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Julia C.,French Institute of Health and Medical Research | Julia C.,French National Institute for Agricultural Research | Julia C.,Nutritional Epidemiology Unit | Julia C.,University of Paris 13 | And 21 more authors.
Journal of Nutrition | Year: 2013

Although n-3 (ω-3) polyunsaturated fatty acids (PUFAs) are considered anti-inflammatory components, the role of dietary n-6 PUFAs in inflammation remains controversial. Some mechanistic evidence suggests vitamin E as a potential effect modifier in the relationship between PUFAs and inflammation. Our objectives were to evaluate the long-term associations between dietary intakes of PUFAs and elevated plasma C-reactive protein (CRP) and to investigate potential effect modification by vitamin E. Individuals in the placebo group of the SU.VI.MAX trial who had available CRPmeasurements in 2007-2009 were included in the study (n = 843). Dietary intakes of n-3 PUFAs, n-6 PUFAs, and vitamin E were assessed in 1994-1996 with at least 6 dietary records. The logistic regression OR for elevated CRP (>3 mg/L) and 95% CI were estimated for individual PUFAs and for total n-3 and n-6 PUFA intakes. Models were adjusted for sociodemographical, lifestyle, anthropometric, and dietary variables. Interactions with vitamin E intakes were also assessed. Inverse associations were observed between intakes of total n-3 PUFAs [α-linolenic acid (ALA; 18:3n-3), ALA + eicosapentaenoic acid (EPA; 20:5n-3), EPA + docosapentaenoic acid (DPA; 22:5n-3), DPA + docosahexaenoic acid (DHA; 22:6n-3)] and n-6 PUFA [linoleic acid (18:2n-6) + arachidonic acid (20:4n-6)] and elevated CRP (OR for tertile 3 vs. tertile 1 of intake: 0.41; 95% CI: 0.21, 0.77; P-trend 5 0.01; and OR 0.38; 95% CI: 0.21, 0.70; P-trend 5 0.002, respectively). Stratification on vitamin E intakes showed that inverse associations between dietary n-3 and n-6 PUFA intakes and elevated CRP were substantial only in individuals with low intakes of vitamin E. Our results supported the contention that intakes of both n-3 and n-6 PUFAs are inversely associated with plasma CRP concentrations. Vitamin E is a potential effect modifier and should therefore be taken into account in such investigations. This trial was registered at clinicaltrials.gov as NCT00272428. © 2013 American Society for Nutrition.


Sluijs I.,University Utrecht | Forouhi N.G.,Addenbrookes Hospital | Beulens J.W.J.,University Utrecht | Van Der Schouw Y.T.,University Utrecht | And 37 more authors.
American Journal of Clinical Nutrition | Year: 2012

Background: Dairy product intake may be inversely associated with risk of type 2 diabetes, but the evidence is inconclusive for total dairy products and sparse for types of dairy products. Objective: The objective was to investigate the prospective association of total dairy products and different dairy subtypes with incidence of diabetes in populations with marked variation of intake of these food groups. Design: A nested case-cohort within 8 European countries of the European Prospective Investigation into Cancer and Nutrition Study (n = 340,234; 3.99 million person-years of follow-up) included a random subcohort (n = 16,835) and incident diabetes cases (n = 12,403). Baseline dairy product intake was assessed by using dietary questionnaires. Country-specific Prentice-weighted Cox regression HRs were calculated and pooled by using a random-effects meta-analysis. Results: Intake of total dairy products was not associated with diabetes (HR for the comparison of the highest with the lowest quintile of total dairy products: 1.01; 95% CI: 0.83, 1.34; P-trend = 0.92) in an analysis adjusted for age, sex, BMI, diabetes risk factors, education, and dietary factors. Of the dairy subtypes, cheese intake tended to have an inverse association with diabetes (HR: 0.88; 95% CI: 0.76, 1.02; P-trend = 0.01), and a higher combined intake of fermented dairy products (cheese, yogurt, and thick fermented milk) was inversely associated with diabetes (HR: 0.88; 95% CI: 0.78, 0.99; P-trend = 0.02) in adjusted analyses that compared extreme quintiles. Conclusions: This large prospective study found no association between total dairy product intake and diabetes risk. An inverse association of cheese intake and combined fermented dairy product intake with diabetes is suggested, which merits further study. © 2012 American Society for Nutrition.


