Adherence to a healthy Nordic food index and risk of myocardial infarction in middle-aged Danes: the diet, cancer and health cohort study.

https://arctichealth.org/en/permalink/ahliterature290731
Source
Eur J Clin Nutr. 2017 05; 71(5):652-658
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
05-2017
Author
V B Gunge
I Andersen
C Kyrø
C P Hansen
C C Dahm
J Christensen
A Tjønneland
A Olsen
Author Affiliation
Unit of Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark.
Source
Eur J Clin Nutr. 2017 05; 71(5):652-658
Date
05-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Cohort Studies
Denmark
Diet, Mediterranean
European Continental Ancestry Group
Female
Follow-Up Studies
Health Behavior
Healthy Diet
Humans
Male
Middle Aged
Myocardial Infarction - epidemiology - prevention & control
Neoplasms - epidemiology - prevention & control
Patient compliance
Proportional Hazards Models
Prospective Studies
Risk factors
Abstract
For decades, the Mediterranean diet has been in focus regarding healthy eating as it has been associated with reduced risk of non-communicable diseases. Less interest has been given to health benefits of other regional diets. The aim of the present study was to assess whether adherence to a healthy Nordic food index was associated with lower risk of myocardial infarction (MI) among middle-aged Danes.
Data were obtained from the Danish Diet, Cancer and Health cohort study of 57?053 men and women aged 50-64 years recruited between 1993 and 1997. The healthy Nordic food index comprised healthy Nordic food items selected a priori (fish, cabbage, rye bread, oatmeal, apple and pears and root vegetables). Information on incident MI was ascertained through linkage with national registries. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated from sex-specific Cox proportional hazard models.
In total, 1669 men and 653 women developed MI during follow-up (13.6 median years). In adjusted models, those with an index score of 5-6 points (highest scores) had significantly lower MI risk (men: HR=0.77, 95% CI=0.62, 0.97; women: HR=0.55, 95% CI=0.37, 0.82) relative to those scoring 0 points in the index (lowest score). A significantly lower MI risk was found per 1-point increment in the index in both men (HR=0.95, 95% CI=0.92, 0.99) and women (HR=0.93, 95% CI=0.88, 0.98).
A healthy Nordic diet is associated with lower MI risk among middle-aged Danes, suggesting that Nordic diets should be considered in recommendations for dietary changes in the promotion of coronary health.
PubMed ID
28247857 View in PubMed
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Adipose tissue fatty acids as biomarkers of dietary exposure in Danish men and women.

https://arctichealth.org/en/permalink/ahliterature24046
Source
Am J Clin Nutr. 1993 May;57(5):629-33
Publication Type
Article
Date
May-1993
Author
A. Tjønneland
K. Overvad
E. Thorling
M. Ewertz
Author Affiliation
Danish Cancer Registry, Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen.
Source
Am J Clin Nutr. 1993 May;57(5):629-33
Date
May-1993
Language
English
Publication Type
Article
Keywords
Adipose Tissue - metabolism
Adult
Biological Markers - analysis
Denmark - epidemiology
Diet - statistics & numerical data
Dietary Fats - administration & dosage
Fatty Acids - analysis
Female
Humans
Male
Middle Aged
Nutrition Surveys
Research Support, Non-U.S. Gov't
Abstract
Adipose tissue fatty acids, it has been proposed, reflect dietary intake. Using data from a validation study preceding a prospective study on diet, cancer, and health in Denmark, we were able to compare fatty acid profiles in adipose tissue biopsies from 86 individuals (23 men and 63 women) aged 40-64 y and dietary intake of fatty acids (as percentage of total fat) assessed by two 7-d weighed-diet records or by a semi-quantitative food frequency questionnaire. Correlation coefficients (Pearson r) between fatty acid concentrations in adipose tissue biopsies (as percentage of total peak area) and dietary intake of fatty acid (percentage of total fat), determined from the diet records for men and women, respectively, were as follows: polyunsaturated fatty acids r = 0.74 and r = 0.46; n - 3 fatty acids of marine origin: eicosapentaenoic acid r = 0.15 and r = 0.61, and docosahexaenoic acid r = 0.47 and r = 0.57. Correlation coefficients obtained by using the food frequency questionnaire were slightly lower for most fatty acids.
PubMed ID
8480677 View in PubMed
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Alcohol drinking and risk of subsequent hospitalisation with pneumonia.

