@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} } @article{SchwingshacklRuzanskaAntonetal.2018, author = {Schwingshackl, Lukas and Ruzanska, Ulrike Alexandra and Anton, Verena and Wallroth, Raphael and Ohla, Kathrin and Knueppel, Sven and Schulze, Matthias Bernd and Pischon, Tobias and Deutschbein, Johannes and Schenk, Liane and Warschburger, Petra and Harttig, Ulrich and Boeing, Heiner and Bergmann, Manuela M.}, title = {The NutriAct Family Study: a web-based prospective study on the epidemiological, psychological and sociological basis of food choice}, series = {BMC public health}, volume = {18}, journal = {BMC public health}, publisher = {BMC}, address = {London}, issn = {1471-2458}, doi = {10.1186/s12889-018-5814-x}, pages = {12}, year = {2018}, abstract = {Background: Most studies on food choice have been focussing on the individual level but familial aspects may also play an important role. This paper reports of a novel study that will focus on the familial aspects of the formation of food choice among men and women aged 50-70 years by recruiting spouses and siblings (NutriAct Family Study; NFS). Discussion: Until August 4th 2017, 4783 EPIC-Participants were contacted by mail of which 446 persons recruited 2 to 5 family members (including themselves) resulting in 1032 participants, of whom 82\% had started answering or already completed the questionnaires. Of the 4337 remaining EPIC-participants who had been contacted, 1040 (24\%) did not respond at all, and 3297 (76\%) responded but declined, in 51\% of the cases because of the request to recruit at least 2 family members in the respective age range. The developed recruitment procedures and web-based methods of data collection are capable to generate the required study population including the data on individual and inter-personal determinants which will be linkable to food choice. The information on familial links among the study participants will show the role of familial traits in midlife for the adoption of food choices supporting healthy aging.}, language = {en} } @article{KoelmanHuybrechtsBiesbroeketal.2022, author = {Koelman, Liselot A. and Huybrechts, Inge and Biesbroek, Sander and van 't Veer, Pieter and Schulze, Matthias Bernd and Aleksandrova, Krasimira}, title = {Dietary choices impact on greenhouse gas emissions}, series = {Sustainability / Multidisciplinary Digital Publishing Institute (MDPI)}, volume = {14}, journal = {Sustainability / Multidisciplinary Digital Publishing Institute (MDPI)}, number = {7}, publisher = {MDPI}, address = {Basel}, issn = {2071-1050}, doi = {10.3390/su14073854}, pages = {10}, year = {2022}, abstract = {The present study estimated diet-related greenhouse gas emissions (GHGE) and land use (LU) in a sample of adults, examined main dietary contributors of GHGE, and evaluated socio demographic, lifestyle, and wellbeing factors as potential determinants of high environmental impact. A cross-sectional design based on data collected from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort (2010-2012) was used. Usual diet was assessed using food frequency questionnaires. Diet-related GHGE and LU were calculated using a European-average lifecycle analyses-food-item database (SHARP-ID). Information on potential determinants were collected using self-administered questionnaires. Men (n = 404) and women (n = 401) at an average age of 66.0 +/- 8.4 years were included. Dietary-related energy-adjusted GHGE in men was 6.6 +/- 0.9 and in women was 7.0 +/- 1.1 kg CO2 eq per 2000 kcal. LU in men was 7.8 +/- 1.2 and in women was 7.7 +/- 1.2 m(2)/year per 2000 kcal. Food groups contributing to most GHGE included dairy, meat and non-alcoholic beverages. Among women, being single, having a job, being a smoker and having higher BMI were characteristics associated with higher GHGE, whereas for men these included being married, longer sleeping duration and higher BMI. Further studies are warranted to provide insights into population-specific determinants of sustainable dietary choices.