Associations between dietary methods and biomarkers, and between fruits and vegetables and risk of ischaemic heart disease, in the EPIC Norfolk Cohort Study

Bingham, Sheila; Luben, Robert; Welch, Ailsa; Low, Yen Ling; Khaw, Kay Tee; Wareham, Nick; Day, Nick

doi:10.1093/ije/dyn111

Cited by 89 publications

(85 citation statements)

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“…Our estimates are not adjusted for energy intake but are adjusted for BMI and physical activity, which are closely related to energy balance. 19,27,28 The FFQ was a qualitative questionnaire that has not been validated in all regions of the world; however, the success of prediction and the consistency of its finding with known protective factors of CVD suggest that this short questionnaire captured important food items. Consumption of some food items such as dairy, tofu, and soy sauce varies largely among countries.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Healthy Diet and Risk of Cardiovascular Disease Among Patients on Drug Therapies for Secondary Prevention

et al. 2012

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Background-Diet quality is strongly related to cardiovascular disease (CVD) incidence, but little is known about its impact on CVD events in older people at high risk of CVD and receiving effective drugs for secondary prevention. This study assessed the association between diet quality and CVD events in a large population of subjects from 40 countries with CVD or diabetes mellitus with end-organ damage receiving proven medications. Methods and Results-Overall, 31 546 women and men 66.5Ϯ6.2 years of age enrolled in 2 randomized trials, the Ongoing Telmisartan Alone and in Combination With Ramipril Global End Point Trial (ONTARGET) and the Telmisartan Randomized Assessment Study in ACEI Intolerant Subjects With Cardiovascular Disease (TRANSCEND), were studied. We used 2 dietary indexes: the modified Alternative Healthy Eating Index and the Diet Risk Score. The association between diet quality and the primary composite outcome of CV death, myocardial infarction, stroke, or congestive heart failure was assessed with Cox proportional hazard regression with adjustment for age, sex, trial enrollment allocation, region, and other known confounders. During the 56-month follow-up, there were 5190 events. Patients in the healthier quintiles of modified Alternative Healthy Eating Index scores had a significantly lower risk of CVD (hazard ratio, 0.78; 95% confidence interval, 0.71-0.87, top versus lowest quintile of modified Alternative Healthy Eating Index). The reductions in risk for CV death, myocardial infarction, and stroke were 35%, 14%, and 19%, respectively. The protective association was consistent regardless of whether patients were receiving proven drugs. Conclusions-A higher-quality diet was associated with a lower risk of recurrent CVD events among people Ն55 years of age with CVD or diabetes mellitus. Highlighting the importance of healthy eating by health professionals would substantially reduce CVD recurrence and save lives globally. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00153101.

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Section: Discussionmentioning

confidence: 99%

Relationship Between Healthy Diet and Risk of Cardiovascular Disease Among Patients on Drug Therapies for Secondary Prevention

et al. 2012

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“…With this information on nutrient intakes from all sources, including supplements, it will be possible to further investigate established relationships with blood biomarkers, nutrition and morbidity in the EPIC-Norfolk study (21,22) . (7) .…”

Section: Resultsmentioning

confidence: 99%

Developing a database of vitamin and mineral supplements (ViMiS) for the Norfolk arm of the European Prospective Investigation into Cancer (EPIC-Norfolk)

Lentjes

Bhaniani

Mulligan

et al. 2010

Public Health Nutr.