https://arctichealth.org/en/permalink/ahliterature100920
Source
Eur Respir J. 2011 Jun 9;
Publication Type
Article
Date
Jun-9-2011
Author
J B Kornum
K M Due
M. Nørgaard
A. Tjønneland
K. Overvad
H T Sørensen
R W Thomsen
Author Affiliation
Clinical Institute, Aarhus University Hospital Aarhus Denmark.
Source
Eur Respir J. 2011 Jun 9;
Date
Jun-9-2011
Language
English
Publication Type
Article
Abstract
The dose-response relationship between alcohol consumption and pneumonia risk in healthy individuals is poorly understood. We examined 22,485 males and 24,682 females from Denmark who were aged 50-64 yrs. Subjects were without major chronic diseases at baseline and had median 12 yrs follow-up for first-time hospitalisation with pneumonia. 1,091 (males) and 944 (females) had a pneumonia-related hospitalisation. Among males, the risk of pneumonia was increased for alcohol abstainers and those who drank large weekly amounts: Adjusted hazard ratios (HRs) for 0, 7-20, 21-34, 35-50, and >50 drinks per week were 1.49 (95% CI 1.00-2.21), 0.88 (0.76-1.03), 0.87 (0.72-1.05), 1.15 (0.93-1.44), and 1.81 (1.40-2.33), respectively, compared with 1-6 drinks per week. The association between high alcohol intake and pneumonia persisted after controlling for subsequent chronic diseases. Among females, HRs for 0, 7-20, 21-35, and >35 drinks weekly were 1.26 (0.89-1.79), 1.01 (0.88-1.17), 1.10 (0.88-1.37), and 0.54 (0.29-1.01), respectively. For the same moderate to high weekly alcohol amount, infrequent intake yielded higher pneumonia HRs than more regular intake in both sexes. Regular moderate alcohol intake is not associated with increased risk of hospitalisation for pneumonia. High weekly alcohol consumption in males and infrequent heavy drinking in both sexes may increase pneumonia risk.
PubMed ID
21659417 View in PubMed
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Source
Cancer Causes Control. 2001 Feb;12(2):173-7
Publication Type
Article
Date
Feb-2001
Author
L. Mellemkjaer
C. Emborg
G. Gridley
P. Munk-Jørgensen
C. Johansen
A. Tjønneland
S K Kjaer
J H Olsen
Author Affiliation
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen. lene@cancer.dk
Source
Cancer Causes Control. 2001 Feb;12(2):173-7
Date
Feb-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Anorexia Nervosa - diagnosis - epidemiology
Case-Control Studies
Child
Cohort Studies
Comorbidity
Comparative Study
Denmark - epidemiology
Female
Humans
Incidence
Male
Middle Aged
Neoplasms - diagnosis - epidemiology
Nutritional Status
Poisson Distribution
Reference Values
Registries
Research Support, U.S. Gov't, P.H.S.
Risk assessment
Sex Distribution
Abstract
OBJECTIVE: Energy restriction reduces the incidence of malignant tumors in experimental animals, but evidence for a similar effect in humans is lacking. To test the hypothesis in humans, we investigated cancer incidence among patients with anorexia nervosa, who have had an extremely low intake of calories for prolonged periods of their lives. METHODS: Patients with anorexia nervosa (2151 women and 186 men) during 1970-1993 were identified in the population-based Danish Psychiatric Case Register and the National Registry of Patients. The cohort was linked to the Danish Cancer Registry, and cancer incidence among cohort members was compared with that of the general population. RESULTS: The overall cancer incidence among women with anorexia nervosa was reduced by a factor of 0.80 (95% confidence interval 0.52-1.18) below that of the general population on the basis of 25 observed and 31.4 expected cases. Among men, two cases of cancer were observed, both confined to the brain, whereas 0.2 cases were expected. CONCLUSIONS: The finding of a slight reduction in cancer risk among women with anorexia nervosa may support the theory that a low-energy diet may decrease tumor development in humans. However, longer follow-up and control for confounding factors are needed to obtain more convincing evidence.
PubMed ID
11246846 View in PubMed
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Avoidable cancers in the Nordic countries. Diet, obesity and low physical activity.

