TY - GEN A1 - Christakoudi, Sofia A1 - Pagoni, Panagiota A1 - Ferrari, Pietro A1 - Cross, Amanda J. A1 - Tzoulaki, Ioanna A1 - Muller, David C. A1 - Weiderpass, Elisabete A1 - Freisling, Heinz A1 - Murphy, Neil A1 - Dossus, Laure A1 - Turzanski Fortner, Renee A1 - Agudo, Antonio A1 - Overvad, Kim A1 - Perez-Cornago, Aurora A1 - Key, Timothy J. A1 - Brennan, Paul A1 - Johansson, Mattias A1 - Tjonneland, Anne A1 - Halkjaer, Jytte A1 - Boutron-Ruault, Marie-Christine A1 - Artaud, Fanny A1 - Severi, Gianluca A1 - Kaaks, Rudolf A1 - Schulze, Matthias Bernd A1 - Bergmann, Manuela M. A1 - Masala, Giovanna A1 - Grioni, Sara A1 - Simeon, Vittorio A1 - Tumino, Rosario A1 - Sacerdote, Carlotta A1 - Skeie, Guri A1 - Rylander, Charlotta A1 - Borch, Kristin Benjaminsen A1 - Quiros, J. Ramon A1 - Rodriguez-Barranco, Miguel A1 - Chirlaque, Maria-Dolores A1 - Ardanaz, Eva A1 - Amiano, Pilar A1 - Drake, Isabel A1 - Stocks, Tanja A1 - Haggstrom, Christel A1 - Harlid, Sophia A1 - Ellingjord-Dale, Merete A1 - Riboli, Elio A1 - Tsilidis, Konstantinos K. T1 - Weight change in middle adulthood and risk of cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort T2 - Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe N2 - Obesity is a risk factor for several major cancers. Associations of weight change in middle adulthood with cancer risk, however, are less clear. We examined the association of change in weight and body mass index (BMI) category during middle adulthood with 42 cancers, using multivariable Cox proportional hazards models in the European Prospective Investigation into Cancer and Nutrition cohort. Of 241 323 participants (31% men), 20% lost and 32% gained weight (>0.4 to 5.0 kg/year) during 6.9 years (average). During 8.0 years of follow-up after the second weight assessment, 20 960 incident cancers were ascertained. Independent of baseline BMI, weight gain (per one kg/year increment) was positively associated with cancer of the corpus uteri (hazard ratio [HR] = 1.14; 95% confidence interval: 1.05-1.23). Compared to stable weight (+/- 0.4 kg/year), weight gain (>0.4 to 5.0 kg/year) was positively associated with cancers of the gallbladder and bile ducts (HR = 1.41; 1.01-1.96), postmenopausal breast (HR = 1.08; 1.00-1.16) and thyroid (HR = 1.40; 1.04-1.90). Compared to maintaining normal weight, maintaining overweight or obese BMI (World Health Organisation categories) was positively associated with most obesity-related cancers. Compared to maintaining the baseline BMI category, weight gain to a higher BMI category was positively associated with cancers of the postmenopausal breast (HR = 1.19; 1.06-1.33), ovary (HR = 1.40; 1.04-1.91), corpus uteri (HR = 1.42; 1.06-1.91), kidney (HR = 1.80; 1.20-2.68) and pancreas in men (HR = 1.81; 1.11-2.95). Losing weight to a lower BMI category, however, was inversely associated with cancers of the corpus uteri (HR = 0.40; 0.23-0.69) and colon (HR = 0.69; 0.52-0.92). Our findings support avoiding weight gain and encouraging weight loss in middle adulthood. T3 - Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe - 1373 KW - BMI change KW - cancer KW - middle adulthood KW - weight gain KW - weight loss Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-573609 SN - 1866-8372 IS - 7 ER - TY - GEN A1 - Saberi Hosnijeh, Fatemeh A1 - Casabonne, Delphine A1 - Nieters, Alexandra A1 - Solans, Marta A1 - Naudin, Sabine A1 - Ferrari, Pietro A1 - Mckay, James D. A1 - Benavente, Yolanda A1 - Weiderpass, Elisabete A1 - Freisling, Heinz A1 - Severi, Gianluca A1 - Boutron Ruault, Marie-Christine A1 - Besson, Caroline A1 - Agnoli, Claudia