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Objective: Supplements are an important source of micronutrient intake, which, unless taken into account, can misclassify individuals with regard to levels of nutrient exposure. A label-based vitamin and mineral supplements (ViMiS) database was developed to contain manufacturers' information and to enter supplement use by participants in the European Prospective Investigation into Cancer and Nutrition in Norfolk (EPIC-Norfolk). The ViMiS database contains information on all ingredients, broken down into nutrient information in order to be combined with nutrient intake derived from food consumption. Design: Development of the ViMiS database and cross-sectional analysis of supplement use in a population-based study. Setting: Men and women aged 40-79 years from the general population participating in the EPIC-Norfolk study between 1993 and 1997, with data available from 7 d diet diaries (7dDD). Subjects: A subset of 19 330 participants with available 7dDD and known supplement status. Results: To date, the ViMiS database includes 2066 supplements, which altogether contain 16 586 ingredients, with a median of eleven nutrient/ingredients per supplement. Forty per cent of the cohort took a supplement, of which cod liver oil was the most common (24?5 %). Conclusions: The ViMiS database provides a flexible tool for estimating total nutrient intake. The high prevalence of supplement use in the general population indicates that supplement use needs to be taken into account when examining the relationship of intake of particular nutrients to health outcomes. Keywords Dietary supplements Development label-based database EPIC-Norfolk ViMiSThe use of vitamin and mineral supplements (ViMiS; referred to as 'supplements') in the UK has risen to 40 % for women and 29 % for men according to national surveys held in 2000-2001 (1) . These results show that supplements can increase the mean intake of vitamins by 4-183 % and of minerals by 0-16 %, depending on the type of vitamin and sex and age of the participant. Previous studies indicate that supplement consumption should be taken into account when assessing dietary nutrient intake; otherwise misclassification of nutrient intakes of individuals and unclear relationships with biomarkers can occur (2) . Although several UK-based cohort studies have compared supplement users (SU) with nonsupplement users (NSU) with regard to sociodemographic factors, morbidity and nutrient and food intakes, they have not been able to estimate total nutrient exposure (3)(4)(5) , i.e. the combined nutrient exposure from foods and supplements.In order to analyse total nutrient exposure for the European Prospective Investigation into Cancer and Nutrition in Norfolk (EPIC-Norfolk), an equivalent to the UK National Food Composition Database (UK FCD) for supplement composition was needed. As laboratory analytical data were not available for supplements on the UK market in the early 1990s, nor to date, it was necessary to design a database structure and calculation method to calculate the nutrients fr...

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“…In addition, calibration studies using biomarkers warrant further investigation [63] . Their extended integration in future dietary assessment, including the use of statistical methods for combining data in large-scale prospective studies, seems to be promising [64] , but is still costly and challenging in terms of sample collection, incorporation in statistical analysis and data interpretation [65] .…”

Section: Discussionmentioning

confidence: 99%

The Assessment of Individual Usual Food Intake in Large-Scale Prospective Studies

Illner¹,

Nöthlings²,

Wagner³

et al. 2010

Ann Nutr Metab

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Recent research has called into question the current practice to estimate individual usual food intake in large-scale studies. In such studies, usual food intake has been defined as diet over the past year. The aim of this review is to summarise the concepts of dietary assessment methods providing food intake data over this time period. A conceptualised framework is given to help researchers to understand the more recent developments to improve dietary assessment in large-scale prospective studies, and also to help to spot the gaps that need to be addressed in future methodological research. The conceptual framework illustrates the current options for the assessment of an individual’s food consumption over 1 year. Ideally, a person’s food intake on each day of this year should be assessed. Due to participants’ burden, and organisational and financial constraints, however, the options are limited to directly requesting the long-term average (e.g. food frequency questionnaires), or selecting a few days with detailed food consumption measurements (e.g. 24-hour dietary recalls) or using snapshot techniques (e.g. barcode scanning of purchases). It seems necessary and important to further evaluate the performance of statistical modelling of the individual usual food intake from all available sources. Future dietary assessment might profit from the growing prominence of internet and telecommunication technologies to further enhance the available data on food consumption for each study participant. Research is crucial to investigate the performance of innovative assessment tools. However, the self-reported nature of the data itself will always lead to bias.

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Associations between dietary methods and biomarkers, and between fruits and vegetables and risk of ischaemic heart disease, in the EPIC Norfolk Cohort Study

Abstract: Nutritional data that reflect the findings from biomarkers reduce measurement error and will thus improve statistical power in studies of gene nutrient interactions in cohort studies.

Cited by 89 publications

References 45 publications

Relationship Between Healthy Diet and Risk of Cardiovascular Disease Among Patients on Drug Therapies for Secondary Prevention

Relationship Between Healthy Diet and Risk of Cardiovascular Disease Among Patients on Drug Therapies for Secondary Prevention

Developing a database of vitamin and mineral supplements (ViMiS) for the Norfolk arm of the European Prospective Investigation into Cancer (EPIC-Norfolk)

The Assessment of Individual Usual Food Intake in Large-Scale Prospective Studies

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