@article{GalbeteKroegerJannaschetal.2018,
  author    = {Galbete, Cecilia and Kr{\"o}ger, Janine and Jannasch, Franziska and Iqbal, Khalid and Schwingshackl, Lukas and Schwedhelm, Carolina and Weikert, Cornelia and Boeing, Heiner and Schulze, Matthias Bernd},
  title     = {Nordic diet, Mediterranean diet, and the risk of chronic diseases},
  series = {BMC Medicine},
  volume    = {16},
  journal   = {BMC Medicine},
  publisher = {BMC},
  address   = {London},
  issn      = {1741-7015},
  doi       = {10.1186/s12916-018-1082-y},
  pages     = {13},
  year      = {2018},
  abstract  = {Background: The Mediterranean Diet (MedDiet) has been acknowledged as a healthy diet. However, its relation with risk of major chronic diseases in non-Mediterranean countries is inconclusive. The Nordic diet is proposed as an alternative across Northern Europe, although its associations with the risk of chronic diseases remain controversial. We aimed to investigate the association between the Nordic diet and the MedDiet with the risk of chronic disease (type 2 diabetes (T2D), myocardial infarction (MI), stroke, and cancer) in the EPIC-Potsdam cohort. Methods: The EPIC-Potsdam cohort recruited 27,548 participants between 1994 and 1998. After exclusion of prevalent cases, we evaluated baseline adherence to a score reflecting the Nordic diet and two MedDiet scores (tMDS, reflecting the traditional MedDiet score, and the MedPyr score, reflecting the MedDiet Pyramid). Cox regression models were applied to examine the association between the diet scores and the incidence of major chronic diseases. Results: During a follow-up of 10.6 years, 1376 cases of T2D, 312 of MI, 321 of stroke, and 1618 of cancer were identified. The Nordic diet showed a statistically non-significant inverse association with incidence of MI in the overall population and of stroke in men. Adherence to the MedDiet was associated with lower incidence of T2D (HR per 1 SD 0.93, 95\% CI 0.88-0.98 for the tMDS score and 0.92, 0.87-0.97 for the MedPyr score). In women, the MedPyr score was also inversely associated with MI. No association was observed for any of the scores with cancer. Conclusions: In the EPIC-Potsdam cohort, the Nordic diet showed a possible beneficial effect on MI in the overall population and for stroke in men, while both scores reflecting the MedDiet conferred lower risk of T2D in the overall population and of MI in women.},
  language  = {en}
}
@phdthesis{Jannasch2017,
  author    = {Jannasch, Franziska},
  title     = {Methodological aspects of the derivation of dietary patterns and their association with type 2 diabetes},
  school      = {Universit{\"a}t Potsdam},
  pages     = {X, 205},
  year      = {2017},
  abstract  = {Hintergrund: Die Untersuchung von Ern{\"a}hrungsmustern als komplement{\"a}rer Ansatz zu der Untersuchung einzelner Lebensmittel nimmt stetig zu. Generell k{\"o}nnen drei verschiedene Ans{\"a}tze unterschieden werden um Ern{\"a}hrungsmuster herzuleiten: A priori Indizes, welche das Wissen {\"u}ber gesundheitsf{\"o}rderliche und -sch{\"a}dliche Eigenschaften eines Lebensmittels f{\"u}r einen gewissen Endpunkt nutzen; A posteriori (exploratorische) Ern{\"a}hrungsmuster, welche die populationsspezifischen vorliegenden Daten ohne eine vorangegangene Hypothese nutzen; gemischte Methoden, die das Wissen {\"u}ber bestimmte N{\"a}hrstoffe oder Biomarker, welche in der Krankheitsentstehung eine Rolle spielen, nutzen und mit einer exploratorischen Methode kombinieren um krankheitsrelevante Ern{\"a}hrungsmuster zu generieren. Vorangegangene systematische {\"U}bersichtsarbeiten, welche die Evidenz der Assoziation zwischen Ern{\"a}hrungsmustern und Diabetes mellitus Typ 2 zusammenfassten, waren entweder beschr{\"a}nkt auf eine Mustermethode oder kombinierten die Muster verschiedener Methoden, ohne die Zusammensetzung der Ern{\"a}hrungsmuster zu ber{\"u}cksichtigen. Ziel: Das Ziel dieser Dissertation war eine umfassende Untersuchung der Assoziation von Ern{\"a}hrungsmustern mit Diabetes mellitus Typ 2. Das erste Teilprojekt zielte auf die Erstellung einer systematischen {\"U}bersichtsarbeit von prospektiven Studien ab, unter der Ber{\"u}cksichtigung der verschiedenen Methoden zur Herleitung von Ern{\"a}hrungsmustern in der meta-analytischen Zusammenfassung, was in vorangegangen {\"U}bersichtsarbeiten eine Limitation darstellte. Das zweite Teilprojekt hatte die Untersuchung der Assoziation mit Diabetes mellitus Typ 2 von exploratorischen Ern{\"a}hrungsmustern, welche mit der Hauptkomponentenanalyse in einer multi-zentrischen europ{\"a}ischen Fall-Kohorten Studie hergeleitet wurden, zum Ziel. Des Weiteren wurde der eingeschr{\"a}nkten Anwendbarkeit von exploratorischen Mustern in anderen Studienpopulationen mit Methoden der Replikation dieser Ern{\"a}hrungsmuster begegnet. Methoden: Im ersten Teilprojekt wurde eine systematische Literatursuche in den Datenbanken MEDLINE und Web of Science vorgenommen, sowie ein dreistufiger Screeningprozess. Die identifizierten Studien wurden nach den jeweiligen Methoden zur Erstellung von Ern{\"a}hrungsmustern zusammengefasst und Meta-Analysen nur f{\"u}r diejenigen Ern{\"a}hrungsmuster mit vergleichbarer Zusammensetzung vorgenommen. Im zweiten Teilprojekt wurden l{\"a}nderspezifische Ern{\"a}hrungsmuster mittels Hauptkomponentenanalyse aus 36 standardisierten Lebensmittelgruppen hergeleitet. Die Assoziation mit Diabetes mellitus Typ 2 Risiko wurde mit verschieden adjustierten Cox Regressionsmodellen zur Berechnung von Hazardratenverh{\"a}ltnissen untersucht. Die Ern{\"a}hrungsmuster, welche eine signifikante Assoziation mit dem Diabetesrisiko aufzeigten, wurden anschließend {\"u}ber alle L{\"a}nder in der EPIC-InterAct Studie repliziert: Entweder wurden Summenscores ungewichteter standardisierter Lebensmittelgruppen berechnet (wenn die Korrelation mit dem originalen Ern{\"a}hrungsmuster r ≥ 0.90 war) oder Summenscores der Produkte von standardisierten Scoringkoeffizienten mit standardisierten Lebensmittelgruppen (wenn die Korrelation mit dem originalen Ern{\"a}hrungsmuster r < 0.90). Die resultierenden Scores wurden standardisiert nach der Verteilung der gesamten EPIC-InterAct Subkohorte, dann in jedem Land angewendet und die Assoziation mit Diabetes mellitus Typ 2 anhand der Cox Regressionsmodelle berechnet. Anschließend wurden Meta-Analysen zur Berechnung der gepoolten Sch{\"a}tzer durchgef{\"u}hrt. Ergebnisse: Im ersten Teilprojekt ergab die Literatursuche 48 Artikel, welche 16 Kohorten umfassten. Die Einhaltung der Mediterranen Di{\"a}t (relatives Risiko (RR) f{\"u}r den Vergleich der extremen Quantile: 0,87; 95\%-Konfidenzintervall (KI): 0,82, 0,93), der DASH Di{\"a}t (RR: 0,81; 95\%-KI: 0,72, 0,92) und des Alternative Healthy Eating Index (AHEI) (RR: 0,79; 95\%-KI: 0,69, 0,90) war mit einer signifikanten Reduzierung des Diabetesrisikos assoziiert. Exploratorische Ern{\"a}hrungsmuster, charakterisiert durch rotes und verarbeitetes Fleisch, prozessiertes Getreide, hochfette Milchprodukte, Eier und frittierte Produkte, waren positiv mit dem Diabetesrisiko assoziiert (RR: 1,44; 95\%-KI: 1,27, 1,62), w{\"a}hrend Ern{\"a}hrungs-muster, charakterisiert durch Gem{\"u}se, H{\"u}lsenfr{\"u}chte, Obst, Gefl{\"u}gel und Fisch, invers mit dem Diabetesrisiko assoziiert waren (RR: 0,84; 95\%-KI: 0,77, 0,91). Ern{\"a}hrungsmuster, welche mit reduzierter Rangregression hergeleitet wurden und charakterisiert waren durch eine hohe Aufnahme von prozessiertem Getreide, zuckerges{\"u}ßten Getr{\"a}nken und verarbeitetem Fleisch und einen niedrigen Weinkonsum, waren alle signifikant mit dem Diabetesrisiko assoziiert. Im zweiten Teilprojekt konnten zwei wesentliche Ern{\"a}hrungsmuster in jedem Land mit der Hauptkomponentenanalyse hergeleitet werden. Ein Ern{\"a}hrungsmuster, welches in Frankreich hergeleitet wurde und charakterisiert war durch N{\"u}sse, andere Fr{\"u}chte, verarbeitetes Fleisch, Fisch, Eier, Kuchen und Kekse, Kaffee und andere alkoholische Getr{\"a}nke, war signifikant assoziiert mit einem erniedrigten Diabetesrisiko. Drei andere Ern{\"a}hrungsmuster, hergeleitet in Spanien, Norfolk und Oxford, welche sich erheblich in ihrer Zusammensetzung unterschieden, waren