https://arctichealth.org/en/permalink/ahliterature22272
Source
APMIS Suppl. 1997;76:100-19
Publication Type
Article
Date
1997
Author
J F Winther
L. Dreyer
K. Overvad
A. Tjønneland
M. Gerhardsson de Verdier
Author Affiliation
Institute of Cancer Epidemiology, Danish Cancer Society.
Source
APMIS Suppl. 1997;76:100-19
Date
1997
Language
English
Publication Type
Article
Keywords
Diet - adverse effects
Exercise
Female
Finland - epidemiology
Humans
Iceland - epidemiology
Incidence
Male
Neoplasms - epidemiology - etiology - prevention & control
Obesity - complications
Risk factors
Scandinavia - epidemiology
Abstract
In the early 1980s, Doll and Peto estimated that about 35% of all deaths from cancer in the United States were attributable to dietary factors, with a margin of uncertainty ranging from 10 to 70%. Since then, several dietary factors, e.g. fat and meat, have been suggested to increase the risk for cancer, while other factors, e.g. fibre, fruit and vegetables, have been suggested to decrease the risk. The case-control and cohort studies have, however, given ambiguous results, and the overall evidence is far from conclusive. The major findings on dietary factors that increase risk have been reported from case-control studies, but have not been confirmed in large population-based cohort studies. Although the research in this area indicates that diet is important in cancer prevention, current knowledge does not allow reliable estimates of the numbers and proportions of cancers that could be avoided through well-described modifications of dietary habits. During the last 10 years, low physical activity has been pinpointed as a risk factor for cancers at various sites, especially the colon; however, the causal mechanism is still unknown. Obesity, defined as a body mass index of 30 or more, is consistently associated with endometrial and gall-bladder cancers in women and renal-cell cancer in both men and women. As the prevalence of obesity was between 5 and almost 20% in the Nordic populations in 1995, 625 cancer cases (310 endometrial cancers, 270 renal-cell cancers in men and women and 45 gall-bladder and bile-duct cancers among women) can be predicted in the Nordic countries around the year 2000 to be caused by obesity. This implies that about 1% of all cancers in Nordic women and less than 1% of those in Nordic men could be avoided around the year 2000 if a healthy body weight could be maintained by all inhabitants.
PubMed ID
9462823 View in PubMed
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Baseline patterns of adipose tissue fatty acids and long-term risk of breast cancer: a case-cohort study in the Danish cohort Diet, Cancer and Health.

https://arctichealth.org/en/permalink/ahliterature264936
Source
Eur J Clin Nutr. 2014 Oct;68(10):1088-94
Publication Type
Article
Date
Oct-2014
Author
J A Schmidt
A. Gorst-Rasmussen
P W Nyström
J H Christensen
E B Schmidt
C. Dethlefsen
A. Tjønneland
K. Overvad
C C Dahm
Source
Eur J Clin Nutr. 2014 Oct;68(10):1088-94
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - epidemiology - pathology
Cohort Studies
Denmark - epidemiology
Fatty Acids - analysis
Female
Humans
Incidence
Male
Middle Aged
Prospective Studies
Risk
Risk factors
Subcutaneous Fat - chemistry
Abstract
The evidence regarding fatty acids and breast cancer risk is inconclusive. Adipose tissue fatty acids can be used as biomarkers of fatty acid intake and of endogenous fatty acid exposure. Fatty acids in adipose tissue are correlated owing to common dietary sources and shared metabolic pathways, which group fatty acids into naturally occurring patterns. We aimed to prospectively investigate associations between adipose tissue fatty acid patterns and long-term risk of total breast cancer and breast cancer subtypes characterised by oestrogen and progesterone receptor status (ER and PR).
This case-cohort study was based on data from the Danish cohort Diet, Cancer and Health. At baseline, a fat biopsy and information on lifestyle and reproductive factors were collected. From the 31 original fatty acids measured, patterns of fatty acids were identified using the treelet transform. During a median follow-up of 5.3 years, 474 breast cancer cases were identified. Hazard ratios and 95% confidence intervals of risk of total breast cancer and of subtypes according to quintiles of factor score were determined by weighted Cox proportional hazards regression.
After adjustment for potential confounders, factor scores for the seven patterns identified by the treelet transform were not associated with risk of total breast cancer, nor with risk of ER+, ER-, PR+ or PR- tumours.
No clear associations between the patterns of fatty acids at baseline and long-term risk of total breast cancer or ER+, ER-, PR+ or PR- tumours were observed.
PubMed ID
24642780 View in PubMed
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Body composition and body fat distribution in relation to later risk of acute myocardial infarction: a Danish follow-up study.

