men with the highest SHEIA15 score compared with the lowest score (HR: 0.91; 95% CI: 0.82, 1.01; P = 0.083). The participants with the highest score of SHEIA15 had lower dietary GHGE compared to those with the lowest score in both women and men (P < 0.001). Conclusions Higher adherence to the Swedish dietary guidelines, estimated by SHEIA15, was associated with lower all-cause mortality for women, but not for men, and indicated lower GHGE from diets for both women and men. Funding Sources The Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning (Formas).
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Amberntsson A, Bärebring L, Winkvist A, Lissner L, Meltzer HM, Brantsæter AL, Papadopoulou E, Augustin H. Maternal vitamin D status in relation to infant BMI growth trajectories up to 2 years of age in two prospective pregnancy cohorts. Obes Sci Pract 2022; 8:670-681. [PMID: 36238227 PMCID: PMC9535664 DOI: 10.1002/osp4.602] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/10/2022] [Accepted: 03/24/2022] [Indexed: 11/20/2022] Open
Abstract
Background Early childhood growth can affect the child's health status later in life. Maternal vitamin D status has been suggested to affect early childhood growth. However, there is a lack of studies investigating the role of maternal vitamin D status on growth trajectories during infancy. By using growth mixture modeling (GMM), maternal vitamin D status during pregnancy can be investigated in relation to different classes of infant growth trajectories. Objectives To examine the association between maternal 25‐hydroxyvitamin D (25OHD) and classes of infant body mass index (BMI) growth trajectories. Methods Mother–child pairs were included from the Norwegian Mother, Father, and Child Cohort Study (MoBa, n = 2522) and the Swedish GraviD cohort (n = 862). Maternal 25OHD in pregnancy was analyzed by liquid chromatography tandem mass spectrometry. Children's weights and heights were registry‐based. GMM identified classes of infant BMI growth trajectories up to 2 years. The association between maternal 25OHD and infant BMI class by cohort was estimated using a log‐link generalized linear model. Mixed model analysis estimated the pooled association including both cohorts. Results Two infant BMI classes were identified, stable normal and stable high. In MoBa, maternal 25OHD <50 and 50–75 nmol/L were associated (RR 2.70, 95% CI 1.26–5.77 and RR 2.56, 95% CI 1.20–5.47) with a higher risk of the infant stable high BMI class, compared with 25OHD >75 nmol/L. In GraviD, no association was found. In pooled analysis, maternal 25OHD ≤75 nmol/L was non‐significantly associated with a higher risk of the stable high BMI growth class. Conclusions Maternal 25OHD ≤75 nmol/L may be associated with a higher class of BMI growth trajectory during infancy.
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Affiliation(s)
- Anna Amberntsson
- Department of Internal Medicine and Clinical Nutrition Institute of Medicine Sahlgrenska Academy University of Gothenburg Goteborg Sweden
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition Institute of Medicine Sahlgrenska Academy University of Gothenburg Goteborg Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition Institute of Medicine Sahlgrenska Academy University of Gothenburg Goteborg Sweden
| | - Lauren Lissner
- School of Public Health and Community Medicine Institute of Medicine, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
| | - Helle Margrete Meltzer
- Department of Food Safety Division of Climate and Environmental Health, Norwegian Institute of Public Health Oslo Norway
| | - Anne Lise Brantsæter
- Department of Food Safety Division of Climate and Environmental Health, Norwegian Institute of Public Health Oslo Norway
| | - Eleni Papadopoulou
- Global Health Cluster Division of Health Services, Norwegian Institute of Public Health Oslo Norway
| | - Hanna Augustin
- Department of Internal Medicine and Clinical Nutrition Institute of Medicine Sahlgrenska Academy University of Gothenburg Goteborg Sweden
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Hulander E, Lindqvist HM, Wadell AT, Gjertsson I, Winkvist A, Bärebring L. Improvements in Body Composition after a Proposed Anti-Inflammatory Diet Are Modified by Employment Status in Weight-Stable Patients with Rheumatoid Arthritis, a Randomized Controlled Crossover Trial. Nutrients 2022; 14:nu14051058. [PMID: 35268033 PMCID: PMC8912542 DOI: 10.3390/nu14051058] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 12/03/2022] Open
Abstract
Rheumatoid Arthritis (RA) is an autoimmune disease affecting peripheral joints. Chronic activation of inflammatory pathways results in decreased function and the development of comorbidities, such as loss of lean mass while retaining total body mass. The objective of this report was to assess whether dietary manipulation affects body composition in patients with RA as a secondary outcome. Fifty patients were included in a randomized controlled crossover trial testing a proposed anti-inflammatory Mediterranean-style diet compared to a Western diet. Body composition was measured by bioelectrical impedance spectroscopy in patients without implants (n = 45). Regardless of treatment, fat-free mass increased and fat mass percentage decreased during weight stability, but no differences between intervention and control in the whole group (n = 42, all p > 0.20) were found. Interaction analysis revealed that participants who were non-employed (n = 15) significantly decreased in fat mass (−1.767 kg; 95% CI: −3.060, −0.475, p = 0.012) and fat mass percentage (−1.805%; 95% CI: −3.024, −0.586, p = 0.008) from the intervention compared to the control period. A Mediterranean-style diet improved body composition in non-employed participants (n = 15). The group as a whole improved regardless of dietary allocation, indicating a potential to treat rheumatoid cachexia by dietary manipulation.
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Affiliation(s)
- Erik Hulander
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden; (E.H.); (A.T.W.); (A.W.); (L.B.)
| | - Helen M. Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden; (E.H.); (A.T.W.); (A.W.); (L.B.)
- Correspondence:
| | - Anna Turesson Wadell
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden; (E.H.); (A.T.W.); (A.W.); (L.B.)
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden;
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden; (E.H.); (A.T.W.); (A.W.); (L.B.)
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden; (E.H.); (A.T.W.); (A.W.); (L.B.)
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Lindqvist HM, Wallengren O, Eriksson A, Hulander E, Winkvist A, Bärebring L. Validity of bioimpedance for assessment of fat-free mass in women with Rheumatoid Arthritis compared to non-rheumatic controls. Clin Nutr ESPEN 2022; 47:333-338. [DOI: 10.1016/j.clnesp.2021.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/29/2021] [Accepted: 11/08/2021] [Indexed: 01/04/2023]
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Karlsson T, Augustin H, Lindqvist M, Otten J, Petersson K, Storck-Lindholm E, Mogren I, Winkvist A. Effect of the New Nordic Diet compared with usual care on glucose control in gestational diabetes mellitus: Study protocol for the randomized controlled trial intervention with new Nordic DIet in women with GestatiOnal diabetes mellitus (iNDIGO). Contemp Clin Trials 2022; 115:106706. [DOI: 10.1016/j.cct.2022.106706] [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] [Received: 10/02/2021] [Revised: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 11/03/2022]
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His M, Viallon V, Dossus L, Schmidt JA, Travis RC, Gunter MJ, Overvad K, Kyrø C, Tjønneland A, Lécuyer L, Rothwell JA, Severi G, Johnson T, Katzke V, Schulze MB, Masala G, Sieri S, Panico S, Tumino R, Macciotta A, Boer JMA, Monninkhof EM, Olsen KS, Nøst TH, Sandanger TM, Agudo A, Sánchez MJ, Amiano P, Colorado-Yohar SM, Ardanaz E, Vidman L, Winkvist A, Heath AK, Weiderpass E, Huybrechts I, Rinaldi S. Lifestyle correlates of eight breast cancer-related metabolites: a cross-sectional study within the EPIC cohort. BMC Med 2021; 19:312. [PMID: 34886862 PMCID: PMC8662901 DOI: 10.1186/s12916-021-02183-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/09/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Metabolomics is a promising molecular tool for identifying novel etiological pathways leading to cancer. In an earlier prospective study among pre- and postmenopausal women not using exogenous hormones, we observed a higher risk of breast cancer associated with higher blood concentrations of one metabolite (acetylcarnitine) and a lower risk associated with higher blood concentrations of seven others (arginine, asparagine, phosphatidylcholines (PCs) aa C36:3, ae C34:2, ae C36:2, ae C36:3, and ae C38:2). METHODS To identify determinants of these breast cancer-related metabolites, we conducted a cross-sectional analysis to identify their lifestyle and anthropometric correlates in 2358 women, who were previously included as controls in case-control studies nested within the European Prospective Investigation into Cancer and Nutrition cohort and not using exogenous hormones at blood collection. Associations of each metabolite concentration with 42 variables were assessed using linear regression models in a discovery set of 1572 participants. Significant associations were evaluated in a validation set (n = 786). RESULTS For the metabolites previously associated with a lower risk of breast cancer, concentrations of PCs ae C34:2, C36:2, C36:3, and C38:2 were negatively associated with adiposity and positively associated with total and saturated fat intakes. PC ae C36:2 was also negatively associated with alcohol consumption and positively associated with two scores reflecting adherence to a healthy lifestyle. Asparagine concentration was negatively associated with adiposity. Arginine and PC aa C36:3 concentrations were not associated to any of the factors examined. For the metabolite previously associated with a higher risk of breast cancer, acetylcarnitine, a positive association with age was observed. CONCLUSIONS These associations may indicate possible mechanisms underlying associations between lifestyle and anthropometric factors, and risk of breast cancer. Further research is needed to identify potential non-lifestyle correlates of the metabolites investigated.
