Dagrun Engeset - Academia.edu (original) (raw)

Papers by Dagrun Engeset

Research paper thumbnail of Consumption of dairy products in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort: data from 35955 24-hour dietary recalls in 10 European countries

Public Health Nutrition, 2002

Objectives: To describe and compare the consumption of dairy products in cohorts included in the ... more Objectives: To describe and compare the consumption of dairy products in cohorts included in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Data from single 24-hour dietary recall interviews collected through a highly standardised computer-based program (EPIC-SOFT) in 27 redefined centres in 10 European countries between 1995 and 2000. From a total random sample of 36 900, 22 924 women and 13 031 men were selected after exclusion of subjects under 35 and over 74 years of age.

Research paper thumbnail of Consumption of predefined ‘Nordic’ dietary items in ten European countries – an investigation in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Public Health Nutrition, 2014

Objective: Health-

Research paper thumbnail of Fruit and Vegetable Intake and Overall Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC)

Journal of the National Cancer Institute, 2010

Research paper thumbnail of The EPIC nutrient database project (ENDB): a first attempt to standardize nutrient databases across the 10 European countries participating in the EPIC study

European Journal of Clinical Nutrition, 2007

Research paper thumbnail of Consumption of meat and fish and risk of lung cancer: results from the European Prospective Investigation into Cancer and Nutrition

Evidence from case–control studies, but less so from cohort studies, suggests a positive associat... more Evidence from case–control studies, but less so from cohort studies, suggests a positive association between meat intake and risk of lung cancer. Therefore, this association was evaluated in the frame of the European Prospective Investigation into Cancer and Nutrition, EPIC. Data from 478,021 participants, recruited from 10

Research paper thumbnail of Eating out is different from eating at home among individuals who occasionally eat out. A cross-sectional study among middle-aged adults from eleven European countries

Eating out has been linked to the current obesity epidemic, but the evaluation of the extent to w... more Eating out has been linked to the current obesity epidemic, but the evaluation of the extent to which out of home (OH) dietary intakes are different from those at home (AH) is limited. Data collected among 8849 men and 14 277 women aged 35– 64 years from the general population of eleven European countries through 24-h dietary recalls or food diaries were analysed to: (1) compare food consumption OH to those AH; (2) describe the characteristics of substantial OH eaters, defined as those who consumed 25 % or more of their total daily energy intake at OH locations. Logistic regression models were fit to identify personal characteristics associated with eating out. In both sexes, beverages, sugar, desserts, sweet and savoury bakery products were consumed more OH than AH. In some countries, men reported

Research paper thumbnail of Eating out, weight and weight gain. A cross-sectional and prospective analysis in the context of the EPIC-PANACEA study

Objective: The aim of this study was to examine the association of body mass index (BMI) and weig... more Objective: The aim of this study was to examine the association of body mass index (BMI) and weight gain with eating at restaurants and similar establishments or eating at work among 10 European countries of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Subjects: This study included a representative sample of 24 310 randomly selected EPIC participants. Methods: Single 24-h dietary recalls with information on the place of consumption were collected using standardized procedures between 1995 and 2000. Eating at restaurants was defined to include all eating and drinking occasions at

Research paper thumbnail of Dietary patterns and whole grain in Scandinavia. The HELGA project

Annals of Nutrition and Metabolism, 2013

Research paper thumbnail of Fiskekonsum og kreftrisiko blant norske kvinner - The Norwegian Women and Cancer Study (NOWAC)

Korrespondanse: Anette Hjartåker, IMBA, Seksjon for medisinsk statistikk, postboks 1122 Blindern,... more Korrespondanse: Anette Hjartåker, IMBA, Seksjon for medisinsk statistikk, postboks 1122 Blindern, 0317 Oslo Telefon: 22 85 10 47 Telefax: 22 85 13 13 e-post: anette.hjartaker@basalmed.uio.no SAMMENDRAG Ved Institutt for samfunnsmedisin, Universitetet i Tromsø, er det over mange år bygget opp en landsdekkende prospektiv undersøkelse kalt 'Kvinner, livsstil og helse'/'Kvinner og kreft'. Studien er primaert designet for å undersøke risikofaktorer for kreft, og i saerdeleshet brystkreft. Siden 1991 har drøyt 100 000 tilfeldig utvalgte kvinner, født 1927-1965, blitt inkludert i studien. Svarprosenten er omlag 60. Deltakerne har fylt ut et spørreskjema med noe varierende innhold, men med en del felles kjernespørsmål. Detaljgraden når det gjelder kostholdsinformasjon varierer. Av de vel 100 000 kvinnene som deltar har omlag halvparten fylt ut et oppfølgingsskjema. Vi er saerlig interessert i å studere en eventuell effekt av et høyt fiskekonsum på kreftrisiko. Spørsmålene om konsum av fisk og fiskeprodukter er validert mot fettsyresammensetningen i serum fosfolipider. Studien inngår i multi-senter prosjektet EPIC -the European Prospective Investigation into Cancer and Nutrition. For å kunne sammenlikne kostdata fra de ti deltakerlandene er det utarbeidet en intern kalibreringsmetode basert på et strengt standardisert dataprogram for 24-timers kostholdsintervju. I Norge vil det bli gjennomført omlag 1800 kostholdsintervju over telefon. Hjartåker A, Engeset D, Brustad M, Lund E. Fish consumption and cancer risk among Norwegian women -The Norwegian Women and Cancer Study (NOWAC). Nor J Epidemiol 2000; 10 (1): 63-70.