A1 - Masala, Giovanna A1 - Sacerdote, Carlotta A1 - Tumino, Rosario A1 - Huerta, Jose Maria A1 - Amiano, Pilar A1 - Rodriguez-Barranco, Miguel A1 - Bonet, Catalina A1 - Barricarte, Aurelio A1 - Christakoudi, Sofia A1 - Knuppel, Anika A1 - Bueno-de-Mesquita, Bas A1 - Schulze, Matthias Bernd A1 - Kaaks, Rudolf A1 - Canzian, Federico A1 - Spath, Florentin A1 - Jerkeman, Mats A1 - Rylander, Charlotta A1 - Tjonneland, Anne A1 - Olsen, Anja A1 - Borch, Kristin Benjaminsen A1 - Vermeulen, Roel T1 - Association between anthropometry and lifestyle factors and risk of B-cell lymphoma BT - an exposome-wide analysis T2 - Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe N2 - To better understand the role of individual and lifestyle factors in human disease, an exposome-wide association study was performed to investigate within a single-study anthropometry measures and lifestyle factors previously associated with B-cell lymphoma (BCL). Within the European Prospective Investigation into Cancer and nutrition study, 2402 incident BCL cases were diagnosed from 475 426 participants that were followed-up on average 14 years. Standard and penalized Cox regression models as well as principal component analysis (PCA) were used to evaluate 84 exposures in relation to BCL risk. Standard and penalized Cox regression models showed a positive association between anthropometric measures and BCL and multiple myeloma/plasma cell neoplasm (MM). The penalized Cox models additionally showed the association between several exposures from categories of physical activity, smoking status, medical history, socioeconomic position, diet and BCL and/or the subtypes. PCAs confirmed the individual associations but also showed additional observations. The PC5 including anthropometry, was positively associated with BCL, diffuse large B-cell lymphoma (DLBCL) and MM. There was a significant positive association between consumption of sugar and confectionary (PC11) and follicular lymphoma risk, and an inverse association between fish and shellfish and Vitamin D (PC15) and DLBCL risk. The PC1 including features of the Mediterranean diet and diet with lower inflammatory score showed an inverse association with BCL risk, while the PC7, including dairy, was positively associated with BCL and DLBCL risk. Physical activity (PC10) was positively associated with DLBCL risk among women. This study provided informative insights on the etiology of BCL. T3 - Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe - 1374 KW - exposome KW - exposome‐ wide association study KW - lifestyle KW - lymphoma KW - prospective study Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-573562 SN - 1866-8372 IS - 9 ER - TY - JOUR A1 - Galbete, Cecilia A1 - Kröger, Janine A1 - Jannasch, Franziska A1 - Iqbal, Khalid A1 - Schwingshackl, Lukas A1 - Schwedhelm, Carolina A1 - Weikert, Cornelia A1 - Boeing, Heiner A1 - Schulze, Matthias Bernd T1 - Nordic diet, Mediterranean diet, and the risk of chronic diseases BT - the EPIC-Potsdam study JF - BMC Medicine N2 - 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. KW - Mediterranean diet KW - Nordic diet KW - regional diets KW - chronic diseases KW - diabetes KW - myocardial infarction KW - stroke KW - cancer KW - EPIC-Potsdam study KW - longitudinal analysis Y1 - 2018 U6 - https://doi.org/10.1186/s12916-018-1082-y SN - 1741-7015 VL - 16 PB - BMC CY - London ER - TY - JOUR A1 - Willmann, Caroline A1 - Heni, Martin A1 - Linder, Katarzyna A1 - Wagner, Robert A1 - Stefan, Norbert A1 - Machann, Jürgen A1 - Schulze, Matthias Bernd A1 - Joost, Hans-Georg A1 - Haring, Hans-Ulrich A1 - Fritsche, Andreas T1 - Potential effects of reduced red meat compared with increased fiber intake on glucose metabolism and liver fat content BT - a randomized and controlled dietary intervention study JF - The American journal of clinical nutrition : a publication of the American Society for Nutrition, Inc. N2 - Background: Epidemiological studies suggest that an increased red meat intake is associated with a higher risk of type 2 diabetes, whereas an increased fiber intake is associated with a lower risk. Objectives: We conducted an intervention study to investigate the effects of these nutritional factors on glucose and lipid metabolism, body-fat distribution, and liver fat content in subjects at increased risk of type 2 diabetes. Methods: This prospective, randomized, and controlled dietary intervention study was performed over 6 mo. All groups decreased their daily caloric intake by 400 kcal. The "control" group (N = 40) only had this requirement. The "no red meat" group (N = 48) in addition aimed to avoid the intake of red meat, and the "fiber" group (N = 44) increased intake of fibers to 40 g/d. Anthropometric parameters and frequently sampled oral glucose tolerance tests were performed before and after intervention. Body-fat mass and distribution, liver fat, and liver iron content were assessed by MRI and single voxel proton magnetic resonance spectroscopy. Results: Participants in all groups lost weight (mean 3.3 +/- 0.5 kg, P < 0.0001). Glucose tolerance and insulin sensitivity improved (P < 0.001), and body and visceral fat mass decreased in all groups (P < 0.001). These changes did not differ between groups. Liver fat content decreased significantly (P < 0.001) with no differences between the groups. The decrease in liver fat correlated with the decrease in ferritin during intervention (r(2) = 0.08, P = 0.0021). This association was confirmed in an independent lifestyle intervention study (Tuebingen Lifestyle Intervention Program, N = 229, P = 0.0084). Conclusions: Our data indicate that caloric restriction leads to a marked improvement in glucose metabolism and body-fat composition, including liver-fat content. The marked reduction in liver fat might be mediated via changes in ferritin levels. In the context of caloric restriction, there seems to be no additional beneficial impact of reduced red meat intake and increased fiber intake on the improvement in cardiometabolic risk parameters. This trial was registered at clinicaltrials.gov as NCT03231839. KW - type 2 diabetes KW - prevention KW - randomized controlled intervention study KW - nutritional factors KW - fiber KW - red meat Y1 - 2019 U6 - https://doi.org/10.1093/ajcn/nqy307 SN - 0002-9165 SN - 1938-3207 VL - 109 IS - 2 SP - 288 EP - 296 PB - Oxford Univ. Press CY - Oxford ER - TY - JOUR A1 - Lehn-Stefan, Angela A1 - Peter, Andreas A1 - Machann, Jürgen A1 - Schick, Fritz A1 - Randrianarisoa, Elko A1 - Heni, Martin A1 - Wagner, Robert A1 - Birkenfeld, Andreas L. A1 - Fritsche, Andreas A1 - Schulze, Matthias Bernd A1 - Stefan, Norbert A1 - Kantartzis, Konstantinos T1 - Impaired metabolic health and low cardiorespiratory fitness independently associate with subclinical atherosclerosis in obesity JF - The journal of clinical endocrinology & metabolism N2 - Context For a given body mass index (BMI), both impaired metabolic health (MH) and reduced cardiorespiratory fitness (CRF) associate with increased risk of cardiovascular disease (CVD). Objective It remains unknown whether both risk phenotypes relate to CVD independently of each other, and whether these relationships differ in normal