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Affiliation(s)
- Mathilde His
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, 150 cours Albert Thomas, 69372, CEDEX 08, Lyon, France
| | - Vivian Viallon
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, 150 cours Albert Thomas, 69372, CEDEX 08, Lyon, France
| | - Laure Dossus
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, 150 cours Albert Thomas, 69372, CEDEX 08, Lyon, France
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Marc J Gunter
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, 150 cours Albert Thomas, 69372, CEDEX 08, Lyon, France
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Cecilie Kyrø
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, Section of Environmental Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lucie Lécuyer
- Université Paris-Saclay, UVSQ, Inserm, CESP U1018, "Exposome and Heredity" team, Gustave Roussy, Villejuif, France
| | - Joseph A Rothwell
- Université Paris-Saclay, UVSQ, Inserm, CESP U1018, "Exposome and Heredity" team, Gustave Roussy, Villejuif, France
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, Inserm, CESP U1018, "Exposome and Heredity" team, Gustave Roussy, Villejuif, France
- Department of Statistics, Computer Science, Applications "G. Parenti", University of Florence, Florence, Italy
| | - Theron Johnson
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Verena Katzke
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Instituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Salvatore Panico
- Dipartimento Di Medicina Clinica E Chirurgia, Federico Ii University, Naples, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP 7) Ragusa, Ragusa, Italy
| | - Alessandra Macciotta
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Jolanda M A Boer
- Center for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, 3720, BA, the Netherlands
| | - Evelyn M Monninkhof
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Karina Standahl Olsen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, NO-9037, Tromsø, Norway
| | - Therese H Nøst
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, NO-9037, Tromsø, Norway
| | - Torkjel M Sandanger
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, NO-9037, Tromsø, Norway
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, L'Hospitalet de Llobregat, Spain
- Nutrition and Cancer Group; Epidemiology, Public Health, Cancer Prevention and Palliative Care Program; Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Maria-Jose Sánchez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Pilar Amiano
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, San Sebastián, Spain
- Biodonostia Health Research Institute, Group of Epidemiology of Chronic and Communicable Diseases, San Sebastián, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Sandra M Colorado-Yohar
- CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Eva Ardanaz
- CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Linda Vidman
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Anna Winkvist
- Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Elisabete Weiderpass
- International Agency for Research on Cancer (IARC/WHO), Office of the Director, Lyon, France
| | - Inge Huybrechts
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, 150 cours Albert Thomas, 69372, CEDEX 08, Lyon, France
| | - Sabina Rinaldi
- International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, 150 cours Albert Thomas, 69372, CEDEX 08, Lyon, France.
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Hulander E, Bärebring L, Turesson Wadell A, Gjertsson I, Calder PC, Winkvist A, Lindqvist HM. Proposed Anti-Inflammatory Diet Reduces Inflammation in Compliant, Weight-Stable Patients with Rheumatoid Arthritis in a Randomized Controlled Crossover Trial. J Nutr 2021; 151:3856-3864. [PMID: 34587253 PMCID: PMC8643575 DOI: 10.1093/jn/nxab313] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 08/17/2021] [Accepted: 08/26/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND It is unclear to what extent adjuvant dietary intervention can influence inflammation in rheumatoid arthritis (RA). OBJECTIVES The objective was to assess the effects of dietary manipulation on inflammation in patients with RA. METHODS In a crossover design, participants [n = 50, 78% females, median BMI (in kg/m2) 27, median age 63 y] were randomly assigned to begin with either a 10-wk portfolio diet of proposed anti-inflammatory foods (i.e., a high intake of fatty fish, whole grains, fruits, nuts, and berries) or a control diet resembling a Western diet with a 4-mo washout in between. This report evaluates the secondary outcome markers of inflammation among participants with stable medication. Analyses were performed using a linear mixed ANCOVA model. RESULTS There were no significant effects on CRP or ESR in the group as a whole. In those with high compliance (n = 29), changes in ESR within the intervention diet period differed significantly compared with changes within the control diet period (mean: -5.490; 95% CI: -10.310, -0.669; P = 0.027). During the intervention diet period, there were lowered serum concentrations of C-X-C motif ligand 1 (CXCL1) (mean: -0.268; 95% CI: -0.452, -0.084;P = 0.006), CXCL5 (mean: -0.278; 95% CI: -0.530, -0.026 P = 0.031), CXCL6 (mean: -0.251; 95% CI: -0.433, -0.069; P = 0.009), and tumor necrosis factor ligand superfamily member 14 (TNFSF14) (mean: -0.139; 95% CI: -0.275, -0.002; P = 0.047) compared with changes within the control diet period. CONCLUSION A proposed anti-inflammatory diet likely reduced systemic inflammation, as indicated by a decreased ESR in those who completed the study with high compliance (n = 29). These findings warrant further studies to validate our results, and to evaluate the clinical relevance of changes in CXCL1, CXCL5, CXCL6, and TNFSF14 in patients with RA.
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Affiliation(s)
- Erik Hulander
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Turesson Wadell
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Philip C Calder
- Faculty of Medicine, University of Southampton and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helen M Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Turesson Wadell A, Bärebring L, Hulander E, Gjertsson I, Hagberg L, Lindqvist HM, Winkvist A. Effects on health-related quality of life in the randomized, controlled crossover trial ADIRA (Anti-inflammatory Diet In Rheumatoid Arthritis). PLoS One 2021; 16:e0258716. [PMID: 34648598 PMCID: PMC8516209 DOI: 10.1371/journal.pone.0258716] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 09/26/2021] [Indexed: 12/18/2022] Open
Abstract
Background Patients with Rheumatoid Arthritis (RA) often report impaired health-related quality of life (HrQoL) such as difficulties in daily life, pain, fatigue and an affected social life. Even when lowering disease activity, pharmacological treatment does not always resolve these factors. Objective To investigate if a proposed anti-inflammatory diet improves HrQoL in patients with RA. Design In this controlled crossover trial, 50 patients were randomized to start with either an intervention diet (anti-inflammatory) or a control diet (usual Swedish intake) for ten weeks followed by a wash out period before switching to the other diet. Participants received food equivalent to ~1100 kcal/day, five days/week, and instructions to consume similarly for the remaining meals. HrQoL was evaluated using Health Assessment Questionnaire (HAQ), 36-item Short Form Survey (SF-36), Visual Analogue Scales (VAS) for pain, fatigue and morning stiffness, and a time scale for morning stiffness. Results Forty-seven participants completed ≥1 diet period and were included in the main analyses. No significant difference between intervention and control diet at end of diet periods was observed for any outcome. However, significant improvements were obtained for SF-36 Physical Functioning (mean:5.79, SE: 2.12, 95% CI: 1.58, 10.01) during the intervention diet period. When excluding participants with anti-rheumatic medication changes, the differences between diet periods increased for most outcomes, favoring the intervention diet period, and the difference for SF-36 Physical Functioning became significant (n = 25, mean:7.90, 95% CI:0.56, 15.24, p = 0.036). Conclusions In main analyses, the proposed anti-inflammatory diet did not significantly improve HrQoL for patients with RA compared to control diet. In sub-analyses, significant improvements in physical functioning were detected. Larger studies with consistent medication use and in populations more affected by the disease may be needed to obtain conclusive evidence.
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Affiliation(s)
- Anna Turesson Wadell
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- * E-mail: (ATW); (AW)
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Erik Hulander
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Hagberg
- Centre for Health Care Science, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Helen M. Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- * E-mail: (ATW); (AW)
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Nybacka S, Simrén M, Störsrud S, Törnblom H, Winkvist A, Lindqvist HM. Changes in serum and urinary metabolomic profile after a dietary intervention in patients with irritable bowel syndrome. PLoS One 2021; 16:e0257331. [PMID: 34634050 PMCID: PMC8504738 DOI: 10.1371/journal.pone.0257331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/22/2021] [Accepted: 08/25/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a multi-faceted gastrointestinal disorder where food intake often triggers symptoms. Metabolomics may provide mechanistical insights to why responses to dietary modifications are diverse. OBJECTIVE This study aimed to identify metabolite patterns related to dietary intake in patients with IBS, and to identify metabolites driving the separation between responders and non-responders to treatment. METHODS Participants were randomized to a low fermentable oligo-, di-, monosaccharide and polyol (FODMAP) diet (LFD) or traditional IBS diet (TID) for four weeks. Fasting serum and urine samples pre- and post-intervention were analyzed using 1H nuclear magnetic resonance (NMR) metabolomics. Response to treatment was defined as a reduction in IBS severity scoring system (IBS-SSS) ≥50. RESULTS Twenty-five individuals in the LFD (13 responders) and 28 in the TID (14 responders) were included in these post hoc analyses. In endpoint samples, significant decreases in polyols and glucose were seen in the LFD. Post-intervention samples revealed that LFD responders had significantly increased levels of 2-hydroxybuturate and decreased levels of glucose and pantothenic acid compared to non-responders. For the TID, only weak multivariate models were identified and a larger diversity in metabolite response compared to the LFD were noted. CONCLUSIONS In this study, metabolite patterns between individuals who responded well to an LFD compared to non-responders could be distinguished. This provides new hypotheses for mechanistic actions related to response to dietary modifications, but the results need to be validated in larger cohorts. CLINICAL TRIAL REGISTRATION This trial was registered at www.clinicaltrials.gov, registry number NCT02107625.