Research paper thumbnail of Energy and macronutrient intake and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

International Journal of Cancer, 2015

Incidence rates of differentiated thyroid carcinoma (TC) have increased in many countries. Adipos... more Incidence rates of differentiated thyroid carcinoma (TC) have increased in many countries. Adiposity and dietary risk factors may play a role, but little is known on the influence of energy intake and macronutrient composition. The aim of this study is to investigate associations between TC and the intake of energy, macronutrients, glycemic index (GI) and glycemic load in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,274 middle-age participants (70.2% women) from 10 European countries. Dietary data were collected using country-specific validated dietary questionnaires. Total carbohydrates, proteins, fats, saturated, monounsaturated and polyunsaturated fats (PUFA), starch, sugar, fiber and glycemic load were computed as g/1000kcal. Multivariable Cox regression was used to calculate multivariable adjusted hazard ratios (HR) and 95% confidence interval (CI) by intake quartile (Q). After a mean follow-up time of 11 years, differentiated TC was diagnosed in 556 participants (90% women). Overall, we only found significant associations with total energy (HRQ4vsQ1 1.29; 95% CI 1.00-1.68) and PUFA intakes (HRQ4vsQ1 0.74, 95% CI 0.57-0.95). However, the associations with starch and sugar intake and GI were significantly heterogeneous across BMI groups, i.e., positive associations with starch and GI were found in participants with a body mass index (BMI) ≥25 and with sugar intake in those with BMI <25. Moreover, inverse associations with starch and GI were observed in subjects with BMI<25. In conclusion, our results suggest that high total energy and low PUFA intakes may increase the risk of differentiated TC. Positive associations with starch intake and GI in participants with BMI ≥25 suggest that those persons may have a greater insulin response to high starch intake and GI than lean people. This article is protected by copyright. All rights reserved.

Research paper thumbnail of Sensitivity of regression calibration to non-perfect validation data with application to the Norwegian Women and Cancer Study

Statistics in medicine, Jan 15, 2015

Measurement error occurs when we observe error-prone surrogates, rather than true values. It is c... more Measurement error occurs when we observe error-prone surrogates, rather than true values. It is common in observational studies and especially so in epidemiology, in nutritional epidemiology in particular. Correcting for measurement error has become common, and regression calibration is the most popular way to account for measurement error in continuous covariates. We consider its use in the context where there are validation data, which are used to calibrate the true values given the observed covariates. We allow for the case that the true value itself may not be observed in the validation data, but instead, a so-called reference measure is observed. The regression calibration method relies on certain assumptions.This paper examines possible biases in regression calibration estimators when some of these assumptions are violated. More specifically, we allow for the fact that (i) the reference measure may not necessarily be an 'alloyed gold standard' (i.e., unbiased) for the ...

Research paper thumbnail of Comparison of standardised dietary folate intake across ten countries participating in the European Prospective Investigation into Cancer and Nutrition

British Journal of Nutrition, 2011

Folate plays an important role in the synthesis and methylation of DNA as a cofactor in one-carbo... more Folate plays an important role in the synthesis and methylation of DNA as a cofactor in one-carbon metabolism. Inadequate folate intake has been linked to adverse health events. However, comparable information on dietary folate intake across European countries has never been reported. The objective of the present study was to describe the dietary folate intake and its food sources in ten countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A cross-sectional analysis was conducted in 36 034 participants (aged 35-74 years) who completed a single 24 h dietary recall using a computerised interview software program, EPIC-Soft w (International Agency for Research on Cancer, Lyon). Dietary folate intake was estimated using the standardised EPIC Nutrient DataBase, adjusted for age, energy intake, weight and height and weighted by season and day of recall. Adjusted mean dietary folate intake in most centres ranged from 250 to 350 mg/d in men and 200 to 300 mg/d in women. Folate intake tended to be lower among current smokers and heavier alcohol drinkers and to increase with educational level, especially in women. Supplement users (any types) were likely to report higher dietary folate intake in most centres. Vegetables, cereals and fruits, nuts and seeds were the main contributors to folate intake. Nonetheless, the type and pattern of consumption of these main food items varied across the centres. These first comparisons of standardised dietary folate intakes across different European populations show moderate regional differences (except the UK health conscious group), and variation by sex, educational level, smoking and alcohol-drinking status, and supplement use.