mit einem erh{\"o}hten Diabetesrisiko assoziiert. Keine der Replikationen dieser vier Ern{\"a}hrungsmuster konnte die signifikante Assoziation mit Diabetes mellitus Typ 2 {\"u}ber andere L{\"a}nder best{\"a}tigen. Schlussfolgerung: Aus der systematischen {\"U}bersichtsarbeit ließ sich schlussfolgern, dass Ern{\"a}hrungsweisen gem{\"a}ß der Mediterranen Di{\"a}t, DASH und AHEI ein starkes Potenzial zur Pr{\"a}vention von Diabetes mellitus Typ 2 zu haben, obwohl sie sich in einigen Komponenten unterscheiden. Exploratorische Ern{\"a}hrungsmuster wurden basierend auf konkordanten Lebensmitteln gruppiert und waren signifikant mit dem Diabetesrisiko assoziiert, auch wenn die Untersuchungen einzelner Lebensmittel eher begrenzte Evidenz f{\"u}r einen Zusammenhang aufwiesen. Trotzdem bleiben sie populationsspezifische Beobachtungen. Das wurde auch in dem zweiten Teilprojekt unterstrichen, als l{\"a}nderspezifische Ern{\"a}hrungsmuster generiert wurden und keines der Ern{\"a}hrungsmuster, welches signifikant mit dem Diabetesrisiko assoziiert war, durch Simplifizierung oder Replikation der Musterstruktur des Originalmusters {\"u}ber alle L{\"a}nder best{\"a}tigt werden konnte. F{\"u}r drei RRR-Muster konnten konsistente positive Assoziationen mit dem Diabetesrisiko {\"u}ber verschiedene Studienpopulationen beobachtet werden.},
  language  = {en}
}
@article{JannaschKroegerAgnolietal.2019,
  author    = {Jannasch, Franziska and Kr{\"o}ger, Janine and Agnoli, Claudia and Barricarte, Aurelio and Boeing, Heiner and Cayssials, Val{\´e}rie and Colorado-Yohar, Sandra and Dahm, Christina C. and Dow, Courtney and Fagherazzi, Guy and Franks, Paul W. and Freisling, Heinz and Gunter, Marc J. and Kerrison, Nicola D. and Key, Timothy J. and Khaw, Kay-Tee and K{\"u}hn, Tilman and Kyro, Cecilie and Mancini, Francesca Romana and Mokoroa, Olatz and Nilsson, Peter and Overvad, Kim and Palli, Domenico and Panico, Salvatore and Quiros Garcia, Jose Ramon and Rolandsson, Olov and Sacerdote, Carlotta and Sanchez, Maria-Jose and Sahrai, Mohammad Sediq and Sch{\"u}bel, Ruth and Sluijs, Ivonne and Spijkerman, Annemieke M. W. and Tjonneland, Anne and Tong, Tammy Y. N. and Tumino, Rosario and Riboli, Elio and Langenberg, Claudia and Sharp, Stephen J. and Forouhi, Nita G. and Schulze, Matthias Bernd and Wareham, Nicholas J.},
  title     = {Generalizability of a Diabetes-Associated Country-Specific Exploratory Dietary Pattern Is Feasible Across European Populations},
  series = {The Journal of Nutrition},
  volume    = {149},
  journal   = {The Journal of Nutrition},
  number    = {6},
  publisher = {Oxford Univ. Press},
  address   = {Oxford},
  issn      = {0022-3166},
  doi       = {10.1093/jn/nxz031},
  pages     = {1047 -- 1055},
  year      = {2019},
  abstract  = {Background: Population-specificity of exploratory dietary patterns limits their generalizability in investigations with type 2 diabetes incidence. Objective: The aim of this study was to derive country-specific exploratory dietary patterns, investigate their association with type 2 diabetes incidence, and replicate diabetes-associated dietary patterns in other countries. Methods: Dietary intake data were used, assessed by country-specific questionnaires at baseline of 11,183 incident diabetes cases and 14,694 subcohort members (mean age 52.9 y) from 8 countries, nested within the European Prospective Investigation into Cancer and Nutrition study (mean follow-up time 6.9 y). Exploratory dietary patterns were derived by principal component analysis. HRs for incident type 2 diabetes were calculated by Prentice-weighted Cox proportional hazard regression models. Diabetes-associated dietary patterns were simplified or replicated to be applicable in other countries. A meta-analysis across all countries evaluated the generalizability of the diabetes-association. Results: Two dietary patterns per country/UK-center, of which overall 3 dietary patterns were diabetes-associated, were identified. A risk-lowering French dietary pattern was not confirmed across other countries: pooled HRFrance per 1 SD: 1.00; 95\% CI: 0.90, 