Patel P.S.,Addenbrookes Hospital | Forouhi N.G.,Addenbrookes Hospital | Kuijsten A.,Wageningen University | Schulze M.B.,German Institute of Human Nutrition | And 50 more authors.
American Journal of Clinical Nutrition | Year: 2012

Background: Epidemiologic evidence of an association between fish intake and type 2 diabetes (T2D) is inconsistent and unresolved. Objective: The objective was to examine the association between total and type of fish intake and T2D in 8 European countries. Design: This was a case-cohort study, nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study, with 3.99 million person-years of follow-up, 12,403 incident diabetes cases, and a random subcohort of 16,835 individuals from 8 European countries. Habitual fish intake (lean fish, fatty fish, total fish, shellfish, and combined fish and shellfish) was assessed by country-specific dietary questionnaires. HRs were estimated in each country by using Prentice-weighted Cox regression models and pooled by using a random-effects meta-analysis. Results: No overall association was found between combined fish and shellfish intake and incident T2D per quartile (adjusted HR: 1.00; 95% CI: 0.94, 1.06; P-trend = 0.99). Total fish, lean fish, and shellfish intakes separately were also not associated with T2D, but fatty fish intake was weakly inversely associated with T2D: adjusted HR per quartile 0.97 (0.94, 1.00), with an HR of 0.84 (0.70, 1.01), 0.85 (0.76, 0.95), and 0.87 (0.78, 0.97) for a comparison of the second, third, and fourth quartiles with the lowest quartile of intake, respectively (P-trend = 0.06). Conclusions: These findings suggest that lean fish, total fish, and shellfish intakes are not associated with incident diabetes but that fatty fish intake may be weakly inversely associated. Replication of these findings in other populations and investigation of the mechanisms underlying these associations are warranted. Meanwhile, current public health recommendations on fish intake should remain unchanged. © 2012 American Society for Nutrition.


Sluijs I.,University Utrecht | Beulens J.W.J.,University Utrecht | Van Der Schouw Y.T.,University Utrecht | Van Der A D.L.,National Institute for Public Health and the Environment | And 32 more authors.
Journal of Nutrition | Year: 2013

The association of glycemic index (GI) and glycemic load (GL) with the risk of type 2 diabetes remains unclear. We investigated associations of dietary GI, GL, and digestible carbohydrate with incident type 2 diabetes.We performed a case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition Study, including a random subcohort (n = 16,835) and incident type 2 diabetes cases (n = 12,403). The median follow-up time was 12 y. Baseline dietary intakes were assessed using countryspecific dietary questionnaires. Country-specific HR were calculated and pooled using random effects meta-analysis. Dietary GI, GL,and digestible carbohydrate in the subcohortwere (mean± SD) 56± 4, 127± 23, and 226± 36 g/d, respectively. After adjustment for confounders, GI and GL were not associated with incident diabetes [HR highest vs. lowest quartile (HRQ4) forGI: 1.05 (95%CI=0.96, 1.16); HRQ4 for GL: 1.07 (95%CI = 0.95, 1.20)]. Digestible carbohydrate intake was not associated with incident diabetes[HRQ4: 0.98 (95% CI = 0.86, 1.10)]. In additional analyses, we found that discrepancies in the GI value assignment to foods possibly explain differences in GI associationswith diabeteswithin the same study population. In conclusion, an expansion of the GI tables and systematic GI value assignment to foods may be needed to improve the validity of GI values derived in such studies, after which GI associations may need reevaluation. Our study shows that digestible carbohydrate intake is not associated with diabetes risk and suggests that diabetes risk with high-GI and -GL diets may be more modest than initial studies suggested. © 2013 American Society for Nutrition.


