European Prospective Investigation into Cancer and Nutrition
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Europe-wide cohort study of diet and cancer
The European Prospective Investigation into Cancer and Nutrition (EPIC) study is a Europe-wide prospective cohort study of the relationships between diet and cancer, as well as other chronic diseases, such as cardiovascular disease. With over half a million participants, it is the largest study of diet and disease to be undertaken.[1]
521,457 healthy adults, mostly aged 35–70 years, were enrolled in 23 centres in ten European countries: Denmark (11%), France (14%), Germany (10%), Greece (5%), Italy (9%), The Netherlands (8%), Norway (7%), Spain (8%), Sweden (10%) and the United Kingdom (17%). One UK centre (Oxford) recruited 27,000 vegetarians and vegans; this subgroup forms the largest study of this dietary group. Recruitment to the study took place between 1993 and 1999, and follow-up is planned for at least ten years, with repeat interview/questionnaires every three to five years. The main prospective data collected are standardised dietary questionnaires (self-administered or interview-based), seven-day food diaries, blood samples and anthropometric measurements, such as body mass index and waist-to-hip ratio. Additionally, the GenAir case-control study is studying the relationship of passive smoking and air pollution with cancers and respiratory diseases.
Up to 2004, there were over 26,000 new cases of cancer recorded among participants, with the most common being cancers of the breast, colorectum, prostate and lung. Current analyses are focusing particularly on stomach, colorectal, breast, prostate and lung cancers. The different dietary patterns in the different countries should enable reliable associations to be made between particular diets and cancers. The analysis of stored blood samples should also allow dissection of genetic factors involved in cancers, as well as the effects of hormones and hormone-like factors.
Key findings
The study and its analysis is ongoing, but key results of the study retrieved in 2008 are:
Lowered sodium from salt intake, high potassium from fruit and vegetable consumption promote healthy blood pressure levels
High physical activity, involving some high impact activities is a good indicator of longevity and low risk of bone fractures
High levels of sex hormones increase risk of breast cancer
Increased fat intake increases the risk of breast cancer
Increases in eating fruit and vegetables reduces the risk from all causes of an early death
High blood glucose levels are associated with increased risk of heart disease
The combined impact of four behaviours – not smoking, being physically active, moderate alcohol intake and the consumption of at least five fruit and vegetable servings a day – was estimated to amount to 14 additional years of life (Khaw et al. 2008)
Regular consumption of processed meat increases the risk of cardiovascular diseases and death from cancer[3]
Subsequent findings from 2021 are:
Dietary factors associated with reduced cancer mortality included raw vegetable intake; dietary fiber intake; the Mediterranean diet; other diet patterns included low meat eaters, vegetarians/vegans, or fish eaters.[4]
↑ Zamora-Ros R, Agudo A, Luján-Barroso L, Romieu I, Ferrari P, Knaze V, Bueno-de-Mesquita HB, Leenders M, Travis RC, Navarro C, Sánchez-Cantalejo E, Slimani N, Scalbert A, Fedirko V, Hjartåker A, Engeset D, Skeie G, Boeing H, Förster J, Li K, Teucher B, Agnoli C, Tumino R, Mattiello A, Saieva C, Johansson I, Stenling R, Redondo ML, Wallström P, Ericson U, Khaw KT, Mulligan AA, Trichopoulou A, Dilis V, Katsoulis M, Peeters PH, Igali L, Tjønneland A, Halkjær J, Touillaud M, Perquier F, Fagherazzi G, Amiano P, Ardanaz E, Bredsdorff L, Overvad K, Ricceri F, Riboli E, González CA (2012). "Dietary flavonoid and lignan intake and gastric adenocarcinoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study". American Journal of Clinical Nutrition. 96 (6): 1398–1408. doi:10.3945/ajcn.112.037358. PMID23076618.