https://arctichealth.org/en/permalink/ahliterature137399
Source
Int J Obes (Lond). 2011 Nov;35(11):1433-41
Publication Type
Article
Date
Nov-2011
Author
J G Stegger
E B Schmidt
T. Obel
T L Berentzen
A. Tjønneland
T I A Sørensen
K. Overvad
Author Affiliation
Department of Cardiology, Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark. Jakob.Stegger@rn.dk
Source
Int J Obes (Lond). 2011 Nov;35(11):1433-41
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Body Composition
Body Fat Distribution
Body mass index
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction - epidemiology - etiology - physiopathology
Obesity - complications - epidemiology - physiopathology
Predictive value of tests
Proportional Hazards Models
Prospective Studies
Questionnaires
Risk factors
Abstract
Obesity is a modifiable risk factor for acute myocardial infarction (MI), but lean body mass (LBM) may also be an important factor. Low LBM may increase the risk of MI and LBM may modify the effect of obesity on MI. Thus, the inability of the classical anthropometric measures to evaluate LBM may lead to misclassification of MI risk in both lean and obese persons. We investigated the associations between incident MI and bioelectrical impedance analyses (BIA) derived measures of body composition in combination with body mass index (BMI) and anthropometric measures of body fat distribution.
From 1993 to 1997, 27?148 men and 29?863 women, aged 50 to 64 year, were recruited into the Danish prospective study Diet, Cancer and Health. During 11.9 years of follow-up we identified 2028 cases of incident MI (1487 men and 541 women). BMI, waist circumference (WC), hip circumference and BIA of body composition including body fat mass (BFM), body fat percentage and LBM were measured at baseline. We used Cox proportional hazard models with age as time axis and performed extensive control for confounding. Weight, BMI, classical estimates of abdominal obesity and BIA estimates of obesity showed significant positive associations with incident MI. However, BFM adjusted for WC showed no association. Low LBM was associated with a higher risk of incident MI in both genders, and high LBM was associated with a higher risk in men.
Obesity was positively associated with MI. Estimates of obesity achieved by BIA seemed not to add additional information to classical anthropometric measures regarding MI risk. Both high and low LBM may be positively associated with MI.
PubMed ID
21285940 View in PubMed
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Cigar and pipe smoking and cancer risk in the european prospective investigation into cancer and nutrition.

https://arctichealth.org/en/permalink/ahliterature98017
Source
Int J Cancer. 2010 Feb 16;
Publication Type
Article
Date
Feb-16-2010
Author
Va McCormack
A. Agudo
Cc Dahm
K. Overvad
A. Olsen
A. Tjonneland
R. Kaaks
H. Boeing
J. Manjer
M. Almquist
G. Hallmans
I. Johansson
Md Chirlaque
A. Barricarte
M. Dorronsoro
L. Rodriguez
Ml Redondo
Kt Khaw
N. Wareham
N. Allen
T. Key
E. Riboli
P. Boffetta
Author Affiliation
International Agency for Research on Cancer, Lyon, France.
Source
Int J Cancer. 2010 Feb 16;
Date
Feb-16-2010
Language
English
Publication Type
Article
Abstract
The carcinogenicity of cigar and pipe smoking is established but the effect of detailed smoking characteristics is less well defined. We examined the effects on cancer incidence of exclusive cigar and pipe smoking, and in combination with cigarettes, among 102395 men from Denmark, Germany, Spain, Sweden and UK in the EPIC cohort. Hazard ratios (HR) and their 95% confidence intervals (CI) for cancer during a median 9 year follow-up from ages 35-70 years were estimated using proportional hazards models. Compared to never smokers, HR of cancers of lung, upper aero-digestive tract and bladder combined was 2.2 (95% CI: 1.3, 3.8) for exclusive cigar smokers (16 cases), 3.0 (2.1, 4.5) for exclusive pipe smokers (33 cases) and 5.3 (4.4, 6.4) for exclusive cigarette smokers (1069 cases). For each smoking type, effects were stronger in current than in ex-smokers, and in inhalers than in non-inhalers. Ever smokers of both cigarettes and cigars (HR 5.7 (4.4, 7.3), 120 cases) and cigarettes and pipes (5.1 (4.1, 6.4), 247 cases) had as high a raised risk as had exclusive cigarette smokers. In these smokers, the magnitude of the raised risk was smaller if they had switched to cigars or pipes only (i.e. quit cigarettes) and had not compensated with greater smoking intensity. Cigar and pipe smoking is not a safe alternative to cigarette smoking. The lower cancer risk of cigar and pipe smokers as compared to cigarette smokers is explained by lesser degree of inhalation and lower smoking intensity. (c) 2010 UICC.
PubMed ID
20162568 View in PubMed
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A cross-sectional study of dietary habits and urinary glucose excretion - a predictor of non-insulin-dependent diabetes mellitus.