Research paper thumbnail of Fish consumption and subsequent change in body weight in European women and men

British Journal of Nutrition, 2013

Fish consumption is the major dietary source of EPA and DHA, which according to rodent experiment... more Fish consumption is the major dietary source of EPA and DHA, which according to rodent experiments may reduce body fat mass and prevent obesity. Only a few human studies have investigated the association between fish consumption and body-weight gain. We investigated the association between fish consumption and subsequent change in body weight. Women and men (n 344,757) participating in the European Prospective Investigation into Cancer and Nutrition were followed for a median of 5.0 years. Linear and logistic regression were used to investigate the associations between fish consumption and subsequent change in body weight. Among women, the annual weight change was 5.70 (95 % CI 4.35, 7.06), 2.23 (95 % CI 0.16, 4.31) and 11.12 (95 % CI 8.17, 14.08) g/10 g higher total, lean and fatty fish consumption per d, respectively. The OR of becoming overweight in 5 years among women who were normal weight at enrolment was 1.02 (95 % CI 1.01, 1.02), 1.01 (95 % CI 1.00, 1.02) and 1.02 (95 % CI 1.01, 1.04) g/10 g higher total, lean and fatty consumption per d, respectively. Among men, fish consumption was not statistically significantly associated with weight change. Adjustment for potential over- or underestimation of fish consumption did not systematically change the observed associations, but the 95 % CI became wider. The results in subgroups from analyses stratified by age or BMI at enrolment were not systematically different. In conclusion, the present study suggests that fish consumption has no appreciable association with body-weight gain.

Research paper thumbnail of Intake estimation of total and individual flavan-3-ols, proanthocyanidins and theaflavins, their food sources and determinants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

British Journal of Nutrition, 2012

Epidemiological studies suggest health-protective effects of flavan-3-ols and their derived compo... more Epidemiological studies suggest health-protective effects of flavan-3-ols and their derived compounds on chronic diseases. The present study aimed to estimate dietary flavan-3-ol, proanthocyanidin (PA) and theaflavin intakes, their food sources and potential determinants in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration cohort. Dietary data were collected using a standardised 24 h dietary recall software administered to 36 037 subjects aged 35-74 years. Dietary data were linked with a flavanoid food composition database compiled from the latest US Department of Agriculture and Phenol-Explorer databases and expanded to include recipes, estimations and retention factors. Total flavan-3-ol intake was the highest in UK Health-conscious men (453·6 mg/d) and women of UK General population (377·6 mg/d), while the intake was the lowest in Greece (men: 160·5 mg/d; women: 124·8 mg/d).

Research paper thumbnail of Cancer Risk and Salmon Intake

Science, 2004

... EILIV LUND,1 DAGRUN ENGESET,1 ELIN ALSAKER,1 GUN SKEIE,1 ANETTE HJÅRTAKER,2 ANNE-KATRINE LUND... more ... EILIV LUND,1 DAGRUN ENGESET,1 ELIN ALSAKER,1 GUN SKEIE,1 ANETTE HJÅRTAKER,2 ANNE-KATRINE LUNDEBYE,3 EVERT NIEBOR4 1Institute of Community ... DALLAS E. WEAVER Scientific Hatcheries, 5542 Engineer Drive, Huntington Beach, CA 92649, USA. ...

Research paper thumbnail of Feasibility of innovative dietary assessment in epidemiological studies using the approach of combining different assessment instruments