1.10. Risk-increasing dietary patterns, derived in Spain and UK-Norfolk, were confirmed, but only the latter statistically significantly: HRSpain: 1.09; 95\% CI: 0.97, 1.22 and HRUK-Norfolk: 1.12; 95\% CI: 1.04, 1.20. Respectively, this dietary pattern was characterized by relatively high intakes of potatoes, processed meat, vegetable oils, sugar, cake and cookies, and tea. Conclusions: Only few country/center-specific dietary patterns (3 of 18) were statistically significantly associated with diabetes incidence in this multicountry European study population. One pattern, whose association with diabetes was confirmed across other countries, showed overlaps in the food groups potatoes and processed meat with identified diabetes-associated dietary patterns from other studies. The study demonstrates that replication of associations of exploratory patterns with health outcomes is feasible and a necessary step to overcome population-specificity in associations from such analyses.},
  language  = {en}
}
@article{JannaschNickelSchulze2021,
  author    = {Jannasch, Franziska and Nickel, Daniela and Schulze, Matthias Bernd},
  title     = {The reliability and relative validity of predefined dietary patterns were higher than that of exploratory dietary patterns in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam population},
  series = {British journal of nutrition : BJN : an international journal of nutritional science / published on behalf of The Nutrition Society},
  volume    = {125},
  journal   = {British journal of nutrition : BJN : an international journal of nutritional science / published on behalf of The Nutrition Society},
  number    = {11},
  publisher = {Cambridge University Press},
  address   = {Cambridge},
  issn      = {1475-2662},
  doi       = {10.1017/S0007114520003517},
  pages     = {1270 -- 1280},
  year      = {2021},
  abstract  = {The aim of this study was to assess the ability of the FFQ to describe reliable and valid dietary pattern (DP) scores. In a total of 134 participants of the European Prospective Investigation into Cancer and Nutrition-Potsdam study aged 35-67 years, the FFQ was applied twice (baseline and after 1 year) to assess its reliability. Between November 1995 and March 1997, twelve 24-h dietary recalls (24HDR) as reference instrument were applied to assess the validity of the FFQ. Exploratory DP were derived by principal component analyses. Investigated predefined DP were the Alternative Healthy Eating Index (AHEI) and two Mediterranean diet indices. From dietary data of each FFQ, two exploratory DP were retained, but differed in highly loading food groups, resulting in moderate correlations (r 0 center dot 45-0 center dot 58). The predefined indices showed higher correlations between the FFQ (r(AHEI) 0 center dot 62, r(Mediterranean Diet Pyramid Index (MedPyr)) 0 center dot 62 and r(traditional Mediterranean Diet Score (tMDS)) 0 center dot 51). From 24HDR dietary data, one exploratory DP retained differed in composition to the first FFQ-based DP, but showed similarities to the second DP, reflected by a good correlation (r 0 center dot 70). The predefined DP correlated moderately (r 0 center dot 40-0 center dot 60). To conclude, long-term analyses on exploratory DP should be interpreted with caution, due to only moderate reliability. The validity differed extensively for the two exploratory DP. The investigated predefined DP showed a better reliability and a moderate validity, comparable to other studies. Within the two Mediterranean diet indices, the MedPyr performed better than the tMDs in this middle-aged, semi-urban German study population.},
  language  = {en}
}
@misc{JannaschNickelSchulze2020,
  author    = {Jannasch, Franziska and Nickel, Daniela and Schulze, Matthias Bernd},
  title     = {The reliability and relative validity of predefined dietary patterns were higher than that of exploratory dietary patterns in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam population},
  series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Mathematisch-Naturwissenschaftliche Reihe},