weight, overweight, and obese subjects. Methods Data from 421 participants from the Tubingen Diabetes Family Study, who had measurements of anthropometrics, metabolic parameters, CRF (maximal aerobic capacity [VO2max]) and carotid intima-media thickness (cIMT), an early marker of atherosclerosis, were analyzed. Subjects were divided by BMI and MH status into 6 phenotypes. Results In univariate analyses, older age, increased BMI, and a metabolic risk profile correlated positively, while insulin sensitivity and VO2max negatively with cIMT. In multivariable analyses in obese subjects, older age, male sex, lower VO2max (std. ss -0.21, P = 0.002) and impaired MH (std. ss 0.13, P = 0.02) were independent determinants of increased cIMT. After adjustment for age and sex, subjects with metabolically healthy obesity (MHO) had higher cIMT than subjects with metabolically healthy normal weight (MHNW; 0.59 +/- 0.009 vs 0.52 +/- 0.01 mm; P < 0.05). When VO2max was additionally included in this model, the difference in cIMT between MHO and MHNW groups became statistically nonsignificant (0.58 +/- 0.009 vs 0.56 +/- 0.02 mm; P > 0.05). Conclusion These data suggest that impaired MH and low CRF independently determine increased cIMT in obese subjects and that low CRF may explain part of the increased CVD risk observed in MHO compared with MHNW. KW - Metabolically healthy obesity KW - cardiorespiratory fitness KW - subclinical KW - atherosclerosis KW - obesity KW - carotid intima-media thickness KW - cardiovascular KW - disease Y1 - 2022 U6 - https://doi.org/10.1210/clinem/dgac091 SN - 0021-972X SN - 1945-7197 VL - 107 IS - 6 SP - E2417 EP - E2424 PB - Endocrine Society CY - Washington ER - TY - JOUR A1 - Zheng, Ju-Sheng A1 - Luan, Jian'an A1 - Sofianopoulou, Eleni A1 - Imamura, Fumiaki A1 - Stewart, Isobel D. A1 - Day, Felix R. A1 - Pietzner, Maik A1 - Wheeler, Eleanor A1 - Lotta, Luca A. A1 - Gundersen, Thomas E. A1 - Amiano, Pilar A1 - Ardanaz, Eva A1 - Chirlaque, Maria-Dolores A1 - Fagherazzi, Guy A1 - Franks, Paul W. A1 - Kaaks, Rudolf A1 - Laouali, Nasser A1 - Mancini, Francesca Romana A1 - Nilsson, Peter M. A1 - Onland-Moret, N. Charlotte A1 - Olsen, Anja A1 - Overvad, Kim A1 - Panico, Salvatore A1 - Palli, Domenico A1 - Ricceri, Fulvio A1 - Rolandsson, Olov A1 - Spijkerman, Annemieke M. W. A1 - Sanchez, Maria-Jose A1 - Schulze, Matthias Bernd A1 - Sala, Nuria A1 - Sieri, Sabina A1 - Tjonneland, Anne A1 - Tumino, Rosario A1 - van der Schouw, Yvonne T. A1 - Weiderpass, Elisabete A1 - Riboli, Elio A1 - Danesh, John A1 - Butterworth, Adam S. A1 - Sharp, Stephen J. A1 - Langenberg, Claudia A1 - Forouhi, Nita G. A1 - Wareham, Nicholas J. T1 - Plasma vitamin C and type 2 diabetes BT - genome-wide association study and Mendelian randomization analysis in European populations JF - Diabetes care N2 - OBJECTIVE: Higher plasma vitamin C levels are associated with lower type 2 diabetes risk, but whether this association is causal is uncertain. To investigate this, we studied the association of genetically predicted plasma vitamin C with type 2 diabetes. RESEARCH DESIGN AND METHODS: We conducted genome-wide association studies of plasma vitamin C among 52,018 individuals of European ancestry to discover novel genetic variants. We performed Mendelian randomization analyses to estimate the association of genetically predicted differences in plasma vitamin C with type 2 diabetes in up to 80,983 case participants and 842,909 noncase participants. We compared this estimate with the observational association between plasma vitamin C and incident type 2 diabetes, including 8,133 case