Public Health Nutrition, 2011

Objective: To assess the feasibility of combining short-term and long-term dietary assessment ins... more Objective: To assess the feasibility of combining short-term and long-term dietary assessment instruments as new concept for improving usual dietary intake assessment on the individual level. Design: Feasibility study of completing three 24 h dietary recalls (24-HDR) and a self-administered food propensity questionnaire (FPQ). The 24-HDR was conducted by monthly telephone interviews, using EPIC-SOFT software. The FPQ was completely standardized across cohorts and offered either as a web-based tool or in paper format. Setting: Random sample derived from five ongoing European cohort studies (EPIC-San Sebastian, EPIC-Florence, EPIC-Potsdam, Estonia Genome Center (EGC) and Norwegian Women and Cancer study (NOWAC)). Subjects: A total of 400 participants. Results: Overall, the total participation rate for the present study was 65?3 % (n 261). On average, completion of the 24-HDR was highest for the first 24-HDR (63?0 %) and decreased slightly for the second (60?3 %) and third 24-HDR (56?3 %). The proportions of selecting the web-based FPQ varied among the study centres, with the highest in EGC (92?9 %) and NOWAC (70?0 %) and the lowest in EPIC-San Sebastian (25?5 %) and EPIC-Potsdam (33?9 %). Web users rarely requested support and were younger and more highly educated than those who completed the paper format. Conclusions: The present study supports the feasibility of a combined application of three 24-HDR and an FPQ in culturally different populations. The varying acceptance of the web-based instrument across populations requires a flexible application of assessment instruments.

Research paper thumbnail of Coffee and tea consumption, genotype-based CYP1A2 and NAT2 activity and colorectal cancer risk-Results from the EPIC cohort study

International Journal of Cancer, 2013

Research paper thumbnail of Essential actions for caterers to promote healthy eating out among European consumers: results from a participatory stakeholder analysis in the HECTOR project

Public health nutrition, 2011

To identify and assess actions by which the catering sector could be engaged in strategies for he... more To identify and assess actions by which the catering sector could be engaged in strategies for healthier eating out in Europe.

Research paper thumbnail of Dietary acrylamide intake of adults in the European Prospective Investigation into Cancer and Nutrition differs greatly according to geographical region

European Journal of Nutrition, 2013

Methodological differences in assessing dietary acrylamide (AA) often hamper comparisons of intak... more Methodological differences in assessing dietary acrylamide (AA) often hamper comparisons of intake across populations. Our aim was to describe the mean dietary AA intake in 27 centers of 10 European countries according to selected lifestyle characteristics and its contributing food sources in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. In this cross-sectional analysis, 36 994 men and women, aged 35-74 years completed a single, standardized 24-hour dietary recall using EPIC-Soft. Food consumption data were matched to a harmonized AA database. Intake was computed by gender and center, and across categories of habitual alcohol consumption, smoking status, physical activity, education, and body mass index (BMI). Adjustment was made for participants' age, height, weight, and energy intake using linear regression models. Adjusted mean AA intake across centers ranged from 13 to 47 μg/day in men and from 12 to 39 μg/day in women; intakes were higher in northern European centers. In most centers, intake in women was significantly higher among alcohol drinkers compared with abstainers. There were no associations between AA intake and physical activity, BMI, or education. At least 50 % of AA intake across centers came from two food groups "bread, crisp bread,…

Research paper thumbnail of Fruit and vegetable consumption and risk of aggressive and non-aggressive urothelial cell carcinomas in the European Prospective Investigation into Cancer and Nutrition

European Journal of Cancer, 2012

Many epidemiological studies have examined fruit and vegetable consumption in relation to the ris... more Many epidemiological studies have examined fruit and vegetable consumption in relation to the risk of urothelial cell carcinoma (UCC) of the bladder, but results are inconsistent. The association between fruit and vegetable consumption and UCC risk may vary by bladder tumour aggressiveness. Therefore, we examined the relation between fruit and vegetable consumption and the risk of aggressive and non-aggressive UCC in the European Prospective Investigation into Cancer and Nutrition (EPIC). After 8.9 years of follow-up, 947UCC were diagnosed among 468,656 EPIC participants. Of these, 421 could be classified as aggressive UCC and 433 as non-aggressive UCC cases. At recruitment, fruit and vegetable consumption was assessed by validated dietary questionnaires. Multivariable hazard ratios were estimated using Cox regression stratified by age, sex and center and adjusted for smoking status, duration and intensity of smoking, and energy intake. Total consumption of fruits and vegetables was not associated with aggressive UCC nor with non-aggressive UCC. A 25 g/day increase in leafy vegetables and grapes consumption was associated with a reduced risk of non-aggressive UCC (hazard ratio (HR) 0.88; 95%confidence interval (CI) 0.78-1.00 and HR 0.87; 95%CI 0.77-0.98, respectively), while the intake of root vegetables was inversely associated with risk of aggressive UCC (HR 0.87; 95%CI 0.77-0.98). Our study did not confirm a protective effect of total fruit and/or vegetable consumption on aggressive or non-aggressive UCC. High consumption of certain types of vegetables and of fruits may reduce the risk of aggressive or non-aggressive UCC; however chance findings cannot be excluded.