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Affiliation(s)
- Sanna Nybacka
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Simrén
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Center for Functional GI & Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Stine Störsrud
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hans Törnblom
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helen M. Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Amberntsson A, Papadopoulou E, Winkvist A, Lissner L, Meltzer HM, Brantsaeter AL, Augustin H. Maternal vitamin D intake and BMI during pregnancy in relation to child's growth and weight status from birth to 8 years: a large national cohort study. BMJ Open 2021; 11:e048980. [PMID: 34598984 PMCID: PMC8488702 DOI: 10.1136/bmjopen-2021-048980] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To examine the associations between maternal vitamin D intake and childhood growth and risk of overweight up to 8 years. We further examined the effect modification by maternal prepregnancy body mass index (BMI). DESIGN Prospective population-based pregnancy cohort study. SETTING The Norwegian Mother, Father and Child Cohort Study. PARTICIPANTS In total, 58 724 mothers and 66 840 singleton children, with information on maternal vitamin D intake during the pregnancy and minimum one postnatal anthropometric measurement. OUTCOME MEASURES Predicted weight and height growth trajectories and velocities from 1 month to 8 years, rapid growth during infancy and toddlerhood, and risk of overweight in preschool and school age. RESULTS Overall, maternal vitamin D intake was associated with lower weight trajectory, lower odds of rapid weight growth and higher odds of childhood overweight. In children of mothers with prepregnancy normal weight, maternal vitamin D intake was negatively associated with weight trajectory and lower OR of a rapid weight growth during the first year, compared with reference (<5 µg/day). Children of mothers with normal weight, with maternal vitamin D intakes of 10-15 and >15 µg/day, also had 0.86 (95% CI 0.77 to 0.97) and 0.88 (95% CI 0.79 to 0.99) lower odds for overweight at 3 years, compared with reference. In contrast, in children of mothers with prepregnancy overweight (BMI ≥25 kg/m2), vitamin D intake was positively associated with weight trajectory. Children of mothers with overweight, with maternal vitamin D intake of 5-9.9 µg/day, also had (1.09 (95% CI 1.01 to 1.18) and 1.12 (95% CI 1.02 to 1.23)) higher odds for overweight at 5 years and 8 years, compared with reference. CONCLUSIONS Maternal vitamin D intake affects postnatal growth and is inversely associated with childhood overweight in children of mothers with normal weight. Associations between maternal vitamin D intake and child growth and risk of overweight varied by prepregnancy BMI.
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Affiliation(s)
- Anna Amberntsson
- Institute of Medicine, University of Gothenburg, Goteborg, Sweden
| | | | - Anna Winkvist
- Institute of Medicine, University of Gothenburg, Goteborg, Sweden
| | - Lauren Lissner
- Institute of Medicine, University of Gothenburg, Goteborg, Sweden
| | | | | | - Hanna Augustin
- Institute of Medicine, University of Gothenburg, Goteborg, Sweden
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Ellegård L, Alstad T, Rütting T, Hammarström Johansson P, Lindqvist HM, Winkvist A. Distinguishing vegan-, vegetarian-, and omnivorous diets by hair isotopic analysis. Clin Nutr 2021; 40:5335. [PMID: 34543888 DOI: 10.1016/j.clnu.2021.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Lars Ellegård
- Institute of Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at the University of Gothenburg, Sweden; Clinical Nutrition Unit, Department of Gastroenterology, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Torgny Alstad
- Department of Odontology, Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Tobias Rütting
- Department of Earth Sciences, University of Gothenburg, Sweden
| | | | - Helen M Lindqvist
- Institute of Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Anna Winkvist
- Institute of Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at the University of Gothenburg, Sweden
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Lindqvist HM, Bärebring L, Gjertsson I, Jylhä A, Laaksonen R, Winkvist A, Hilvo M. A Randomized Controlled Dietary Intervention Improved the Serum Lipid Signature towards a Less Atherogenic Profile in Patients with Rheumatoid Arthritis. Metabolites 2021; 11:632. [PMID: 34564448 PMCID: PMC8472309 DOI: 10.3390/metabo11090632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/26/2022] Open
Abstract
Diet is a major modifiable risk factor for cardiovascular disease (CVD). One explanation for this is its effect on specific lipids. However, knowledge on how the lipidome is affected is limited. We aimed to investigate if diet can change the new ceramide- and phospholipid-based CVD risk score CERT2 and the serum lipidome towards a more favorable CVD signature. In a crossover trial (ADIRA), 50 patients with rheumatoid arthritis (RA) had 10 weeks of a Mediterranean-style diet intervention or a Western-style control diet and then switched diets after a 4-month wash-out-period. Five hundred and thirty-eight individual lipids were measured in serum by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Lipid risk scores were analyzed by Wilcoxon signed-rank test or mixed model and lipidomic data with multivariate statistical methods. In the main analysis, including the 46 participants completing ≥1 diet period, there was no significant difference in CERT2 after the intervention compared with the control, although several CERT2 components were changed within periods. In addition, triacylglycerols, cholesteryl esters, phosphatidylcholines, alkylphosphatidylcholines and alkenylphosphatidylcholines had a healthier composition after the intervention compared to after the control diet. This trial indicates that certain dietary changes can improve the serum lipid signature towards a less atherogenic profile in patients with RA.
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Affiliation(s)
- Helen M Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
| | | | | | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
| | - Mika Hilvo
- Zora Biosciences Oy, 02150 Espoo, Finland
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Strid A, Johansson I, Lindahl B, Hallström E, Winkvist A. Diets Varying in Nutrient Density and Climate Impact and Their Association With Risk of Myocardial Infarction in Northern Sweden. Curr Dev Nutr 2021. [DOI: 10.1093/cdn/nzab053_088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objectives
Assess the effects of diets varying in nutrient density and climate impact on risk of myocardial infarction (MI).
Methods
Dietary data from 39 927 women and 37 390 men 35–65 years in the population-based prospective study Västerbotten Intervention Programme (Sweden) between the years 1990–2016 were used to characterize dietary quality and dietary climate impact. Nutrient density was estimated by the Sweden-adapted Nutrient Rich Foods index NRF11.3, based on 11 nutrients (protein, dietary fiber, iron, folate, vitamins A, C, D, E, magnesium, calcium, potassium) to be encouraged and three nutrients (saturated fat, added sugar, sodium) to be limited. Dietary climate impact was estimated using data from life cycle assessments. Information on MI diagnosis was obtained from registers at the National Board of Health and Welfare in Sweden using personal identification numbers. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using multivariable Cox proportional hazards regression for four groups of women and men, respectively higher nutrient density, lower climate impact; higher nutrient density, higher climate impact; lower nutrient density, lower climate impact; and lower nutrient density, higher climate impact (reference group). Potential confounders were adjusted for.
Results
Median follow-up times from recruitment to MI diagnosis for women were 15.8 years and for men 12.8 years, during which time 962 and 2 607 first-time events occurred, respectively. For men a significantly increased risk of MI was found for the group with lower nutrient density and lower climate impact [HR 1.20 (95% CI: 1.06, 1.34); P = 0.003] compared to the group with lower nutrient density and higher climate impact. No significant association was found between the groups of nutrient density and dietary climate impact and MI in women, although a similar trend as that for men was found.
Conclusions
A lower compared with a higher dietary climate impact was associated with a higher risk of MI in men when diet quality was below median values, reflecting the importance of considering diet quality when decreasing the climate impact of diets. For women no significant relationship was identified.
Funding Sources
The Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning (Formas).
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Strid A, Johansson I, Bianchi M, Sonesson U, Hallström E, Lindahl B, Winkvist A. Diets benefiting health and climate relate to longevity in northern Sweden. Am J Clin Nutr 2021; 114:515-529. [PMID: 33871543 PMCID: PMC8326051 DOI: 10.1093/ajcn/nqab073] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 02/25/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Diets combining adequate nutritional quality and low climate impact are highly needed for human and planet health. OBJECTIVES We aimed to 1) evaluate nutrient density indexes' ability to predict mortality, and 2) assess the effects of diets varying in nutrient density and climate impact on total mortality. METHODS Dietary data from 49,124 women and 47,651 men aged 35-65 y in the population-based prospective study Västerbotten Intervention Programme (Sweden) were used. Greenhouse gas emissions (GHGEs) were estimated using data from life cycle assessments. Fifteen variants of nutrient density indexes were evaluated and the index that best predicted mortality was used to estimate participants' nutrient density. GHGEs and nutrient density were adjusted for energy intakes. Total mortality risk was estimated by Cox proportional hazards models for 4 groups of women and men, respectively, i.e., higher nutrient density, lower climate impact (HNutr/LClim); higher nutrient density, higher climate impact (HNutr/HClim); lower nutrient density, lower climate impact (LNutr/LClim); and lower nutrient density, higher climate impact (LNutr/HClim-reference group). RESULTS NRF11.3, a Sweden-adapted variant of the Nutrient Rich Foods index, was identified to have the best ability to predict mortality in the study population. Median follow-up times for women and men were 16.0 and 14.7 y, respectively. For women a significantly lower mortality risk was found for HNutr/LClim (HR: 0.87; 95% CI: 0.79, 0.96; P = 0.008) and HNutr/HClim (HR: 0.87; 95% CI: 0.78, 0.97; P = 0.011) than for LNutr/HClim. Among men LNutr/LClim had a significantly higher mortality risk (HR: 1.10; 95% CI: 1.01, 1.21; P = 0.033) than LNutr/HClim. CONCLUSIONS Diets beneficial for both health and climate are feasible and associated with lower mortality risk in women. Further studies are needed to understand how men may transition into diets that are more sustainable from a combined health and climate perspective.