participants and 11,073 noncase participants. RESULTS: We identified 11 genomic regions associated with plasma vitamin C (P < 5 x 10(-8)), with the strongest signal at SLC23A1, and 10 novel genetic loci including SLC23A3, CHPT1, BCAS3, SNRPF, RER1, MAF, GSTA5, RGS14, AKT1, and FADS1. Plasma vitamin C was inversely associated with type 2 diabetes (hazard ratio per SD 0.88; 95% CI 0.82, 0.94), but there was no association between genetically predicted plasma vitamin C (excluding FADS1 variant due to its apparent pleiotropic effect) and type 2 diabetes (1.03; 95% CI 0.96, 1.10). CONCLUSIONS: These findings indicate discordance between biochemically measured and genetically predicted plasma vitamin C levels in the association with type 2 diabetes among European populations. The null Mendelian randomization findings provide no strong evidence to suggest the use of vitamin C supplementation for type 2 diabetes prevention. Y1 - 2020 U6 - https://doi.org/10.2337/dc20-1328 SN - 0149-5992 SN - 1935-5548 VL - 44 IS - 1 SP - 98 EP - 106 PB - American Diabetes Association CY - Alexandria ER - TY - JOUR A1 - Kroeger, Janine A1 - Meidtner, Karina A1 - Stefan, Norbert A1 - Guevara, Marcela A1 - Kerrison, Nicola D. A1 - Ardanaz, Eva A1 - Aune, Dagfinn A1 - Boeing, Heiner A1 - Dorronsoro, Miren A1 - Dow, Courtney A1 - Fagherazzi, Guy A1 - Franks, Paul W. A1 - Freisling, Heinz A1 - Gunter, Marc J. A1 - Maria Huerta, Jose A1 - Kaaks, Rudolf A1 - Key, Timothy J. A1 - Khaw, Kay Tee A1 - Krogh, Vittorio A1 - Kuehn, Tilman A1 - Mancini, Francesca Romana A1 - Mattiello, Amalia A1 - Nilsson, Peter M. A1 - Olsen, Anja A1 - Overvad, Kim A1 - Palli, Domenico A1 - Ramon Quiros, J. A1 - Rolandsson, Olov A1 - Sacerdote, Carlotta A1 - Sala, Nuria A1 - Salamanca-Fernandez, Elena A1 - Sluijs, Ivonne A1 - Spijkerman, Annemieke M. W. A1 - Tjonneland, Anne A1 - Tsilidis, Konstantinos K. A1 - Tumino, Rosario A1 - van der Schouw, Yvonne T. A1 - Forouhi, Nita G. A1 - Sharp, Stephen J. A1 - Langenberg, Claudia A1 - Riboli, Elio A1 - Schulze, Matthias Bernd A1 - Wareham, Nicholas J. T1 - Circulating Fetuin-A and Risk of Type 2 Diabetes BT - a mendelian randomization analysis JF - Diabetes : a journal of the American Diabetes Association N2 - Fetuin-A, a hepatic-origin protein, is strongly positively associated with risk of type 2 diabetes in human observational studies, but it is unknown whether this association is causal. Weaimed to study the potential causal relation of circulating fetuin-A to risk of type 2 diabetes in a Mendelian randomization study with single nucleotide polymorphisms located in the fetuin-A-encoding AHSG gene. We used data from eight European countries of the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study including 10,020 incident cases. Plasma fetuin-A concentration was measured in a subset of 965 subcohort participants and 654 case subjects. A genetic score of the AHSG single nucleotide polymorphisms was strongly associated with fetuin-A (28% explained variation). Using the genetic score as instrumental variable of fetuin-A, we observed no significant association of a 50 mu g/mL higher fetuin-A concentration with diabetes risk (hazard ratio 1.02 [95% CI 0.97, 1.07]). Combining our results with those from the DIAbetes Genetics Replication And Meta-analysis (DIAGRAM) consortium (12,171 case subjects) also did not suggest a clear significant relation of fetuin-A with diabetes risk. In conclusion, although there is mechanistic evidence for an effect of fetuin-A on insulin sensitivity and secretion, this study does not support a strong, relevant relationship between