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 -