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Affiliation(s)
| | | | - Marta Bianchi
- Department of Agriculture and Food, RISE Research Institutes of Sweden, Gothenburg & Lund, Sweden
| | - Ulf Sonesson
- Department of Agriculture and Food, RISE Research Institutes of Sweden, Gothenburg & Lund, Sweden
| | - Elinor Hallström
- Department of Agriculture and Food, RISE Research Institutes of Sweden, Gothenburg & Lund, Sweden
| | - Bernt Lindahl
- Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Stepien M, Keski-Rahkonen P, Kiss A, Robinot N, Duarte-Salles T, Murphy N, Perlemuter G, Viallon V, Tjønneland A, Rostgaard-Hansen AL, Dahm CC, Overvad K, Boutron-Ruault MC, Mancini FR, Mahamat-Saleh Y, Aleksandrova K, Kaaks R, Kühn T, Trichopoulou A, Karakatsani A, Panico S, Tumino R, Palli D, Tagliabue G, Naccarati A, Vermeulen RCH, Bueno-de-Mesquita HB, Weiderpass E, Skeie G, Ramón Quirós J, Ardanaz E, Mokoroa O, Sala N, Sánchez MJ, Huerta JM, Winkvist A, Harlid S, Ohlsson B, Sjöberg K, Schmidt JA, Wareham N, Khaw KT, Ferrari P, Rothwell JA, Gunter M, Riboli E, Scalbert A, Jenab M. Metabolic perturbations prior to hepatocellular carcinoma diagnosis: Findings from a prospective observational cohort study. Int J Cancer 2021; 148:609-625. [PMID: 32734650 DOI: 10.1002/ijc.33236] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 06/16/2020] [Accepted: 06/26/2020] [Indexed: 12/19/2022]
Abstract
Hepatocellular carcinoma (HCC) development entails changes in liver metabolism. Current knowledge on metabolic perturbations in HCC is derived mostly from case-control designs, with sparse information from prospective cohorts. Our objective was to apply comprehensive metabolite profiling to detect metabolites whose serum concentrations are associated with HCC development, using biological samples from within the prospective European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (>520 000 participants), where we identified 129 HCC cases matched 1:1 to controls. We conducted high-resolution untargeted liquid chromatography-mass spectrometry-based metabolomics on serum samples collected at recruitment prior to cancer diagnosis. Multivariable conditional logistic regression was applied controlling for dietary habits, alcohol consumption, smoking, body size, hepatitis infection and liver dysfunction. Corrections for multiple comparisons were applied. Of 9206 molecular features detected, 220 discriminated HCC cases from controls. Detailed feature annotation revealed 92 metabolites associated with HCC risk, of which 14 were unambiguously identified using pure reference standards. Positive HCC-risk associations were observed for N1-acetylspermidine, isatin, p-hydroxyphenyllactic acid, tyrosine, sphingosine, l,l-cyclo(leucylprolyl), glycochenodeoxycholic acid, glycocholic acid and 7-methylguanine. Inverse risk associations were observed for retinol, dehydroepiandrosterone sulfate, glycerophosphocholine, γ-carboxyethyl hydroxychroman and creatine. Discernible differences for these metabolites were observed between cases and controls up to 10 years prior to diagnosis. Our observations highlight the diversity of metabolic perturbations involved in HCC development and replicate previous observations (metabolism of bile acids, amino acids and phospholipids) made in Asian and Scandinavian populations. These findings emphasize the role of metabolic pathways associated with steroid metabolism and immunity and specific dietary and environmental exposures in HCC development.
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Affiliation(s)
- Magdalena Stepien
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Pekka Keski-Rahkonen
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Agneta Kiss
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Nivonirina Robinot
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Talita Duarte-Salles
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Neil Murphy
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Gabriel Perlemuter
- INSERM UMRS U996 - Intestinal Microbiota, Macrophages and Liver Inflammation, Clamart, France
- Université Paris-Sud, Clamart, France
- AP-HP, Hepato-gastroenterology and Nutrition, Antoine-Béclère Hospital, Clamart, France
| | - Vivian Viallon
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Anne Tjønneland
- Diet, Genes and Environment Unit, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Christina C Dahm
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Kim Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Marie-Christine Boutron-Ruault
- CESP, Faculté de médecine-Université Paris-Sud, Faculté de médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Francesca Romana Mancini
- CESP, Faculté de médecine-Université Paris-Sud, Faculté de médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Yahya Mahamat-Saleh
- CESP, Faculté de médecine-Université Paris-Sud, Faculté de médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Krasimira Aleksandrova
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept. of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- Second Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP) Ragusa, Ragusa, Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Giovanna Tagliabue
- Lombardy Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessio Naccarati
- Molecular and Genetic Epidemiology Unit, Italian Institute for Genomic Medicine (IIGM) Torino, Torino, Italy
| | - Roel C H Vermeulen
- Institute of Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Hendrik Bastiaan Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Elisabete Weiderpass
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | | | - Eva Ardanaz
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Olatz Mokoroa
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain
| | - Núria Sala
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program and Translational Research Laboratory, Catalan Institute of Oncology (IDIBELL), Barcelona, Spain
| | - Maria-Jose Sánchez
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs. Granada. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - José María Huerta
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain
| | - Anna Winkvist
- The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- Department of Public Health and Clinical Medicine, Nutrition Research, Umeå University, Umeå, Sweden
| | - Sophia Harlid
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Bodil Ohlsson
- Skåne University Hospital, Department of Internal Medicine, Lund University, Malmö, Sweden
| | - Klas Sjöberg
- Skåne University Hospital, Department of Gastroenterology and Nutrition, Lund University, Malmö, Sweden
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Nick Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Kay-Tee Khaw
- University of Cambridge, School of Clinical Medicine, Clinical Gerontology Unit, Addenbrooke's Hospital, Cambridge, UK
| | - Pietro Ferrari
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Joseph A Rothwell
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
- Institut Gustave Roussy, Villejuif, France
| | - Marc Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Augustin Scalbert
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Mazda Jenab
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
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Hulander E, Bärebring L, Turesson Wadell A, Gjertsson I, Calder PC, Winkvist A, Lindqvist HM. Diet intervention improves cardiovascular profile in patients with rheumatoid arthritis: results from the randomized controlled cross-over trial ADIRA. Nutr J 2021; 20:9. [PMID: 33485336 PMCID: PMC7827982 DOI: 10.1186/s12937-021-00663-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/13/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The chronic inflammation in patients with rheumatoid arthritis (RA) increases the risk for cardiovascular diseases (CVD). The contribution of diet as a risk factor for CVD among these patients is however not fully understood. The aim of this study is to investigate if a proposed anti-inflammatory diet improves cardiovascular profile in weight stable patients with RA. METHODS Patients (n = 50) with RA were included in a cross-over trial. They were randomized to either a diet rich in whole grain, fatty fish, nuts, vegetables and fruit and supplemented with probiotics, or a control diet resembling average nutritional intake in Sweden, for ten weeks. After a 4-month washout they switched diet. Participants received food bags and dietary guidelines. Primary outcome was triglyceride (TG) concentration. Secondary outcomes were total-, high density lipoprotein- (HDL) and low density lipoprotein- (LDL) cholesterol, Apolipoprotein-B100 and -A1, lipoprotein composition, plasma phospholipid fatty acids and blood pressure. RESULTS Forty-seven patients completed at least one period and they remained weight stable. There was a significant between-dietary treatment effect in TG and HDL-cholesterol concentration in favor of intervention (p = 0.007 and p = 0.049, respectively). Likewise, Apolipoprotein-B100/A1 ratio shifted toward a less atherogenic profile in favor of the intervention (p = 0.007). Plasma fatty acids increased in polyunsaturated- and decreased in monounsaturated- and saturated fatty acids between diet periods in favor of the intervention period. CONCLUSION Blood lipid profile improved indicating cardioprotective effects from an anti-inflammatory dietary intervention in patients with RA. TRIAL REGISTRATION This trial is registered at ClinicalTrials.gov as NCT02941055 .
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Affiliation(s)
- Erik Hulander
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 459, SE-405 30, Gothenburg, Sweden.
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 459, SE-405 30, Gothenburg, Sweden
| | - Anna Turesson Wadell
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 459, SE-405 30, Gothenburg, Sweden
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Philip C Calder
- Faculty of Medicine, University of Southampton and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16-6YD, UK
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 459, SE-405 30, Gothenburg, Sweden
| | - Helen M Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 459, SE-405 30, Gothenburg, Sweden
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Bärebring L, Palmqvist M, Winkvist A, Augustin H. Gender differences in perceived food healthiness and food avoidance in a Swedish population-based survey: a cross sectional study. Nutr J 2020; 19:140. [PMID: 33375947 PMCID: PMC7772926 DOI: 10.1186/s12937-020-00659-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this work was to study potential gender differences in perceived food healthiness and food avoidance in a population-representative sample of the Swedish adult population. METHODS A questionnaire regarding diet and health was posted to 2000 randomly selected residents in Sweden, aged 20-65 years. Questions were posed regarding which foods or food components the participants avoided due to perceived unhealthiness and how healthy they believed the food items to be. The pre-specified food components included sugar, carbohydrate, gluten, lactose, dairy, fat, saturated fat, red meat, white flour, salt, alcohol and food additives (specifically glutamate, sweetening, preservative and coloring agents). Chi square tests were used to study differences in perceived food healthiness and food avoidance depending on gender. RESULTS Around 50% reported avoidance of sugar (51.6%) and sweeting agents (45.2%), whereas fewer reported avoidance of saturated fat (16.8%) and salt (10.6%). Women were more likely than men to avoid gluten (AOR [95% CI] 2.84 [1.33-6.05]), red meat (3.29 [1.86-5.80]), white flour (2.64 [1.65-4.21]), preservatives (1.7 [1.07-2.70]) and coloring agents (2.10 [1.29-3.41]) due to perceived unhealthiness. Gender differences were also apparent in perceived healthiness of sugar, gluten, dairy, red meat, white flour, alcohol and food additives, where women tended to be more negative than men in their attitudes. Women more often said to read new findings in media about diet (16% vs 9%, p = 0.029) and prioritize a healthy lifestyle (35% vs 25%, p = 0.015). More than a third of both women and men reported worrying over the healthiness of their diet, and a higher proportion of women than men (18% vs 11%, p = 0.015) agreed with the statement that they were often anxious over having an unhealthy diet. CONCLUSIONS Women in this population-based study of residents in Sweden were more likely than men to avoid eating gluten, red meat, white flour and food additives due to perceived unhealthiness, and reported more diet and health related anxiety. Future research to identify effective ways of promoting healthy eating for both women and men, while minimizing diet-health related anxiety, is highly warranted.