Research paper thumbnail of Consumption of dairy products in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort: data from 35955 24-hour dietary recalls in 10 European countries

Public Health Nutrition, 2002

Objectives: To describe and compare the consumption of dairy products in cohorts included in the ... more Objectives: To describe and compare the consumption of dairy products in cohorts included in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Data from single 24-hour dietary recall interviews collected through a highly standardised computer-based program (EPIC-SOFT) in 27 redefined centres in 10 European countries between 1995 and 2000. From a total random sample of 36 900, 22 924 women and 13 031 men were selected after exclusion of subjects under 35 and over 74 years of age.

Research paper thumbnail of Consumption of predefined ‘Nordic’ dietary items in ten European countries – an investigation in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Public Health Nutrition, 2014

Objective: Health-

Research paper thumbnail of Fruit and Vegetable Intake and Overall Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC)

Journal of the National Cancer Institute, 2010

Research paper thumbnail of The EPIC nutrient database project (ENDB): a first attempt to standardize nutrient databases across the 10 European countries participating in the EPIC study

European Journal of Clinical Nutrition, 2007

Research paper thumbnail of Consumption of meat and fish and risk of lung cancer: results from the European Prospective Investigation into Cancer and Nutrition

Evidence from case–control studies, but less so from cohort studies, suggests a positive associat... more Evidence from case–control studies, but less so from cohort studies, suggests a positive association between meat intake and risk of lung cancer. Therefore, this association was evaluated in the frame of the European Prospective Investigation into Cancer and Nutrition, EPIC. Data from 478,021 participants, recruited from 10

Research paper thumbnail of Eating out is different from eating at home among individuals who occasionally eat out. A cross-sectional study among middle-aged adults from eleven European countries

Eating out has been linked to the current obesity epidemic, but the evaluation of the extent to w... more Eating out has been linked to the current obesity epidemic, but the evaluation of the extent to which out of home (OH) dietary intakes are different from those at home (AH) is limited. Data collected among 8849 men and 14 277 women aged 35– 64 years from the general population of eleven European countries through 24-h dietary recalls or food diaries were analysed to: (1) compare food consumption OH to those AH; (2) describe the characteristics of substantial OH eaters, defined as those who consumed 25 % or more of their total daily energy intake at OH locations. Logistic regression models were fit to identify personal characteristics associated with eating out. In both sexes, beverages, sugar, desserts, sweet and savoury bakery products were consumed more OH than AH. In some countries, men reported

Research paper thumbnail of Eating out, weight and weight gain. A cross-sectional and prospective analysis in the context of the EPIC-PANACEA study

Objective: The aim of this study was to examine the association of body mass index (BMI) and weig... more Objective: The aim of this study was to examine the association of body mass index (BMI) and weight gain with eating at restaurants and similar establishments or eating at work among 10 European countries of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Subjects: This study included a representative sample of 24 310 randomly selected EPIC participants. Methods: Single 24-h dietary recalls with information on the place of consumption were collected using standardized procedures between 1995 and 2000. Eating at restaurants was defined to include all eating and drinking occasions at

Research paper thumbnail of Dietary patterns and whole grain in Scandinavia. The HELGA project

Annals of Nutrition and Metabolism, 2013

Research paper thumbnail of Fiskekonsum og kreftrisiko blant norske kvinner - The Norwegian Women and Cancer Study (NOWAC)

Korrespondanse: Anette Hjartåker, IMBA, Seksjon for medisinsk statistikk, postboks 1122 Blindern,... more Korrespondanse: Anette Hjartåker, IMBA, Seksjon for medisinsk statistikk, postboks 1122 Blindern, 0317 Oslo Telefon: 22 85 10 47 Telefax: 22 85 13 13 e-post: anette.hjartaker@basalmed.uio.no SAMMENDRAG Ved Institutt for samfunnsmedisin, Universitetet i Tromsø, er det over mange år bygget opp en landsdekkende prospektiv undersøkelse kalt 'Kvinner, livsstil og helse'/'Kvinner og kreft'. Studien er primaert designet for å undersøke risikofaktorer for kreft, og i saerdeleshet brystkreft. Siden 1991 har drøyt 100 000 tilfeldig utvalgte kvinner, født 1927-1965, blitt inkludert i studien. Svarprosenten er omlag 60. Deltakerne har fylt ut et spørreskjema med noe varierende innhold, men med en del felles kjernespørsmål. Detaljgraden når det gjelder kostholdsinformasjon varierer. Av de vel 100 000 kvinnene som deltar har omlag halvparten fylt ut et oppfølgingsskjema. Vi er saerlig interessert i å studere en eventuell effekt av et høyt fiskekonsum på kreftrisiko. Spørsmålene om konsum av fisk og fiskeprodukter er validert mot fettsyresammensetningen i serum fosfolipider. Studien inngår i multi-senter prosjektet EPIC -the European Prospective Investigation into Cancer and Nutrition. For å kunne sammenlikne kostdata fra de ti deltakerlandene er det utarbeidet en intern kalibreringsmetode basert på et strengt standardisert dataprogram for 24-timers kostholdsintervju. I Norge vil det bli gjennomført omlag 1800 kostholdsintervju over telefon. Hjartåker A, Engeset D, Brustad M, Lund E. Fish consumption and cancer risk among Norwegian women -The Norwegian Women and Cancer Study (NOWAC). Nor J Epidemiol 2000; 10 (1): 63-70.