circulating fetuin-A and diabetes risk in the general population. Y1 - 2018 U6 - https://doi.org/10.2337/db17-1268 SN - 0012-1797 SN - 1939-327X VL - 67 IS - 6 SP - 1200 EP - 1205 PB - American Diabetes Association CY - Alexandria ER - TY - GEN A1 - Jannasch, Franziska A1 - Nickel, Daniela A1 - Schulze, Matthias Bernd T1 - 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 T2 - Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe N2 - 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. T3 - Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe - 1349 KW - dietary patterns KW - reliability KW - validity Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-550030 SN - 1866-8372 VL - 125 IS - 11 ER - TY - JOUR A1 - Birukov, Anna A1 - Cuadrat, Rafael R. C. A1 - Polemiti, Elli A1 - Eichelmann, Fabian A1 - Schulze, Matthias Bernd T1 - Advanced glycation end-products, measured as skin autofluorescence, associate with vascular stiffness in diabetic, pre-diabetic and normoglycemic individuals BT - a cross-sectional study JF - Cardiovascular diabetology N2 - Background Advanced glycation end-products are proteins that become glycated after contact with sugars and are implicated in endothelial dysfunction and arterial stiffening. We aimed to investigate the relationships between advanced glycation end-products, measured as skin autofluorescence, and vascular stiffness in various glycemic strata. Methods We performed a cross-sectional analysis within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort, comprising n = 3535 participants (median age 67 years, 60% women). Advanced glycation end-products were measured as skin autofluorescence with AGE-Reader (TM), vascular stiffness was measured as pulse wave velocity, augmentation index and ankle-brachial index with Vascular Explorer (TM). A subset of 1348 participants underwent an oral glucose tolerance test. Participants were sub-phenotyped into normoglycemic, prediabetes and diabetes groups. Associations between skin autofluorescence and various indices of vascular stiffness were assessed by multivariable regression analyses and were adjusted for age, sex, measures of adiposity and lifestyle, blood pressure, prevalent conditions, medication use and blood biomarkers. Results Skin autofluorescence associated with pulse wave velocity, augmentation index and ankle-brachial index, adjusted beta coefficients (95% CI) per unit skin autofluorescence increase: 0.38 (0.21; 0.55) for carotid-femoral pulse wave velocity, 0.25 (0.14; 0.37) for aortic pulse wave velocity, 1.00 (0.29; 1.70) for aortic augmentation index, 4.12 (2.24; 6.00) for brachial augmentation index and - 0.04 (- 0.05; - 0.02) for ankle-brachial index. The associations were strongest in men, younger individuals and were consistent across all glycemic strata: for carotid-femoral pulse wave velocity 0.36 (0.12; 0.60) in normoglycemic, 0.33 (- 0.01; 0.67) in prediabetes and 0.45 (0.09; 0.80) in diabetes groups; with similar estimates for aortic pulse wave velocity. Augmentation index was associated with skin autofluorescence only in normoglycemic and diabetes groups. Ankle-brachial index inversely associated with skin autofluorescence across all sex, age and glycemic strata. Conclusions Our findings indicate that advanced glycation end-products measured as skin autofluorescence might be involved in vascular stiffening independent of age and other cardiometabolic risk factors not only in individuals with diabetes but also in normoglycemic and prediabetic conditions. Skin autofluorescence might prove as a rapid and non-invasive method for assessment of