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Affiliation(s)
- Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Box 459, 40530, Gothenburg, Sweden.
| | - Maria Palmqvist
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Box 459, 40530, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Box 459, 40530, Gothenburg, Sweden
| | - Hanna Augustin
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Box 459, 40530, Gothenburg, Sweden
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38
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Van Guelpen B, Gylling B, Harlid S, Winkvist A, Brenner H, Buchanan DD, Campbell PT, Chan AT, Chang-Claude J, Gallinger SJ, Giles GG, Gunter MJ, Hoffmeister M, Hsu L, Jenkins MA, Milne RL, Newcomb PA, Ogino S, Potter JD, Qu C, Sakoda LC, Schoen RE, Slattery ML, Woods MO, Harrison TA, Peters U. Abstract 2355: Folate and folic acid intake in relation to molecular subtypes of colorectal cancer; a pooled analysis of 7542 cases. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-2355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Higher folate intake has been reported to be associated with modestly lower risk of colorectal cancer, but the overall state of the evidence is inconclusive. Revisiting putative and established lifestyle-related risk factors from the perspective of intertumoral heterogeneity is warranted, as risk relationships for a molecular subtype may be attenuated toward the null when colorectal cancer is investigated as a single disease.
Aim: To investigate folate and folic acid intakes in relation to the risk of molecular subtypes of colorectal cancer.
Methods: We pooled individual-level observational data from 7542 colorectal cancer cases and 7066 controls within the collaborative framework of the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO) and the Colon Cancer Family Registry (CCFR). Odds ratios per sex- and study-specific quartile increase in dietary and total folate intake, and for folic acid supplement use (yes/no), were estimated using logistic regression for case-only analyses and multinomial models for case-control analyses. Minimally adjusted analyses included sex, age, study and total energy intake as covariates. Tumor marker variables included microsatellite instability (MSI) status, CpG island methylator phenotype (CIMP), and BRAF and KRAS mutations.
Results: In case-only analyses, we observed no heterogeneity in associations between folate intake, with or without supplemental folic acid (taking into consideration folic acid fortification when relevant), or with folic acid supplement use, and the risk of any subtype of colorectal cancer based on individual molecular tumor markers (lowest p for heterogeneity 0.073). In case-control analyses, higher dietary and total folate intake and folic acid supplement use were associated with a lower risk of most molecular tumor subtypes (all odds ratios were below one, and most were statistically significant). Adjustment for a larger set of potential confounders had no material effect on risk estimates.
Conclusion: In this large, pooled analysis, higher dietary and total folate intakes and folic acid supplement use were all associated with a lower risk of colorectal cancer, regardless of individual molecular tumor markers including MSI status, CIMP, and BRAF and KRAS mutations.
Citation Format: Bethany Van Guelpen, Björn Gylling, Sophia Harlid, Anna Winkvist, Hermann Brenner, Daniel D. Buchanan, Peter T. Campbell, Andrew T. Chan, Jenny Chang-Claude, Steven J. Gallinger, Graham G. Giles, Marc J. Gunter, Michael Hoffmeister, Li Hsu, Mark A. Jenkins, Roger L. Milne, Polly A. Newcomb, Shuji Ogino, John D. Potter, Conghui Qu, Lori C. Sakoda, Robert E. Schoen, Martha L. Slattery, Mikael O. Woods, Tabitha A. Harrison, Ulrike Peters. Folate and folic acid intake in relation to molecular subtypes of colorectal cancer; a pooled analysis of 7542 cases [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2355.
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Affiliation(s)
| | | | | | | | - Hermann Brenner
- 3German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Germany
| | - Daniel D. Buchanan
- 4University of Melbourne, Victorian Comprehensive Cancer Centre, and Royal Melbourne Hospital, Australia
| | | | - Andrew T. Chan
- 6Massachusetts General Hospital, Brigham and Women's Hospital, Harvard Medical School, Broad Institute of Harvard and MIT, and Harvard University, Boston, MA
| | - Jenny Chang-Claude
- 7German Cancer Research Center (DKFZ) and University Medical Centre Hamburg-Eppendorf, Germany
| | | | - Graham G. Giles
- 9Cancer Council Victoria, The University of Melbourne, and Monash University, Australia
| | | | | | - Li Hsu
- 12Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA
| | | | - Roger L. Milne
- 9Cancer Council Victoria, The University of Melbourne, and Monash University, Australia
| | - Polly A. Newcomb
- 12Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA
| | - Shuji Ogino
- 14Brigham and Women's Hospital, Harvard Medical School, Dana-Farber Cancer Institute, Harvard University, and Broad Institute of MIT and Harvard, Boston, MA
| | | | - Conghui Qu
- 15Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Lori C. Sakoda
- 16Kaiser Permanente Northern California and Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | | | - Mikael O. Woods
- 19Memorial University of Newfoundland, Newfoundland and Labrador, Canada
| | | | - Ulrike Peters
- 12Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA
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Vadell AKE, Bärebring L, Hulander E, Gjertsson I, Lindqvist HM, Winkvist A. Anti-inflammatory Diet In Rheumatoid Arthritis (ADIRA)-a randomized, controlled crossover trial indicating effects on disease activity. Am J Clin Nutr 2020; 111:1203-1213. [PMID: 32055820 PMCID: PMC7266686 DOI: 10.1093/ajcn/nqaa019] [Citation(s) in RCA: 76] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 01/27/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Many patients with rheumatoid arthritis (RA) report symptom relief from certain foods. Earlier research indicates positive effects of food and food components on clinical outcomes in RA, but insufficient evidence exists to provide specific dietary advice. Food components may interact but studies evaluating combined effects are lacking. OBJECTIVES We aimed to investigate if an anti-inflammatory diet reduces disease activity in patients with RA. METHODS In this single-blinded crossover trial, 50 patients with RA were randomly assigned to an intervention diet containing a portfolio of suggested anti-inflammatory foods, or a control diet similar to the general dietary intake in Sweden, for 10 wk. After a 4-mo washout period the participants switched diet. Food equivalent to ∼50% of energy requirements was delivered weekly to their homes. For the remaining meals, they were encouraged to consume the same type of foods as the ones provided during each diet. Primary outcome was change in Disease Activity Score in 28 joints-Erythrocyte Sedimentation Rate (DAS28-ESR). Secondary outcomes were changes in the components of DAS28-ESR (tender and swollen joints, ESR, and visual analog scale for general health) and DAS28-C-reactive protein. RESULTS In the main analysis, a linear mixed ANCOVA model including the 47 participants completing ≥1 diet period, there was no significant difference in DAS28-ESR between the intervention and control periods (P = 0.116). However, in unadjusted analyses, DAS28-ESR significantly decreased during the intervention period and was significantly lower after the intervention than after the control period in the participants who completed both periods (n = 44; median: 3.05; IQR: 2.41, 3.79 compared with median: 3.27; IQR: 2.69, 4.28; P = 0.04, Wilcoxon's Signed Rank test). No significant differences in the components were observed. CONCLUSIONS This trial indicates positive effects of a proposed anti-inflammatory diet on disease activity in patients with RA. Additional studies are required to determine if this diet can cause clinically relevant improvements.This trial was registered at clinicaltrials.gov as NCT02941055.
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Affiliation(s)
- Anna K E Vadell
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Erik Hulander
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helen M Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Address correspondence to AKEV (e-mail: )
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Shi L, Brunius C, Johansson I, Bergdahl IA, Rolandsson O, van Guelpen B, Winkvist A, Hanhineva K, Landberg R. Plasma metabolite biomarkers of boiled and filtered coffee intake and their association with type 2 diabetes risk. J Intern Med 2020; 287:405-421. [PMID: 31814205 DOI: 10.1111/joim.13009] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 07/03/2019] [Revised: 10/06/2019] [Accepted: 11/07/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Habitual coffee intake has been associated with a lower risk of developing type 2 diabetes (T2D), but few studies used biomarkers to reflect intake and investigated different coffee brews, that is boiled and filtered, separately. OBJECTIVES To identify plasma metabolites associated with boiled or filtered coffee intake and to examine their association with T2D risk in Swedish adults. METHODS In a case-control study nested within the Västerbotten Intervention Programme, baseline plasma samples from 421 case-control pairs and samples from a subset of 149 pairs at a 10-year follow-up were analysed using untargeted LC-MS metabolomics. We identified metabolites associated with food frequency questionnaires (FFQ)-estimated coffee intake and assessed odds ratios of T2D. RESULTS In total, 24 and 32 metabolites were associated with boiled or filtered coffee intake. We determined robust metabolite panels for highly specific prediction of boiled or filtered coffee. We observed an inverse association between the metabolite panel of filtered coffee and T2D risk. No association with T2D was observed for the panel of boiled coffee intake. Similar results were observed for FFQ-estimated coffee intake. CONCLUSIONS We identified plasma metabolites specifically associated with boiled or filtered coffee intake, which might be used as selective biomarkers. Our study supports a protective role of habitual intake of filtered coffee on T2D development. The lack of association for boiled coffee intake might be due to the lack of a protective effect of boiled coffee or due to the limited number of boiled coffee consumers in this population, but it warrants further investigation.