Research paper thumbnail of Energy and macronutrient intake and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

International Journal of Cancer, 2015

Incidence rates of differentiated thyroid carcinoma (TC) have increased in many countries. Adipos... more Incidence rates of differentiated thyroid carcinoma (TC) have increased in many countries. Adiposity and dietary risk factors may play a role, but little is known on the influence of energy intake and macronutrient composition. The aim of this study is to investigate associations between TC and the intake of energy, macronutrients, glycemic index (GI) and glycemic load in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,274 middle-age participants (70.2% women) from 10 European countries. Dietary data were collected using country-specific validated dietary questionnaires. Total carbohydrates, proteins, fats, saturated, monounsaturated and polyunsaturated fats (PUFA), starch, sugar, fiber and glycemic load were computed as g/1000kcal. Multivariable Cox regression was used to calculate multivariable adjusted hazard ratios (HR) and 95% confidence interval (CI) by intake quartile (Q). After a mean follow-up time of 11 years, differentiated TC was diagnosed in 556 participants (90% women). Overall, we only found significant associations with total energy (HRQ4vsQ1 1.29; 95% CI 1.00-1.68) and PUFA intakes (HRQ4vsQ1 0.74, 95% CI 0.57-0.95). However, the associations with starch and sugar intake and GI were significantly heterogeneous across BMI groups, i.e., positive associations with starch and GI were found in participants with a body mass index (BMI) ≥25 and with sugar intake in those with BMI <25. Moreover, inverse associations with starch and GI were observed in subjects with BMI<25. In conclusion, our results suggest that high total energy and low PUFA intakes may increase the risk of differentiated TC. Positive associations with starch intake and GI in participants with BMI ≥25 suggest that those persons may have a greater insulin response to high starch intake and GI than lean people. This article is protected by copyright. All rights reserved.

Research paper thumbnail of Sensitivity of regression calibration to non-perfect validation data with application to the Norwegian Women and Cancer Study

Statistics in medicine, Jan 15, 2015

Measurement error occurs when we observe error-prone surrogates, rather than true values. It is c... more Measurement error occurs when we observe error-prone surrogates, rather than true values. It is common in observational studies and especially so in epidemiology, in nutritional epidemiology in particular. Correcting for measurement error has become common, and regression calibration is the most popular way to account for measurement error in continuous covariates. We consider its use in the context where there are validation data, which are used to calibrate the true values given the observed covariates. We allow for the case that the true value itself may not be observed in the validation data, but instead, a so-called reference measure is observed. The regression calibration method relies on certain assumptions.This paper examines possible biases in regression calibration estimators when some of these assumptions are violated. More specifically, we allow for the fact that (i) the reference measure may not necessarily be an 'alloyed gold standard' (i.e., unbiased) for the ...

Research paper thumbnail of Comparison of standardised dietary folate intake across ten countries participating in the European Prospective Investigation into Cancer and Nutrition

British Journal of Nutrition, 2011

Folate plays an important role in the synthesis and methylation of DNA as a cofactor in one-carbo... more Folate plays an important role in the synthesis and methylation of DNA as a cofactor in one-carbon metabolism. Inadequate folate intake has been linked to adverse health events. However, comparable information on dietary folate intake across European countries has never been reported. The objective of the present study was to describe the dietary folate intake and its food sources in ten countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A cross-sectional analysis was conducted in 36 034 participants (aged 35-74 years) who completed a single 24 h dietary recall using a computerised interview software program, EPIC-Soft w (International Agency for Research on Cancer, Lyon). Dietary folate intake was estimated using the standardised EPIC Nutrient DataBase, adjusted for age, energy intake, weight and height and weighted by season and day of recall. Adjusted mean dietary folate intake in most centres ranged from 250 to 350 mg/d in men and 200 to 300 mg/d in women. Folate intake tended to be lower among current smokers and heavier alcohol drinkers and to increase with educational level, especially in women. Supplement users (any types) were likely to report higher dietary folate intake in most centres. Vegetables, cereals and fruits, nuts and seeds were the main contributors to folate intake. Nonetheless, the type and pattern of consumption of these main food items varied across the centres. These first comparisons of standardised dietary folate intakes across different European populations show moderate regional differences (except the UK health conscious group), and variation by sex, educational level, smoking and alcohol-drinking status, and supplement use.