}, language = {en} } @article{MuehlenbruchZhuoBardenheieretal.2019, author = {M{\"u}hlenbruch, Kristin and Zhuo, Xiaohui and Bardenheier, Barbara and Shao, Hui and Laxy, Michael and Icks, Andrea and Zhang, Ping and Gregg, Edward W. and Schulze, Matthias Bernd}, title = {Selecting the optimal risk threshold of diabetes risk scores to identify high-risk individuals for diabetes prevention}, series = {Acta Diabetologica}, volume = {57}, journal = {Acta Diabetologica}, number = {4}, publisher = {Springer}, address = {Mailand}, issn = {1432-5233}, doi = {10.1007/s00592-019-01451-1}, pages = {447 -- 454}, year = {2019}, abstract = {Aims: Although risk scores to predict type 2 diabetes exist, cost-effectiveness of risk thresholds to target prevention interventions are unknown. We applied cost-effectiveness analysis to identify optimal thresholds of predicted risk to target a low-cost community-based intervention in the USA. Methods: We used a validated Markov-based type 2 diabetes simulation model to evaluate the lifetime cost-effectiveness of alternative thresholds of diabetes risk. Population characteristics for the model were obtained from NHANES 2001-2004 and incidence rates and performance of two noninvasive diabetes risk scores (German diabetes risk score, GDRS, and ARIC 2009 score) were determined in the ARIC and Cardiovascular Health Study (CHS). Incremental cost-effectiveness ratios (ICERs) were calculated for increasing risk score thresholds. Two scenarios were assumed: 1-stage (risk score only) and 2-stage (risk score plus fasting plasma glucose (FPG) test (threshold 100 mg/dl) in the high-risk group). Results: In ARIC and CHS combined, the area under the receiver operating characteristic curve for the GDRS and the ARIC 2009 score were 0.691 (0.677-0.704) and 0.720 (0.707-0.732), respectively. The optimal threshold of predicted diabetes risk (ICER < \$50,000/QALY gained in case of intervention in those above the threshold) was 7\% for the GDRS and 9\% for the ARIC 2009 score. In the 2-stage scenario, ICERs for all cutoffs >= 5\% were below \$50,000/QALY gained. Conclusions: Intervening in those with >= 7\% diabetes risk based on the GDRS or >= 9\% on the ARIC 2009 score would be cost-effective. A risk score threshold >= 5\% together with elevated FPG would also allow targeting interventions cost-effectively.}, language = {en} } @article{RothwellMurphyAleksandrovaetal.2020, author = {Rothwell, Joseph A. and Murphy, Neil and Aleksandrova, Krasimira and Schulze, Matthias Bernd and Bešević, Jelena and Kliemann, Nathalie and Jenab, Mazda and Ferrari, Pietro and Achaintre, David and Gicquiau, Audrey and Vozar, B{\´e}atrice and Scalbert, Augustin and Huybrechts, Inge and Freisling, Heinz and Prehn, Cornelia and Adamski, Jerzy and Cross, Amanda J. and Pala, Valeria Maria and Boutron-Ruault, Marie-Christine and Dahm, Christina C. and Overvad, Kim and Gram, Inger Torhild and Sandanger, Torkjel M. and Skeie, Guri and Jakszyn, Paula and Tsilidis, Kostas K. and Hughes, David J. and van Guelpen, Bethany and Bod{\´e}n, Stina and S{\´a}nchez, Maria-Jos{\´e} and Schmidt, Julie A. and Katzke, Verena and K{\"u}hn, Tilman and Colorado-Yohar, Sandra and Tumino, Rosario and Bueno-de-Mesquita, Bas and Vineis, Paolo and Masala, Giovanna and Panico, Salvatore and Eriksen, Anne Kirstine and Tj{\o}nneland, Anne and Aune, Dagfinn and Weiderpass, Elisabete and Severi, Gianluca and Chaj{\`e}s, V{\´e}ronique and Gunter, Marc J.}, title = {Metabolic signatures of healthy lifestyle patterns and colorectal cancer risk in a European cohort}, series = {Clinical gastroenterology and hepatology}, volume = {20}, journal = {Clinical gastroenterology and hepatology}, publisher = {Elsevier}, address = {New York, NY}, issn = {1542-3565}, doi = {10.1016/j.cgh.2020.11.045}, pages = {E1061 -- E1082}, year = {2020}, abstract = {BACKGROUND \& AIMS: Colorectal cancer risk can be lowered by adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines. We derived metabolic signatures of adherence to these guidelines and tested their associations with colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort. METHODS: Scores reflecting adherence to the WCRF/AICR recommendations (scale, 1-5) were calculated from participant data on weight maintenance, physical activity, diet, and alcohol among a discovery set of 5738 cancer-free European Prospective Investigation into Cancer and Nutrition participants with metabolomics data. Partial least-squares regression was used to derive fatty acid and endogenous metabolite signatures of the WCRF/AICR score in this group. In an independent set of 1608 colorectal cancer cases and matched controls, odds ratios (ORs) and 95\% CIs were calculated for colorectal cancer risk per unit increase in WCRF/AICR score and per the corresponding change in metabolic signatures using multivariable conditional logistic regression. RESULTS: Higher WCRF/AICR scores were characterized by metabolic signatures of increased odd-chain fatty acids, serine, glycine, and specific phosphatidylcholines. Signatures were inversely associated more strongly with colorectal cancer risk (fatty acids: OR, 0.51 per unit increase; 95\% CI, 0.29-0.90; endogenous metabolites: OR, 0.62 per unit change; 95\% CI, 0.50-0.78) than the WCRF/AICR score (OR, 0.93 per unit change; 95\% CI, 0.86-1.00) overall. Signature associations were stronger in male compared with female participants. CONCLUSIONS: Metabolite profiles reflecting adherence to WCRF/AICR guidelines and additional lifestyle or biological risk factors were associated with colorectal cancer. Measuring a specific panel of metabolites representative of a healthy or unhealthy lifestyle may identify strata of the population at higher risk of colorectal cancer.}, language = {en} } @article{PolemitiBaudryKuxhausetal.2021, author = {Polemiti, Elli and Baudry, Julia and Kuxhaus, Olga and J{\"a}ger, Susanne and Bergmann, Manuela and Weikert, Cornelia and Schulze, Matthias Bernd}, title = {BMI and BMI change following incident type 2 diabetes and risk of microvascular and macrovascular complications}, series = {Diabetologia : journal of the European Association for the Study of Diabetes (EASD)}, volume = {64}, journal = {Diabetologia : journal of the European Association for the Study of Diabetes (EASD)}, number = {4}, publisher = {Springer}, address = {Berlin ; Heidelberg}, issn = {0012-186X}, doi = {10.1007/s00125-020-05362-7}, pages = {814 -- 825}, year = {2021}, abstract = {Aims/hypothesis Studies suggest decreased mortality risk among people who are overweight or obese compared with individuals with normal weight in type 2 diabetes (obesity paradox). However, the relationship between body weight or weight change and microvascular vs macrovascular complications of type 2 diabetes remains unresolved. We investigated the association between BMI and BMI change with long-term risk of microvascular and macrovascular complications in type 2 diabetes in a prospective cohort study. Methods We studied participants with incident type 2 diabetes from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort, who were free of cancer, cardiovascular disease and microvascular disease at diagnosis (n = 1083). Pre-diagnosis BMI and relative annual change between pre- and post-diagnosis BMI were evaluated in multivariable-adjusted Cox models. Results There were 85 macrovascular (myocardial infarction and stroke) and 347 microvascular events (kidney disease, neuropathy and retinopathy) over a median follow-up of 10.8 years. Median pre-diagnosis BMI was 29.9 kg/m(2) (IQR 27.4-33.2), and the median relative annual BMI change was -0.4\% (IQR -2.1 to 0.9). Higher pre-diagnosis BMI was positively associated with total microvascular complications (multivariable-adjusted HR per 5 kg/m(2) [95\% CI]: 1.21 [1.07, 1.36], kidney disease 1.39 [1.21, 1.60] and neuropathy 1.12 [0.96, 1.31]) but not with macrovascular complications (HR 1.05 [95\% CI 0.81, 1.36]). Analyses according to BMI categories corroborated these findings. Effect modification was not evident by sex, smoking status or age groups. In analyses according to BMI change categories, BMI loss of more than 1\% indicated a decreased risk of total microvascular