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Affiliation(s)
- L Shi
- From the, College of Food Engineering and Nutritional Science, Shaanxi Normal University, Xi'an, China.,Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - C Brunius
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - I Johansson
- Department of Odontology, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - I A Bergdahl
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,Department of Biobank Research, Umeå University, Umeå, Sweden
| | - O Rolandsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - B van Guelpen
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.,Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - A Winkvist
- Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden.,Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden
| | - K Hanhineva
- LC-MS Metabolomics Center, Kuopio, Finland.,Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - R Landberg
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden.,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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41
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Lindqvist HM, Rådjursöga M, Torstensson T, Jansson L, Ellegård L, Winkvist A. Urine Metabolite Profiles and Nutrient Intake Based on 4-Day Weighed Food Diary in Habitual Vegans, Vegetarians, and Omnivores. J Nutr 2020; 151:30-39. [PMID: 32047921 PMCID: PMC7779212 DOI: 10.1093/jn/nxaa019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 12/03/2019] [Accepted: 01/22/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Increasing interest in diets excluding meat and other products of animal origin emphasizes the importance of objective and reliable methods to measure dietary exposure, to evaluate associations and causation between diet and health, and to quantify nutrient intakes in different diets. OBJECTIVES This study aimed to investigate if NMR analysis of urine samples can serve as an objective method to discriminate vegan, vegetarian with or without fish, and omnivore diets. A secondary aim was to assess the influence of dietary nutrient intake on the metabolomics results. METHODS Healthy individuals (43 men and 75 women, age 19-57 y) complying with habitual vegan (n = 42), vegetarian (n = 25), vegetarian + fish (n = 13), or omnivore (n = 38) diets were enrolled. Data were collected on clinical phenotype and lifestyle including a 4-d weighed food diary. Urine was analyzed for metabolites by NMR spectroscopy and data normalized using probabilistic quotient normalization and Pareto-scaled before multivariate analysis. Before orthogonal projections to latent structures with discriminant analysis, participants were assigned as meat consumers or nonmeat consumers (vegans and vegetarians), vegans or nonvegans (omnivores, vegetarian, and vegetarian + fish). RESULTS The main results showed that it was possible to discriminate meat and nonmeat consumers (91% correctly classified), but discrimination between vegans and nonvegans was less rigorous (75% correctly classified). Secondary outcomes showed that reported intake of protein was higher in omnivores, and saturated fat lower and fiber higher in vegans, compared with the other groups. Discriminating metabolites were mainly related to differences in protein intake. CONCLUSIONS NMR urine metabolomics appears suitable to objectively identify and predict habitual intake of meat in healthy individuals, but results should be interpreted with caution because not only food groups but also specific foods contribute to the patterns.This trial was registered at clinicaltrials.gov as NCT02039609.
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Affiliation(s)
| | | | - Terese Torstensson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linda Jansson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Ellegård
- Clinical Nutrition Unit, Department of Gastroenterology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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42
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Heath AK, Muller DC, van den Brandt PA, Papadimitriou N, Critselis E, Gunter M, Vineis P, Weiderpass E, Fagherazzi G, Boeing H, Ferrari P, Olsen A, Tjønneland A, Arveux P, Boutron-Ruault MC, Mancini FR, Kühn T, Turzanski-Fortner R, Schulze MB, Karakatsani A, Thriskos P, Trichopoulou A, Masala G, Contiero P, Ricceri F, Panico S, Bueno-de-Mesquita B, Bakker MF, van Gils CH, Olsen KS, Skeie G, Lasheras C, Agudo A, Rodríguez-Barranco M, Sánchez MJ, Amiano P, Chirlaque MD, Barricarte A, Drake I, Ericson U, Johansson I, Winkvist A, Key T, Freisling H, His M, Huybrechts I, Christakoudi S, Ellingjord-Dale M, Riboli E, Tsilidis KK, Tzoulaki I. Nutrient-wide association study of 92 foods and nutrients and breast cancer risk. Breast Cancer Res 2020; 22:5. [PMID: 31931881 PMCID: PMC6958698 DOI: 10.1186/s13058-019-1244-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 09/26/2019] [Accepted: 12/30/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Several dietary factors have been reported to be associated with risk of breast cancer, but to date, unequivocal evidence only exists for alcohol consumption. We sought to systematically assess the association between intake of 92 foods and nutrients and breast cancer risk using a nutrient-wide association study. METHODS Using data from 272,098 women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, we assessed dietary intake of 92 foods and nutrients estimated by dietary questionnaires. Cox regression was used to quantify the association between each food/nutrient and risk of breast cancer. A false discovery rate (FDR) of 0.05 was used to select the set of foods and nutrients to be replicated in the independent Netherlands Cohort Study (NLCS). RESULTS Six foods and nutrients were identified as associated with risk of breast cancer in the EPIC study (10,979 cases). Higher intake of alcohol overall was associated with a higher risk of breast cancer (hazard ratio (HR) for a 1 SD increment in intake = 1.05, 95% CI 1.03-1.07), as was beer/cider intake and wine intake (HRs per 1 SD increment = 1.05, 95% CI 1.03-1.06 and 1.04, 95% CI 1.02-1.06, respectively), whereas higher intakes of fibre, apple/pear, and carbohydrates were associated with a lower risk of breast cancer (HRs per 1 SD increment = 0.96, 95% CI 0.94-0.98; 0.96, 95% CI 0.94-0.99; and 0.96, 95% CI 0.95-0.98, respectively). When evaluated in the NLCS (2368 cases), estimates for each of these foods and nutrients were similar in magnitude and direction, with the exception of beer/cider intake, which was not associated with risk in the NLCS. CONCLUSIONS Our findings confirm a positive association of alcohol consumption and suggest an inverse association of dietary fibre and possibly fruit intake with breast cancer risk.
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Affiliation(s)
- Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK.
| | - David C Muller
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | - Piet A van den Brandt
- Department of Epidemiology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Nikos Papadimitriou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Elena Critselis
- Proteomics Facility, Center for Systems Biology, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Marc Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
- Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Guy Fagherazzi
- Center of Research in Epidemiology and Population Health (CESP), Inserm U1018, Paris-South Paris-Saclay University, Gustave Roussy, Villejuif, France
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Pietro Ferrari
- Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | - Patrick Arveux
- Center of Research in Epidemiology and Population Health (CESP), Inserm U1018, Paris-South Paris-Saclay University, Gustave Roussy, Villejuif, France
- Breast and Gynaecologic Cancer Registry of Côte d'Or, Georges-François Leclerc Cancer Centre, UNICANCER, Dijon, France
| | - Marie-Christine Boutron-Ruault
- Center of Research in Epidemiology and Population Health (CESP), Inserm U1018, Paris-South Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Francesca Romana Mancini
- Center of Research in Epidemiology and Population Health (CESP), Inserm U1018, Paris-South Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Sciences, University of Potsdam, Nuthetal, Germany
| | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece
| | | | | | - Giovanna Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Paolo Contiero
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Pantai Valley, Kuala Lumpur, Malaysia
| | - Marije F Bakker
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Carla H van Gils
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Karina Standahl Olsen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Guri Skeie
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Cristina Lasheras
- Functional Biology Department, School of Medicine, University of Oviedo, Asturias, Spain
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology - ICO, Group of Research on Nutrition and Cancer, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet of Llobregat, Barcelona, Spain
| | - Miguel Rodríguez-Barranco
- Andalusian School of Public Health (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universidad de Granada (UGR), Granada, Spain
| | - Maria-José Sánchez
- Andalusian School of Public Health (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universidad de Granada (UGR), Granada, Spain
| | - Pilar Amiano
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - María-Dolores Chirlaque
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain
| | - Aurelio Barricarte
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Isabel Drake
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Ulrika Ericson
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | | | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Tim Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Heinz Freisling
- Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Mathilde His
- Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Inge Huybrechts
- Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Sofia Christakoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
- MRC Centre for Transplantation, King's College London, London, UK
| | - Merete Ellingjord-Dale
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Ioanna Tzoulaki
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
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Hjorth T, Huseinovic E, Hallström E, Strid A, Johansson I, Lindahl B, Sonesson U, Winkvist A. Changes in dietary carbon footprint over ten years relative to individual characteristics and food intake in the Västerbotten Intervention Programme. Sci Rep 2020; 10:20. [PMID: 31913331 PMCID: PMC6949226 DOI: 10.1038/s41598-019-56924-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/18/2019] [Indexed: 01/06/2023] Open
Abstract
The objective was to examine 10-year changes in dietary carbon footprint relative to individual characteristics and food intake in the unique longitudinal Västerbotten Intervention Programme, Sweden. Here, 14 591 women and 13 347 men had been followed over time. Food intake was assessed via multiple two study visits 1996–2016, using a 64-item food frequency questionnaire. Greenhouse gas emissions (GHGE) related to food intake, expressed as kg carbon dioxide equivalents/1000 kcal and day, were estimated. Participants were classified into GHGE quintiles within sex and 10-year age group strata at both visits. Women and men changing from lowest to highest GHGE quintile exhibited highest body mass index within their quintiles at first visit, and the largest increase in intake of meat, minced meat, chicken, fish and butter and the largest decrease in intake of potatoes, rice and pasta. Women and men changing from highest to lowest GHGE quintile exhibited basically lowest rates of university degree and marriage and highest rates of smoking within their quintiles at first visit. Among these, both sexes reported the largest decrease in intake of meat, minced meat and milk, and the largest increase in intake of snacks and, for women, sweets. More research is needed on how to motivate dietary modifications to reduce climate impact and support public health.