Research paper thumbnail of Fish consumption and subsequent change in body weight in European women and men

British Journal of Nutrition, 2013

Fish consumption is the major dietary source of EPA and DHA, which according to rodent experiment... more Fish consumption is the major dietary source of EPA and DHA, which according to rodent experiments may reduce body fat mass and prevent obesity. Only a few human studies have investigated the association between fish consumption and body-weight gain. We investigated the association between fish consumption and subsequent change in body weight. Women and men (n 344,757) participating in the European Prospective Investigation into Cancer and Nutrition were followed for a median of 5.0 years. Linear and logistic regression were used to investigate the associations between fish consumption and subsequent change in body weight. Among women, the annual weight change was 5.70 (95 % CI 4.35, 7.06), 2.23 (95 % CI 0.16, 4.31) and 11.12 (95 % CI 8.17, 14.08) g/10 g higher total, lean and fatty fish consumption per d, respectively. The OR of becoming overweight in 5 years among women who were normal weight at enrolment was 1.02 (95 % CI 1.01, 1.02), 1.01 (95 % CI 1.00, 1.02) and 1.02 (95 % CI 1.01, 1.04) g/10 g higher total, lean and fatty consumption per d, respectively. Among men, fish consumption was not statistically significantly associated with weight change. Adjustment for potential over- or underestimation of fish consumption did not systematically change the observed associations, but the 95 % CI became wider. The results in subgroups from analyses stratified by age or BMI at enrolment were not systematically different. In conclusion, the present study suggests that fish consumption has no appreciable association with body-weight gain.

Research paper thumbnail of Intake estimation of total and individual flavan-3-ols, proanthocyanidins and theaflavins, their food sources and determinants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

British Journal of Nutrition, 2012

Epidemiological studies suggest health-protective effects of flavan-3-ols and their derived compo... more Epidemiological studies suggest health-protective effects of flavan-3-ols and their derived compounds on chronic diseases. The present study aimed to estimate dietary flavan-3-ol, proanthocyanidin (PA) and theaflavin intakes, their food sources and potential determinants in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration cohort. Dietary data were collected using a standardised 24 h dietary recall software administered to 36 037 subjects aged 35-74 years. Dietary data were linked with a flavanoid food composition database compiled from the latest US Department of Agriculture and Phenol-Explorer databases and expanded to include recipes, estimations and retention factors. Total flavan-3-ol intake was the highest in UK Health-conscious men (453·6 mg/d) and women of UK General population (377·6 mg/d), while the intake was the lowest in Greece (men: 160·5 mg/d; women: 124·8 mg/d).

Research paper thumbnail of Cancer Risk and Salmon Intake

Science, 2004

... EILIV LUND,1 DAGRUN ENGESET,1 ELIN ALSAKER,1 GUN SKEIE,1 ANETTE HJÅRTAKER,2 ANNE-KATRINE LUND... more ... EILIV LUND,1 DAGRUN ENGESET,1 ELIN ALSAKER,1 GUN SKEIE,1 ANETTE HJÅRTAKER,2 ANNE-KATRINE LUNDEBYE,3 EVERT NIEBOR4 1Institute of Community ... DALLAS E. WEAVER Scientific Hatcheries, 5542 Engineer Drive, Huntington Beach, CA 92649, USA. ...

Research paper thumbnail of Feasibility of innovative dietary assessment in epidemiological studies using the approach of combining different assessment instruments