complications (HR 0.62 [95\% CI 0.47, 0.80]), kidney disease (HR 0.57 [95\% CI 0.40, 0.81]) and neuropathy (HR 0.73 [95\% CI 0.52, 1.03]), compared with participants with a stable BMI; no clear association was observed for macrovascular complications (HR 1.04 [95\% CI 0.62, 1.74]). The associations between BMI gain compared with stable BMI and diabetes-related vascular complications were less apparent. Associations were consistent across strata of sex, age, pre-diagnosis BMI or medication but appeared to be stronger among never-smokers compared with current or former smokers. Conclusions/interpretation Among people with incident type 2 diabetes, pre-diagnosis BMI was positively associated with microvascular complications, while a reduced risk was observed with weight loss when compared with stable weight. The relationships with macrovascular disease were less clear.}, language = {en} } @article{BotteriPeveriBerstadetal.2022, author = {Botteri, Edoardo and Peveri, Giulia and Berstad, Paula and Bagnardi, Vincenzo and Chen, Sairah L. F. and Sandanger, Torkjel M. and Hoff, Geir and Dahm, Christina C. and Antoniussen, Christian S. and Tjonneland, Anne and Eriksen, Anne Kirstine and Skeie, Guri and Perez-Cornago, Aurora and Huerta, Jose Maria and Jakszyn, Paula and Harlid, Sophia and Sundstroem, Bjoern and Barricarte, Aurelio and Monninkhof, Evelyn M. and Derksen, Jeroen W. G. and Schulze, Matthias Bernd and Bueno-de-Mesquita, Bas and Sanchez, Maria-Jose and Cross, Amanda J. and Tsilidis, Konstantinos K. and De Magistris, Maria Santucci and Kaaks, Rudolf and Katzke, Verena and Rothwell, Joseph A. and Laouali, Nasser and Severi, Gianluca and Amiano, Pilar and Contiero, Paolo and Sacerdote, Carlotta and Goldberg, Marcel and Touvier, Mathilde and Freisling, Heinz and Viallon, Vivian and Weiderpass, Elisabete and Riboli, Elio and Gunter, Marc J. and Jenab, Mazda and Ferrari, Pietro}, title = {Changes in lifestyle and risk of colorectal cancer in the European prospective investigation into cancer and nutrition}, series = {The American journal of gastroenterology : AJG}, volume = {118}, journal = {The American journal of gastroenterology : AJG}, number = {4}, publisher = {Lippincott Williams \& Wilkins}, address = {Philadelphia}, issn = {0002-9270}, doi = {10.14309/ajg.0000000000002065}, pages = {702 -- 711}, year = {2022}, abstract = {INTRODUCTION: We investigated the impact of changes in lifestyle habits on colorectal cancer (CRC) risk in a multicountry European cohort. METHODS: We used baseline and follow-up questionnaire data from the European Prospective Investigation into Cancer cohort to assess changes in lifestyle habits and their associations with CRC development. We calculated a healthy lifestyle index (HLI) score based on smoking status, alcohol consumption, body mass index, and physical activity collected at the 2 time points. HLI ranged from 0 (most unfavorable) to 16 (most favorable). We estimated the association between HLI changes and CRC risk using Cox regression models and reported hazard ratios (HR) with 95\% confidence intervals (CI). RESULTS: Among 295,865 participants, 2,799 CRC cases were observed over a median of 7.8 years. The median time between questionnaires was 5.7 years. Each unit increase in HLI from the baseline to the follow-up assessment was associated with a statistically significant 3\% lower CRC risk. Among participants in the top tertile at baseline (HLI > 11), those in the bottom tertile at follow-up (HLI <= 9) had a higher CRC risk (HR 1.34; 95\% CI 1.02-1.75) than those remaining in the top tertile. Among individuals in the bottom tertile at baseline, those in the top tertile at follow-up had a lower risk (HR 0.77; 95\% CI 0.59-1.00) than those remaining in the bottom tertile. DISCUSSION: Improving adherence to a healthy lifestyle was inversely associated with CRC risk, while worsening adherence was positively associated with CRC risk. These results justify and support recommendations for healthy lifestyle changes and healthy lifestyle maintenance for CRC prevention.}, language = {en} }