https://arctichealth.org/en/permalink/ahliterature20439
Source
Eur J Clin Nutr. 2000 May;54(5):434-9
Publication Type
Article
Date
May-2000
Author
A. Ekblond
L. Mellemkjaer
A. Tjonneland
M. Suntum
C. Stripp
K. Overvad
C. Johansen
J H Olsen
Author Affiliation
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark.
Source
Eur J Clin Nutr. 2000 May;54(5):434-9
Date
May-2000
Language
English
Publication Type
Article
Keywords
Animals
Cereals
Cross-Sectional Studies
Denmark
Diabetes Mellitus, Type 2 - etiology - prevention & control - urine
Diet
Dietary Fiber - administration & dosage
Female
Fishes
Fruit
Glycosuria
Humans
Male
Middle Aged
Milk
Poultry
Research Support, Non-U.S. Gov't
Sex Characteristics
Abstract
OBJECTIVE: To investigate the association between consumption of certain foods and macronutrients and urinary glucose excretion, which is a predictor of non-insulin-dependent diabetes mellitus. DESIGN: A cross-sectional study, Denmark, 1993-97. SUBJECTS: Participants in the Danish study 'Diet, Cancer and Health'. After exclusion of persons with postprandial urine samples and persons with diabetes or other diseases potentially resulting in glycosuria, the study population included 14 743 men and 18 064 women aged 50-64 y. We identified 183 men and 43 women with glucose in their urine. RESULTS: Consumption of poultry was negatively associated with glycosuria in both men (odds ratio, OR=0.87; 95% confidence interval, 95% CI=0.77-0.98) and women (OR=0.69; 0.48-1.00). Fiber from fruit showed a weak negative association with glycosuria in both men (0. 95; 0.90-1.01) and women (0.89; 0.78-1.02), whereas a significant negative association with total fiber (0.68; 0.51-0.91) and fiber from vegetables (0.94; 0.88-0.99) was seen in men. Intake of fish tended to reduce the risk of glycosuria in women only (0.80; 0.63-1. 02), whereas ingestion of milk products increased their risk significantly (1.15; 1.06-1.24). CONCLUSION: Although statistical significance and consistency in the two sexes were not achieved for all end-points, the study indicates a protective effect of dietary products like poultry, fruit and cereals against glycosuria and suggests a promoting effect of milk. SPONSORSHIP: The Danish National Board of Health and the Danish Cancer Society.
PubMed ID
10822293 View in PubMed
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Determinants of plasma alkylresorcinol concentration in Danish post-menopausal women.

https://arctichealth.org/en/permalink/ahliterature140604
Source
Eur J Clin Nutr. 2011 Jan;65(1):94-101
Publication Type
Article
Date
Jan-2011
Author
R. Landberg
A. Kamal-Eldin
P. Aman
J. Christensen
K. Overvad
A. Tjønneland
A. Olsen
Author Affiliation
Department of Food Science, Swedish University of Agriculture Science, SLU, Uppsala, Sweden. rikard.landberg@lmv.slu.se
Source
Eur J Clin Nutr. 2011 Jan;65(1):94-101
Date
Jan-2011
Language
English
Publication Type
Article
Keywords
Biological Markers - blood
Bread
Denmark
Diet
Dietary Fiber - analysis
Female
Humans
Middle Aged
Multivariate Analysis
Postmenopause
Questionnaires
Regression Analysis
Resorcinols - blood
Secale cereale - chemistry
Abstract
Alkylresorcinols (AR), a group of phenolic lipids present in the outer parts of wheat and rye grain kernels, have been suggested as biomarkers of whole-grain wheat and rye intake. In this study, we investigated potential determinants of plasma AR concentration in a free-living population.
Non-fasting samples from post-menopausal women enrolled in the Danish Diet, Cancer and Health study (n = 360) were selected. Diet was assessed using a semi-quantitative food frequency questionnaires (FFQ) and the association between food items likely to contain AR and relevant non-dietary factors were studied by analysis of covariance models.
The median AR concentration was 78 nmol/l (interquartile range = 106.9 nmol/l). Intake of rye bread, identified as the main determinant, was associated with 87% higher plasma total AR concentration per 100 g of bread (95% confidence interval = 46-139%). About 8-12% of the total variation (depending on the AR homologue) in plasma AR concentration was explained by the selected dietary variables. At a nutrient level, total dietary fiber and cereal fiber were significantly associated with plasma total AR concentration (P = 0.05), but only ˜2% of the total plasma AR concentration was explained by the dietary fiber or cereal fiber intake.
In the studied population, AR plasma concentration was mainly affected by rye bread intake among investigated determinants.
PubMed ID
20859297 View in PubMed
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