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Affiliation(s)
- Therese Hjorth
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ena Huseinovic
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Elinor Hallström
- Department of Agrifood and Bioscience, RISE- Research Institutes of Sweden, Gothenburg, Sweden
| | - Anna Strid
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Bernt Lindahl
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Ulf Sonesson
- Department of Agrifood and Bioscience, RISE- Research Institutes of Sweden, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
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44
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Huseinovic E, Hörnell A, Johansson I, Esberg A, Lindahl B, Winkvist A. Changes in food intake patterns during 2000-2007 and 2008-2016 in the population-based Northern Sweden Diet Database. Nutr J 2019; 18:36. [PMID: 31299991 PMCID: PMC6626352 DOI: 10.1186/s12937-019-0464-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 07/04/2019] [Indexed: 02/05/2023] Open
Abstract
Background Food intake patterns provide a summary of dietary intake. Few studies have examined trends in food intake patterns over time in large, population-based studies. We examined food intake patterns and related sociodemographic and individual characteristics in the large Northern Sweden Diet Database during the two time windows 2000–2007 and 2008–2016. Methods In total, 100 507 participants (51% women) who had filled in a 64-item food frequency questionnaire and provided background and sociodemographic data between 2000 and 2016 were included. Food intake patterns were evaluated for women and men separately for the two time windows 2000–2007 and 2008–2016, respectively. Latent class analysis was used to identify distinct, latent clusters based on 40 food groups. Results Among both women and men, a greater proportion of participants were classified into food intake patterns characterized by high-fat spread and high-fat dairy during 2008–2016 compared to 2000–2007. In the earlier time window, these high-fat clusters were related to lower educational level and smoking. Simultaneously, the proportion of women and men classified into a cluster characterized by high intake of fruit, vegetables, and fibre decreased from the earlier to the later time window. Conclusion From a public health perspective, the increase in clusters with a high conditional mean for high-fat spread and high-fat dairy and decrease in clusters with a high conditional mean for fruit and vegetables, during the time period 2008–2016 compared to 2000–2007, is worrisome as it indicates a shift away from the recommended food habits. Subgroups of women and men with less healthy dietary patterns in the time window 2008–2016 with lower education, lower age, higher body mass index, lower levels of physical activity and more smoking were identified and future interventions may be targeted towards these groups. Electronic supplementary material The online version of this article (10.1186/s12937-019-0464-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ena Huseinovic
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Box 459, SE-405 30, Gothenburg, Sweden
| | - Agneta Hörnell
- Department of Food and Nutrition, Umeå University, Umeå, Sweden
| | | | - Anders Esberg
- Department of Odontology, Umeå University, Umeå, Sweden
| | - Bernt Lindahl
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Box 459, SE-405 30, Gothenburg, Sweden. .,Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
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45
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Nilsson LM, Winkvist A, Esberg A, Jansson JH, Wennberg P, van Guelpen B, Johansson I. Dairy Products and Cancer Risk in a Northern Sweden Population. Nutr Cancer 2019; 72:409-420. [PMID: 31298944 DOI: 10.1080/01635581.2019.1637441] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The role of dairy products in cancer is unclear. We assessed consumption of fermented milk, non-fermented milk, cheese, and butter, estimated from semi-quantitative food frequency questionnaires, in relation to prospective risk of breast, prostate, colorectal, smoking-, and obesity-related cancers in 101,235 subjects, including 12,552 cancer cases, in the population-based Northern Sweden Health and Disease Study. Most analyses (n = 20) rendered null results. In men, we observed an increased prostate cancer risk among high-consumers of cheese (hazard ratio (HR) for highest vs. lowest quintile (Q5-Q1), 1.11; 95% CI, 0.97-1.27; Ptrend = 0.013). In women, high-consumers of cheese had a decreased risk of overall cancer (HR Q5-Q1, 0.95; 95% CI, 0.88-1.04; Ptrend = 0.039), smoking-related (HR Q5-Q1, 0.84; 95% CI, 0.72-0.97; Ptrend ≤ 0.001), and colorectal cancers (HR Q5-Q1, 0.82; 95% CI, 0.63-1.07; Ptrend = 0.048). Butter yielded a weak decreased obesity-related cancer risk in women (HR Q5-Q1, 0.91; 95% CI, 0.81-1.02; Ptrend = 0.049). Fermented milk yielded HRs below zero in women, but with no clear linear associations. In conclusion, this study does not support any major adverse or beneficial effects of fermented milk, non-fermented milk, cheese, and butter in the diet from a cancer risk perspective.
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Affiliation(s)
- Lena M Nilsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anders Esberg
- Department of Odontology, Umeå University, Umeå, Sweden
| | - Jan-Håkan Jansson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Patrik Wennberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Bethany van Guelpen
- Department of Radiation Sciences, Oncology and Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - Ingegerd Johansson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,Department of Odontology, Umeå University, Umeå, Sweden
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Lindqvist HM, Rådjursöga M, Malmodin D, Winkvist A, Ellegård L. Serum metabolite profiles of habitual diet: evaluation by 1H-nuclear magnetic resonance analysis. Am J Clin Nutr 2019; 110:53-62. [PMID: 31127814 PMCID: PMC6885523 DOI: 10.1093/ajcn/nqz032] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 02/12/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Objective and reliable methods to measure dietary exposure and prove associations and causation between diet and health are desirable. OBJECTIVE The aim of this study was to investigate if 1H-nuclear magnetic resonance (1H-NMR) analysis of serum samples may be used as an objective method to discriminate vegan, vegetarian, and omnivore diets. Specifically, the aim was to identify a metabolite pattern that separated meat-eaters from non-meat-eaters and vegans from nonvegans. METHODS Healthy volunteers (45 men and 75 women) complying with habitual vegan (n = 43), vegetarian (n = 24 + vegetarians adding fish n = 13), or omnivore (n = 40) diets were enrolled in the study. Data were collected on clinical phenotype, body composition, lifestyle including a food-frequency questionnaire (FFQ), and a 4-d weighed food diary. Serum samples were analyzed by routine clinical test and for metabolites by 1H-NMR spectroscopy. NMR data were nonnormalized, UV-scaled, and analyzed with multivariate data analysis [principal component analysis, orthogonal projections to latent structures (OPLS) and OPLS with discriminant analysis]. In the multivariate analysis volunteers were assigned as meat-eaters (omnivores), non-meat-eaters (vegans and vegetarians), vegans, or nonvegans (lacto-ovo-vegetarians, vegetarians adding fish, and omnivores). Metabolites were identified by line-fitting of 1D 1H-NMR spectra and the use of statistical total correlation spectroscopy. RESULTS Although many metabolites differ in concentration between men and women as well as by age, body mass index, and body composition, it was possible to correctly classify 97.5% of the meat-eaters compared with non-meat-eaters and 92.5% of the vegans compared with nonvegans. The branched-chain amino acids, creatine, lysine, 2-aminobutyrate, glutamine, glycine, trimethylamine, and 1 unidentified metabolite were among the most important metabolites in the discriminating patterns in relation to intake of both meat and other animal products. CONCLUSIONS 1H-NMR serum metabolomics appears to be a possible objective tool to identify and predict habitual intake of meat and other animal products in healthy subjects. These results should be confirmed in larger cohort studies or intervention trials. This trial was registered at clinicaltrials.gov as NCT02039609.
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Affiliation(s)
- Helen M Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy,Address correspondence to HML (e-mail: )
| | - Millie Rådjursöga
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy,Swedish NMR Centre, University of Gothenburg, Gothenburg, Sweden
| | - Daniel Malmodin
- Swedish NMR Centre, University of Gothenburg, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy
| | - Lars Ellegård
- Clinical Nutrition Unit, Department of Gastroenterology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Bärebring L, O'Connell M, Winkvist A, Johannsson G, Augustin H. Serum cortisol and vitamin D status are independently associated with blood pressure in pregnancy. J Steroid Biochem Mol Biol 2019; 189:259-264. [PMID: 30710744 DOI: 10.1016/j.jsbmb.2019.01.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 01/21/2019] [Accepted: 01/30/2019] [Indexed: 12/19/2022]
Abstract
The aim was to study if serum cortisol during pregnancy was associated with blood pressure and development of gestational hypertensive disorders. Additionally, associations between 25-hydroxyvitamin D (25OHD) and cortisol, including confounding effects and interactions in their relation to blood pressure were investigated. In total, 1413 pregnant women from the prospective Swedish GraviD cohort were included. Serum was collected in the first (T1) and third trimester (T3) and analyzed for 25OHD by liquid chromatography mass spectrometry and cortisol using an electro-chemiluminescence immunoassay. The main outcome measures were T1 blood pressure and development of gestational hypertensive disorders (gestational hypertension or preeclampsia). Gestational hypertensive disorders were defined as new onset hypertension, with or without proteinuria, after gestational week 20. Mean ± SD cortisol increased significantly from T1 to T3 (312 ± 123 vs. 659 ± 201 nmol/L, p < 0.001) and this increase was influenced by ethnicity. Serum concentrations of cortisol and 25OHD correlated in both T1 (B = 0.35, p < 0.001) and T3 (B = 0.30, p < 0.001). Cortisol and 25OHD were positively associated with T1 blood pressure, and there were non-significant trends for associations with gestational hypertensive disorders. Cortisol and 25OHD did not display any confounding effect or effect modification in their relationships with blood pressure. In conclusion, there was a positive correlation between serum cortisol and 25OHD in both early and late pregnancy. Both cortisol and 25OHD were positively associated with early pregnancy blood pressure. These results imply that the two hormones might be on different paths in their relationship with blood pressure.