Public Health Nutrition, 2011

Objective: To assess the feasibility of combining short-term and long-term dietary assessment ins... more Objective: To assess the feasibility of combining short-term and long-term dietary assessment instruments as new concept for improving usual dietary intake assessment on the individual level. Design: Feasibility study of completing three 24 h dietary recalls (24-HDR) and a self-administered food propensity questionnaire (FPQ). The 24-HDR was conducted by monthly telephone interviews, using EPIC-SOFT software. The FPQ was completely standardized across cohorts and offered either as a web-based tool or in paper format. Setting: Random sample derived from five ongoing European cohort studies (EPIC-San Sebastian, EPIC-Florence, EPIC-Potsdam, Estonia Genome Center (EGC) and Norwegian Women and Cancer study (NOWAC)). Subjects: A total of 400 participants. Results: Overall, the total participation rate for the present study was 65?3 % (n 261). On average, completion of the 24-HDR was highest for the first 24-HDR (63?0 %) and decreased slightly for the second (60?3 %) and third 24-HDR (56?3 %). The proportions of selecting the web-based FPQ varied among the study centres, with the highest in EGC (92?9 %) and NOWAC (70?0 %) and the lowest in EPIC-San Sebastian (25?5 %) and EPIC-Potsdam (33?9 %). Web users rarely requested support and were younger and more highly educated than those who completed the paper format. Conclusions: The present study supports the feasibility of a combined application of three 24-HDR and an FPQ in culturally different populations. The varying acceptance of the web-based instrument across populations requires a flexible application of assessment instruments.

Research paper thumbnail of Coffee and tea consumption, genotype-based CYP1A2 and NAT2 activity and colorectal cancer risk-Results from the EPIC cohort study

International Journal of Cancer, 2013

Research paper thumbnail of Essential actions for caterers to promote healthy eating out among European consumers: results from a participatory stakeholder analysis in the HECTOR project

Public health nutrition, 2011

To identify and assess actions by which the catering sector could be engaged in strategies for he... more To identify and assess actions by which the catering sector could be engaged in strategies for healthier eating out in Europe.

Research paper thumbnail of Dietary acrylamide intake of adults in the European Prospective Investigation into Cancer and Nutrition differs greatly according to geographical region

European Journal of Nutrition, 2013

Methodological differences in assessing dietary acrylamide (AA) often hamper comparisons of intak... more Methodological differences in assessing dietary acrylamide (AA) often hamper comparisons of intake across populations. Our aim was to describe the mean dietary AA intake in 27 centers of 10 European countries according to selected lifestyle characteristics and its contributing food sources in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. In this cross-sectional analysis, 36 994 men and women, aged 35-74 years completed a single, standardized 24-hour dietary recall using EPIC-Soft. Food consumption data were matched to a harmonized AA database. Intake was computed by gender and center, and across categories of habitual alcohol consumption, smoking status, physical activity, education, and body mass index (BMI). Adjustment was made for participants' age, height, weight, and energy intake using linear regression models. Adjusted mean AA intake across centers ranged from 13 to 47 μg/day in men and from 12 to 39 μg/day in women; intakes were higher in northern European centers. In most centers, intake in women was significantly higher among alcohol drinkers compared with abstainers. There were no associations between AA intake and physical activity, BMI, or education. At least 50 % of AA intake across centers came from two food groups "bread, crisp bread,…

Research paper thumbnail of Fruit and vegetable consumption and risk of aggressive and non-aggressive urothelial cell carcinomas in the European Prospective Investigation into Cancer and Nutrition

European Journal of Cancer, 2012

Many epidemiological studies have examined fruit and vegetable consumption in relation to the ris... more Many epidemiological studies have examined fruit and vegetable consumption in relation to the risk of urothelial cell carcinoma (UCC) of the bladder, but results are inconsistent. The association between fruit and vegetable consumption and UCC risk may vary by bladder tumour aggressiveness. Therefore, we examined the relation between fruit and vegetable consumption and the risk of aggressive and non-aggressive UCC in the European Prospective Investigation into Cancer and Nutrition (EPIC). After 8.9 years of follow-up, 947UCC were diagnosed among 468,656 EPIC participants. Of these, 421 could be classified as aggressive UCC and 433 as non-aggressive UCC cases. At recruitment, fruit and vegetable consumption was assessed by validated dietary questionnaires. Multivariable hazard ratios were estimated using Cox regression stratified by age, sex and center and adjusted for smoking status, duration and intensity of smoking, and energy intake. Total consumption of fruits and vegetables was not associated with aggressive UCC nor with non-aggressive UCC. A 25 g/day increase in leafy vegetables and grapes consumption was associated with a reduced risk of non-aggressive UCC (hazard ratio (HR) 0.88; 95%confidence interval (CI) 0.78-1.00 and HR 0.87; 95%CI 0.77-0.98, respectively), while the intake of root vegetables was inversely associated with risk of aggressive UCC (HR 0.87; 95%CI 0.77-0.98). Our study did not confirm a protective effect of total fruit and/or vegetable consumption on aggressive or non-aggressive UCC. High consumption of certain types of vegetables and of fruits may reduce the risk of aggressive or non-aggressive UCC; however chance findings cannot be excluded.