Touvier M.,French Institute of Health and Medical Research | Touvier M.,French National Institute for Agricultural Research | Touvier M.,Nutritional Epidemiology Unit | Touvier M.,University of Paris 13 | And 29 more authors.
Breast Cancer Research and Treatment | Year: 2013

Studies of the association between polyphenols dietary intake and breast cancer risk have been limited due to the lack of detailed food composition tables. In addition, none has examined this association according to alcohol intake, despite the facts that alcohol is an established risk factor for breast cancer and that the contribution of alcoholic beverages to polyphenol intake varies according to the level of alcohol consumption. Our objectives were (1) to estimate the associations between breast cancer risk and a wide range of dietary polyphenols using the recently published Phenol-Explorer database; and (2) to evaluate if/how alcohol intake modulates these relationships. 4,141 women from the SU.VI.MAX prospective cohort were followed from 1994 to 2007 (median followup: 12.6 years); 152 developed a first incident invasive primary breast cancer. Dietary intakes were assessed by repeated 24-h records. The Phenol-Explorer database was used to estimate polyphenol intake. Multivariable Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95 % confidence intervals (CIs) for quartiles of polyphenol intake. Analyses were stratified by median alcohol intake (< vs. ≥6.5 g/d). In non-to-low alcohol drinkers, intakes of some classes of polyphenols were associated with decreased breast cancer risk: hydroxybenzoic acids (HRQ4vsQ1 = 0.38, 95 % CI: 0.17-0.86, P trend = 0.005), flavonoids (0.35, 0.17-0.75, P trend = 0.02), flavonols (0.36, 0.18-0.74, P trend = 0.002), catechins (0.48, 0.22-1.05, P trend = 0.02), theaflavins (0.42, 0.19-0.93, P trend = 0.02), and proanthocyanidins (0.39, 0.18-0.84, P trend = 0.02). In contrast, in women with higher alcohol use, intakes of hydroxybenzoic acids (2.28, 1.16-4.49, P trend = 0.04), flavonoids (2.46, 1.23-4.92, P trend = 0.01), anthocyanins (2.94, 1.32-6.53, P trend = 0.01), catechins (2.28, 1.19-4.36, P trend = 0.02), and proanthocyanidins (2.98, 1.40-6.33, P trend = 0.006) were associated with increased breast cancer risk. In conclusion, this prospective study suggests that several classes of polyphenols could potentially contribute to breast cancer prevention among non-to-low alcohol drinkers, but some may increase breast cancer risk among women with higher alcohol intake. © 2012 Springer Science+Business Media New York.


Ferry M.,University of Paris 13 | Ferry M.,Nutritional Epidemiology Unit | Coley N.,French Institute of Health and Medical Research | Coley N.,University Paul Sabatier | And 24 more authors.
Journal of Nutrition, Health and Aging | Year: 2013

interventions are crucial as they offer simple and inexpensive public health solutions that will be useful over the long term use. A Task Force on designing trials of nutritional interventions to slow cognitive decline in older adults was held in Toulouse in September 2012. The aim of the Task Force was to bring together leading experts from academia, the food industry and regulatory agencies to determine the best trial designs that would enable us to reach our goal of maintaining or improving cognitive function in apparently healthy aging people. An associated challenge for this Task Force was to determine the type of trials required by the Public Food Agencies for assessing the impact of nutritional compounds in comparison to well established requirements for drug trials. Although the required quality of the study design, rationale and statistical analysis remains the same, the studies designed to show reduction of cognitive decline require a long duration and the objectives of this task force was to determine best design for these trials. Two specific needs were identified to support trials of nutritional interventions: 1- Risk-reduction strategies are needed to tackle the growing burden of cognitive decline that may lead to dementia, 2- Innovative study designs are needed to improve the quality of these studies. © 2013 Serdi and Springer-Verlag France.


Santaliestra-Pasias A.M.,University of Zaragoza | Santaliestra-Pasias A.M.,Institute Salud Carlos III | Mouratidou T.,University of Zaragoza | Reisch L.,Copenhagen Business School | And 14 more authors.
European Journal of Clinical Nutrition | Year: 2015

Dietary patterns, physical activity (PA) and sedentary behaviours are some of the main behavioural determinants of obesity; their combined influence in children has been addressed in a limited number of studies.Subjects/Methods:Children (16 228) aged 2-9 years old from eight European countries participated in the baseline survey of the IDEFICS study. A subsample of 11 674 children (50.8% males) were included in the present study. Children's food and beverage consumption (fruit and vegetables (F&V) and sugar-sweetened beverages (SSBs)), PA and sedentary behaviours were assessed via parental questionnaires. Sex-specific cluster analysis was applied to identify behavioural clusters. Analysis of covariance and logistic regression were applied to examine the association between behavioural clusters and body composition indicators (BCIs).Results:Six behavioural clusters were identified (C1-C6) both in boys and girls. In both sexes, clusters characterised by high level of PA (C1 and C3) included a large proportion of older children, whereas clusters characterised by low SSB consumption (C5 and C6) included a large proportion of younger children. Significant associations between derived clusters and BCI were observed only in boys; those boys in the cluster with the highest time spent in sedentary activities and low PA had increased odds of having a body mass index z-score (odds ratio (OR)=1.33; 95% confidence interval (CI)=(1.01, 1.74)) and a waist circumference z-score (OR=1.41; 95%CI=(1.06, 1.86)) greater than one.Conclusion:Clusters characterised by high sedentary behaviour, low F&V and SSB consumption and low PA turned out to be the most obesogenic factors in this sample of European children. © 2015 Macmillan Publishers Limited.