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Affiliation(s)
- Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Box 459, 40530, Gothenburg, Sweden.
| | - Moira O'Connell
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Box 459, 40530, Gothenburg, Sweden.
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Box 459, 40530, Gothenburg, Sweden.
| | - Gudmundur Johannsson
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Box 459, 40530, Gothenburg, Sweden; Department of Endocrinology, Sahlgrenska University Hospital, Medicinmottagning Sahlgrenska, 413 45, Gothenburg, Sweden.
| | - Hanna Augustin
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Box 459, 40530, Gothenburg, Sweden.
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Rådjursöga M, Lindqvist HM, Pedersen A, Karlsson GB, Malmodin D, Brunius C, Ellegård L, Winkvist A. The 1H NMR serum metabolomics response to a two meal challenge: a cross-over dietary intervention study in healthy human volunteers. Nutr J 2019; 18:25. [PMID: 30961592 PMCID: PMC6454665 DOI: 10.1186/s12937-019-0446-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 03/21/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Metabolomics represents a powerful tool for exploring modulation of the human metabolome in response to food intake. However, the choice of multivariate statistical approach is not always evident, especially for complex experimental designs with repeated measurements per individual. Here we have investigated the serum metabolic responses to two breakfast meals: an egg and ham based breakfast and a cereal based breakfast using three different multivariate approaches based on the Projections to Latent Structures framework. METHODS In a cross over design, 24 healthy volunteers ate the egg and ham breakfast and cereal breakfast on four occasions each. Postprandial serum samples were subjected to metabolite profiling using 1H nuclear magnetic resonance spectroscopy and metabolites were identified using 2D nuclear magnetic resonance spectroscopy. Metabolic profiles were analyzed using Orthogonal Projections to Latent Structures with Discriminant Analysis and Effect Projections and ANOVA-decomposed Projections to Latent Structures. RESULTS The Orthogonal Projections to Latent Structures with Discriminant Analysis model correctly classified 92 and 90% of the samples from the cereal breakfast and egg and ham breakfast, respectively, but confounded dietary effects with inter-personal variability. Orthogonal Projections to Latent Structures with Effect Projections removed inter-personal variability and performed perfect classification between breakfasts, however at the expense of comparing means of respective breakfasts instead of all samples. ANOVA-decomposed Projections to Latent Structures managed to remove inter-personal variability and predicted 99% of all individual samples correctly. Proline, tyrosine, and N-acetylated amino acids were found in higher concentration after consumption of the cereal breakfast while creatine, methanol, and isoleucine were found in higher concentration after the egg and ham breakfast. CONCLUSIONS Our results demonstrate that the choice of statistical method will influence the results and adequate methods need to be employed to manage sample dependency and repeated measurements in cross-over studies. In addition, 1H nuclear magnetic resonance serum metabolomics could reproducibly characterize postprandial metabolic profiles and identify discriminatory metabolites largely reflecting dietary composition. TRIAL REGISTRATION Registered with ClinicalTrials.gov, identifier: NCT02039596 . Date of registration: January 17, 2014.
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Affiliation(s)
| | - Helen M Lindqvist
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anders Pedersen
- Swedish NMR Centre, University of Gothenburg, Gothenburg, Sweden
| | - Göran B Karlsson
- Swedish NMR Centre, University of Gothenburg, Gothenburg, Sweden
| | - Daniel Malmodin
- Swedish NMR Centre, University of Gothenburg, Gothenburg, Sweden
| | - Carl Brunius
- Department of Biology and Biological Engineering Food and Nutrition Science Chalmers University of Technology, Gothenburg, Sweden
| | - Lars Ellegård
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Huseinovic E, Winkvist A, Freisling H, Slimani N, Boeing H, Buckland G, Schwingshackl L, Olsen A, Tjønneland A, Stepien M, Boutron-Ruault MC, Mancini F, Artaud F, Kühn T, Katzke V, Trichopoulou A, Naska A, Orfanos P, Tumino R, Masala G, Krogh V, Santucci de Magistris M, Ocké MC, Brustad M, Jensen TE, Skeie G, Rodríguez-Barranco M, Huerta JM, Ardanaz E, Quirós JR, Jakszyn P, Sonestedt E, Ericson U, Wennberg M, Key TJ, Aune D, Riboli E, Weiderpass E, Bertéus Forslund H. Timing of eating across ten European countries - results from the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study. Public Health Nutr 2019; 22:324-335. [PMID: 30326988 PMCID: PMC10260579 DOI: 10.1017/s1368980018002288] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/08/2018] [Accepted: 08/06/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To examine timing of eating across ten European countries. DESIGN Cross-sectional analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study using standardized 24 h diet recalls collected during 1995-2000. Eleven predefined food consumption occasions were assessed during the recall interview. We present time of consumption of meals and snacks as well as the later:earlier energy intake ratio, with earlier and later intakes defined as 06.00-14.00 and 15.00-24.00 hours, respectively. Type III tests were used to examine associations of sociodemographic, lifestyle and health variables with timing of energy intake. SETTING Ten Western European countries. SUBJECTS In total, 22 985 women and 13 035 men aged 35-74 years (n 36 020). RESULTS A south-north gradient was observed for timing of eating, with later consumption of meals and snacks in Mediterranean countries compared with Central and Northern European countries. However, the energy load was reversed, with the later:earlier energy intake ratio ranging from 0·68 (France) to 1·39 (Norway) among women, and from 0·71 (Greece) to 1·35 (the Netherlands) among men. Among women, country, age, education, marital status, smoking, day of recall and season were all independently associated with timing of energy intake (all P<0·05). Among men, the corresponding variables were country, age, education, smoking, physical activity, BMI and day of recall (all P<0·05). CONCLUSIONS We found pronounced differences in timing of eating across Europe, with later meal timetables but greater energy load earlier during the day in Mediterranean countries compared with Central and Northern European countries.
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Affiliation(s)
- Ena Huseinovic
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Box 459, SE-405 30, Gothenburg, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Box 459, SE-405 30, Gothenburg, Sweden
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
| | - Heinz Freisling
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Nadia Slimani
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany
| | - Genevieve Buckland
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Lukas Schwingshackl
- Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany
| | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Magdalena Stepien
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Marie-Christine Boutron-Ruault
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Francesca Mancini
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Fanny Artaud
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Verena Katzke
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Androniki Naska
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Philippos Orfanos
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, ‘Civic – M.P. Arezzo’ Hospital, ASP, Ragusa, Italy
| | - Giovanna Masala
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Florence, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Marga C Ocké
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | | | | | - Guri Skeie
- UiT The Arctic University of Norway, Tromsø, Norway
| | - Miguel Rodríguez-Barranco
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs. GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Eva Ardanaz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | | | - Paula Jakszyn
- Unit of Nutrition, Environment and Cancer, L’Hospitallet de Llobregat, Barcelona, Spain
| | - Emily Sonestedt
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Ulrika Ericson
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Maria Wennberg
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, UIT The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, and Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Heléne Bertéus Forslund
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Box 459, SE-405 30, Gothenburg, Sweden
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Nybacka S, Störsrud S, Liljebo T, Le Nevé B, Törnblom H, Simrén M, Winkvist A. Within- and Between-Subject Variation in Dietary Intake of Fermentable Oligo-, Di-, Monosaccharides, and Polyols Among Patients with Irritable Bowel Syndrome. Curr Dev Nutr 2019; 3:nzy101. [PMID: 30838348 PMCID: PMC6396026 DOI: 10.1093/cdn/nzy101] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/12/2018] [Accepted: 12/17/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND A diet low in fermentable carbohydrates, fermentable oligo-, di-, monosaccharides, and polyols (FODMAPs) is a promising treatment option for patients with irritable bowel syndrome (IBS). In order to correctly estimate and study the intake of FODMAPs, information about within- and between-subject variations in intakes is needed, but is currently lacking. OBJECTIVES The aim was to characterize the variation in FODMAP intake among patients with IBS and to calculate how many days of observations are required to capture absolute intakes as well as to rank individuals. METHODS Food intake was recorded during 4 consecutive days, and intakes of energy and FODMAPs were calculated. The coefficient of variation within subjects (CVw), coefficient of variation between subjects (CVb), number of days required to estimate an individual's intake, and number of observations required to correctly rank individuals into quartiles of consumption were calculated. RESULTS Diet records were provided from 151 women and 46 men with IBS. The reported mean energy intake was 2039 ± 502 kcal among women and 2385 ± 573 kcal among men, and the median FODMAP intakes were 18.7 g (range 3.7-73.4) and 22.8 g (range 3.6-165.7), respectively. The ratio of CVw/CVb for total FODMAP intake was 0.83 for women and 0.67 for men, and below 1 for all FODMAPs. To capture intake of FODMAPs at the individual level, 19 d of observations are required. Ranking individuals within a group would require 2-6 d of observations. CONCLUSION There is more variation between subjects than within subjects regarding FODMAP intake. To correctly estimate an individual's absolute intake of FODMAPs, the number of days of diet records required exceeds what is reasonable for a participant to accomplish. However, ranking individuals into quartiles of FODMAP consumption can be achieved using a 4-d food record. This trial was registered at www.clinicaltrials.gov as NCT02107625 and NCT01252550.
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Affiliation(s)
- Sanna Nybacka
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stine Störsrud
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | | | - Hans Törnblom
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Simrén
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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