  volume    = {125},
  journal   = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Mathematisch-Naturwissenschaftliche Reihe},
  number    = {11},
  issn      = {1866-8372},
  doi       = {10.25932/publishup-55003},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-550030},
  pages     = {13},
  year      = {2020},
  abstract  = {The aim of this study was to assess the ability of the FFQ to describe reliable and valid dietary pattern (DP) scores. In a total of 134 participants of the European Prospective Investigation into Cancer and Nutrition-Potsdam study aged 35-67 years, the FFQ was applied twice (baseline and after 1 year) to assess its reliability. Between November 1995 and March 1997, twelve 24-h dietary recalls (24HDR) as reference instrument were applied to assess the validity of the FFQ. Exploratory DP were derived by principal component analyses. Investigated predefined DP were the Alternative Healthy Eating Index (AHEI) and two Mediterranean diet indices. From dietary data of each FFQ, two exploratory DP were retained, but differed in highly loading food groups, resulting in moderate correlations (r 0 center dot 45-0 center dot 58). The predefined indices showed higher correlations between the FFQ (r(AHEI) 0 center dot 62, r(Mediterranean Diet Pyramid Index (MedPyr)) 0 center dot 62 and r(traditional Mediterranean Diet Score (tMDS)) 0 center dot 51). From 24HDR dietary data, one exploratory DP retained differed in composition to the first FFQ-based DP, but showed similarities to the second DP, reflected by a good correlation (r 0 center dot 70). The predefined DP correlated moderately (r 0 center dot 40-0 center dot 60). To conclude, long-term analyses on exploratory DP should be interpreted with caution, due to only moderate reliability. The validity differed extensively for the two exploratory DP. The investigated predefined DP showed a better reliability and a moderate validity, comparable to other studies. Within the two Mediterranean diet indices, the MedPyr performed better than the tMDs in this middle-aged, semi-urban German study population.},
  language  = {en}
}
@article{JannaschNickelBergmannetal.2022,
  author    = {Jannasch, Franziska and Nickel, Daniela V. and Bergmann, Manuela M. and Schulze, Matthias Bernd},
  title     = {A new evidence-based diet score to capture associations of food consumption and chronic disease risk},
  series = {Nutrients / Molecular Diversity Preservation International (MDPI)},
  volume    = {14},
  journal   = {Nutrients / Molecular Diversity Preservation International (MDPI)},
  number    = {11},
  publisher = {MDPI},
  address   = {Basel},
  issn      = {2072-6643},
  doi       = {10.3390/nu14112359},
  pages     = {16},
  year      = {2022},
  abstract  = {Previously, the attempt to compile German dietary guidelines into a diet score was predominantly not successful with regards to preventing chronic diseases in the EPIC-Potsdam study. Current guidelines were supplemented by the latest evidence from systematic reviews and expert papers published between 2010 and 2020 on the prevention potential of food groups on chronic diseases such as type 2 diabetes, cardiovascular diseases and cancer. A diet score was developed by scoring the food groups according to a recommended low, moderate or high intake. The relative validity and reliability of the diet score, assessed by a food frequency questionnaire, was investigated. The consideration of current evidence resulted in 10 key food groups being preventive of the chronic diseases of interest. They served as components in the diet score and were scored from 0 to 1 point, depending on their recommended intake, resulting in a maximum of 10 points. Both the reliability (r = 0.53) and relative validity (r = 0.43) were deemed sufficient to consider the diet score as a stable construct in future investigations. This new diet score can be a promising tool to investigate dietary intake in etiological research by concentrating on 10 key dietary determinants with evidence-based prevention potential for chronic diseases.},
  language  = {en}
}