PubMed | University of Bremen, University of Zaragoza, Ghent University, National Institute for Health Development and 6 more.
Type: Journal Article | Journal: European journal of clinical nutrition | Year: 2015

Dietary patterns, physical activity (PA) and sedentary behaviours are some of the main behavioural determinants of obesity; their combined influence in children has been addressed in a limited number of studies.Children (16,228) aged 2-9 years old from eight European countries participated in the baseline survey of the IDEFICS study. A subsample of 11,674 children (50.8% males) were included in the present study. Childrens food and beverage consumption (fruit and vegetables (F&V) and sugar-sweetened beverages (SSBs)), PA and sedentary behaviours were assessed via parental questionnaires. Sex-specific cluster analysis was applied to identify behavioural clusters. Analysis of covariance and logistic regression were applied to examine the association between behavioural clusters and body composition indicators (BCIs).Six behavioural clusters were identified (C1-C6) both in boys and girls. In both sexes, clusters characterised by high level of PA (C1 and C3) included a large proportion of older children, whereas clusters characterised by low SSB consumption (C5 and C6) included a large proportion of younger children. Significant associations between derived clusters and BCI were observed only in boys; those boys in the cluster with the highest time spent in sedentary activities and low PA had increased odds of having a body mass index z-score (odds ratio (OR)=1.33; 95% confidence interval (CI)=(1.01, 1.74)) and a waist circumference z-score (OR=1.41; 95%CI=(1.06, 1.86)) greater than one.Clusters characterised by high sedentary behaviour, low F&V and SSB consumption and low PA turned out to be the most obesogenic factors in this sample of European children.


Faure C.,Jean Verdier Hospital | Faure C.,Nutritional Epidemiology Unit | Dupont C.,Jean Verdier Hospital | Dupont C.,Nutritional Epidemiology Unit | And 5 more authors.
Fertility and Sterility | Year: 2015

Several experimental models suggest a link between maternal nutrition during gestation and reproductive function in offspring, but the impact of birth weight on male fertility in adulthood in humans is poorly documented. To study whether birth weight is associated with unexplained male subfertility later in life, we evaluated the relationship between birth weight and sperm parameters in adulthood in white subfertile men, partners of couples with primary idiopathic subfertility, and fertile men recruited within the ALIFERT (Diet and Its Relationship with Couple Infertility) study. Total sperm count, progressive motility, and sperm DNA fragmentation were analyzed in sperm, and metabolic assays were performed on blood. Birth weight was associated with sperm DNA fragmentation and inversely correlated with total sperm count, underlining the importance of the in utero environment for male reproductive function. Clinical Trial Registration Number: NCT01093378. ©2015 by American Society for Reproductive Medicine.


Interventions are crucial as they offer simple and inexpensive public health solutions that will be useful over the long term use. A Task Force on designing trials of nutritional interventions to slow cognitive decline in older adults was held in Toulouse in September 2012. The aim of the Task Force was to bring together leading experts from academia, the food industry and regulatory agencies to determine the best trial designs that would enable us to reach our goal of maintaining or improving cognitive function in apparently healthy aging people. An associated challenge for this Task Force was to determine the type of trials required by the Public Food Agencies for assessing the impact of nutritional compounds in comparison to well established requirements for drug trials. Although the required quality of the study design, rationale and statistical analysis remains the same, the studies designed to show reduction of cognitive decline require a long duration and the objectives of this task force was to determine best design for these trials. Two specific needs were identified to support trials of nutritional interventions: 1- Risk- reduction strategies are needed to tackle the growing burden of cognitive decline that may lead to dementia, 2- Innovative study designs are needed to improve the quality of these studies.

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