macrovascular disease progression across all glycemic strata. KW - Advanced glycation end-products KW - AGE KW - Ankle-brachial index KW - Augmentation KW - index KW - Prediabetes KW - Glycemia KW - Pulse wave velocity KW - Skin KW - autofluorescence KW - Vascular stiffness Y1 - 2021 U6 - https://doi.org/10.1186/s12933-021-01296-5 SN - 1475-2840 VL - 20 IS - 1 PB - BioMed Central CY - London ER - TY - JOUR A1 - Schulze, Matthias Bernd T1 - Dietary linoleic acid: will modifying dietary fat quality reduce the risk of type 2 diabetes? JF - Diabetes care Y1 - 2021 U6 - https://doi.org/10.2337/dci21-0031 SN - 0149-5992 SN - 1935-5548 VL - 44 IS - 9 SP - 1913 EP - 1915 PB - American Diabetes Association CY - Alexandria ER - TY - JOUR A1 - Jannasch, Franziska A1 - Nickel, Daniela V. A1 - Bergmann, Manuela M. A1 - Schulze, Matthias Bernd T1 - A new evidence-based diet score to capture associations of food consumption and chronic disease risk JF - Nutrients / Molecular Diversity Preservation International (MDPI) N2 - 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. KW - diet score KW - dietary guidelines KW - food groups KW - chronic disease KW - type 2 KW - diabetes KW - cardiovascular disease KW - cancer KW - prevention KW - reliability; KW - validity Y1 - 2022 U6 - https://doi.org/10.3390/nu14112359 SN - 2072-6643 VL - 14 IS - 11 PB - MDPI CY - Basel ER - TY - JOUR A1 - Schwingshackl, Lukas A1 - Ruzanska, Ulrike Alexandra A1 - Anton, Verena A1 - Wallroth, Raphael A1 - Ohla, Kathrin A1 - Knueppel, Sven A1 - Schulze, Matthias Bernd A1 - Pischon, Tobias A1 - Deutschbein, Johannes A1 - Schenk, Liane A1 - Warschburger, Petra A1 - Harttig, Ulrich A1 - Boeing, Heiner A1 - Bergmann, Manuela M. T1 - The NutriAct Family Study: a web-based prospective study on the epidemiological, psychological and sociological basis of food choice JF - BMC public health N2 - 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. KW - NutriAct family study KW - Study protocol KW - Food choice KW - Determinants Y1 - 2018 U6 - https://doi.org/10.1186/s12889-018-5814-x SN - 1471-2458 VL - 18 PB - BMC CY - London ER - TY - JOUR A1 - Koelman, Liselot A. A1 - Huybrechts, Inge A1 - Biesbroek, Sander A1 - van 't Veer, Pieter A1 - Schulze, Matthias Bernd A1 - Aleksandrova, Krasimira T1 - Dietary choices impact on greenhouse gas emissions BT - determinants and correlates in a sample of adults from Eastern Germany JF - Sustainability / Multidisciplinary Digital Publishing Institute (MDPI) N2 - 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. KW - dietary choices KW - environmental impact KW - greenhouse gas emissions KW - land use KW - determinants Y1 - 2022 U6 - https://doi.org/10.3390/su14073854 SN - 2071-1050 VL - 14 IS - 7 PB - MDPI CY - Basel ER - TY - JOUR A1 - Mühlenbruch, Kristin A1 - Zhuo, Xiaohui A1 - Bardenheier, Barbara A1 - Shao, Hui A1 - Laxy, Michael A1 - Icks, Andrea A1 - Zhang, Ping A1 - Gregg, Edward W. A1 - Schulze, Matthias Bernd T1 - Selecting the optimal risk threshold of diabetes risk scores to identify high-risk individuals for diabetes prevention BT - a cost-effectiveness analysis JF - Acta Diabetologica N2 - 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. KW - diabetes mellitus KW - type 2 KW - cost-effectiveness analysis KW - lifestyle risk reduction KW - clinical prediction rule Y1 - 2019 U6 - https://doi.org/10.1007/s00592-019-01451-1 SN - 1432-5233 VL - 57 IS - 4 SP - 447 EP - 454 PB - Springer CY - Mailand ER - TY - JOUR A1 - Rothwell, Joseph A. A1 - Murphy, Neil A1 - Aleksandrova, Krasimira A1 - Schulze, Matthias Bernd A1 - Bešević, Jelena A1 - Kliemann, Nathalie A1 - Jenab, Mazda A1 - Ferrari, Pietro A1 - Achaintre, David A1 - Gicquiau, Audrey A1 - Vozar, Béatrice A1 - Scalbert, Augustin A1 - Huybrechts, Inge A1 - Freisling, Heinz A1 - Prehn, Cornelia A1 - Adamski, Jerzy A1 - Cross, Amanda J. A1 - Pala, Valeria Maria A1 - Boutron-Ruault, Marie-Christine A1 - Dahm, Christina C. A1 - Overvad, Kim A1 - Gram, Inger Torhild A1 - Sandanger, Torkjel M. A1 - Skeie, Guri A1 - Jakszyn, Paula A1 - Tsilidis, Kostas K. A1 - Hughes, David J. A1 - van Guelpen, Bethany A1 - Bodén, Stina A1 - Sánchez, Maria-José A1 - Schmidt, Julie A. A1 - Katzke, Verena A1 - Kühn, Tilman A1 - Colorado-Yohar, Sandra A1 - Tumino, Rosario A1 - Bueno-de-Mesquita, Bas A1 - Vineis, Paolo A1 - Masala, Giovanna A1 - Panico, Salvatore A1 - Eriksen, Anne Kirstine A1 - Tjønneland, Anne A1 - Aune, Dagfinn A1 - Weiderpass, Elisabete A1 - Severi, Gianluca A1 - Chajès, Véronique A1 - Gunter, Marc J. T1 - Metabolic signatures of healthy lifestyle patterns and colorectal cancer risk in a European cohort JF - Clinical gastroenterology and hepatology N2 - 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. KW - colorectal neoplasm KW - risk factors KW - World Cancer Research Fund/American Institute for Cancer Research Recommendations KW - targeted metabolomics Y1 - 2020 U6 - https://doi.org/10.1016/j.cgh.2020.11.045 SN - 1542-3565 SN - 1542-7714 VL - 20 SP - E1061 EP - E1082 PB - Elsevier CY - New York, NY ER - TY - JOUR A1 - Polemiti, Elli A1 - Baudry, Julia A1 - Kuxhaus, Olga A1 - Jäger, Susanne A1 - Bergmann, Manuela A1 - Weikert, Cornelia A1 - Schulze, Matthias Bernd T1 - BMI and BMI change following incident type 2 diabetes and risk of microvascular and macrovascular complications BT - the EPIC-Potsdam study JF - Diabetologia : journal of the European Association for the Study of Diabetes (EASD) N2 - 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. KW - BMI KW - CVD KW - Diabetes-related vascular complications KW - Nephropathy KW - Neuropathy KW - T2D KW - Weight change Y1 - 2021 U6 - https://doi.org/10.1007/s00125-020-05362-7 SN - 0012-186X SN - 1432-0428 VL - 64 IS - 4 SP - 814 EP - 825 PB - Springer CY - Berlin ; Heidelberg ER - TY - JOUR A1 - Botteri, Edoardo A1 - Peveri, Giulia A1 - Berstad, Paula A1 - Bagnardi, Vincenzo A1 - Chen, Sairah L. F. A1 - Sandanger, Torkjel M. A1 - Hoff, Geir A1 - Dahm, Christina C. A1 - Antoniussen, Christian S. A1 - Tjonneland, Anne A1 - Eriksen, Anne Kirstine A1 - Skeie, Guri A1 - Perez-Cornago, Aurora A1 - Huerta, Jose Maria A1 - Jakszyn, Paula A1 - Harlid, Sophia A1 - Sundstroem, Bjoern A1 - Barricarte, Aurelio A1 - Monninkhof, Evelyn M. A1 - Derksen, Jeroen W. G. A1 - Schulze, Matthias Bernd A1 - Bueno-de-Mesquita, Bas A1 - Sanchez, Maria-Jose A1 - Cross, Amanda J. A1 - Tsilidis, Konstantinos K. A1 - De Magistris, Maria Santucci A1 - Kaaks, Rudolf A1 - Katzke, Verena A1 - Rothwell, Joseph A. A1 - Laouali, Nasser A1 - Severi, Gianluca A1 - Amiano, Pilar A1 - Contiero, Paolo A1 - Sacerdote, Carlotta A1 - Goldberg, Marcel A1 - Touvier, Mathilde A1 - Freisling, Heinz A1 - Viallon, Vivian A1 - Weiderpass, Elisabete A1 - Riboli, Elio A1 - Gunter, Marc J. A1 - Jenab, Mazda A1 - Ferrari, Pietro T1 - Changes in lifestyle and risk of colorectal cancer in the European prospective investigation into cancer and nutrition JF - The American journal of gastroenterology : AJG N2 - 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. Y1 - 2022 U6 - https://doi.org/10.14309/ajg.0000000000002065 SN - 0002-9270 SN - 1572-0241 VL - 118 IS - 4 SP - 702 EP - 711 PB - Lippincott Williams & Wilkins CY - Philadelphia ER -