↑ Sabine Rohrmann; Kim Overvad; H Bas Bueno-de-Mesquita; Marianne U Jakobsen; Rikke Egeberg; Anne Tjønneland; Laura Nailler; Marie-Christine Boutron-Ruault; Françoise Clavel-Chapelon; Vittorio Krogh; Domenico Palli; Salvatore Panico; Rosario Tumino; Fulvio Ricceri; Manuela M Bergmann; Heiner Boeing; Kuanrong Li; Rudolf Kaaks; Kay-Tee Khaw; Nicholas J Wareham; Francesca L Crowe; Timothy J Key; Androniki Naska; Antonia Trichopoulou; Dimitirios Trichopoulos; Max Leenders; Petra HM Peeters; Dagrun Engeset; Christine L Parr; Guri Skeie; Paula Jakszyn; María-José Sánchez; José M Huerta; M Luisa Redondo; Aurelio Barricarte; Pilar Amiano; Isabel Drake; Emily Sonestedt; Göran Hallmans; Ingegerd Johansson; Veronika Fedirko; Isabelle Romieux; Pietro Ferrari; Teresa Norat; Anne C Vergnaud; Elio Riboli; Jakob Linseisen (7 March 2013). "Meat consumption and mortality – results from the European Prospective Investigation into Cancer and Nutrition". BMC Medicine. 11: 63. doi:10.1186/1741-7015-11-63. PMC3599112. PMID23497300. The results of our analysis support a moderate positive association between processed meat consumption and mortality, in particular due to cardiovascular diseases, but also to cancer.
Bingham SA, Day NE, Luben R; etal. (May 2003). "Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study". Lancet. 361 (9368): 1496–501. doi:10.1016/S0140-6736(03)13174-1. PMID12737858. S2CID44459032.{{cite journal}}: CS1 maint: multiple names: authors list (link)
Khaw KT, Bingham S, Welch A, etal. (March 2001). "Relation between plasma ascorbic acid and mortality in men and women in EPIC-Norfolk prospective study: a prospective population study. European Prospective Investigation into Cancer and Nutrition". Lancet. 357 (9257): 657–63. doi:10.1016/S0140-6736(00)04128-3. PMID11247548. S2CID34752014.
In nutrition, biology, and chemistry, fat usually means any ester of fatty acids, or a mixture of such compounds, most commonly those that occur in living beings or in food.
A saturated fat is a type of fat in which the fatty acid chains have all single bonds. A fat known as a glyceride is made of two kinds of smaller molecules: a short glycerol backbone and fatty acids that each contain a long linear or branched chain of carbon (C) atoms. Along the chain, some carbon atoms are linked by single bonds (-C-C-) and others are linked by double bonds (-C=C-). A double bond along the carbon chain can react with a pair of hydrogen atoms to change into a single -C-C- bond, with each H atom now bonded to one of the two C atoms. Glyceride fats without any carbon chain double bonds are called saturated because they are "saturated with" hydrogen atoms, having no double bonds available to react with more hydrogen.
The Mediterranean diet is a diet inspired by the eating habits and traditional food typical of southern Spain, southern Italy, and Crete, and formulated in the early 1960s. It is distinct from Mediterranean cuisine, which covers the actual cuisines of the Mediterranean countries. While inspired by a specific time and place, the "Mediterranean diet" was later refined based on the results of multiple scientific studies.
Lunch meats—also known as cold cuts, luncheon meats, cooked meats, sliced meats, cold meats, sandwich meats, delicatessens, and deli meats—are precooked or cured meats that are sliced and served cold or hot. They are typically served in sandwiches or on a tray. They can be purchased pre-sliced, usually in vacuum packs, or they can be sliced to order.
A plant-based diet is a diet consisting mostly or entirely of plant-based foods. Plant-based diets encompass a wide range of dietary patterns that contain low amounts of animal products and high amounts of fiber-rich plant products such as vegetables, fruits, whole grains, legumes, nuts and seeds. They do not need to be vegan or vegetarian but are defined in terms of low frequency of animal food consumption.
In biochemistry and nutrition, a monounsaturated fat is a fat that contains a monounsaturated fatty acid (MUFA), a subclass of fatty acid characterized by having a double bond in the fatty acid chain with all of the remaining carbon atoms being single-bonded. By contrast, polyunsaturated fatty acids (PUFAs) have more than one double bond.
A healthy diet is a diet that maintains or improves overall health. A healthy diet provides the body with essential nutrition: fluid, macronutrients such as protein, micronutrients such as vitamins, and adequate fibre and food energy.
In gastronomy, red meat is commonly red when raw, in contrast to white meat, which is pale in color before cooking. In culinary terms, only flesh from mammals or fowl is classified as red or white. In nutritional science, red meat is defined as any meat that has more of the protein myoglobin than white meat. White meat is defined as non-dark meat from fish or chicken.
Processed meat is considered to be any meat that has been modified in order to either improve its taste or to extend its shelf life. Methods of meat processing include salting, curing, fermentation, smoking, boiling, frying, and/or the addition of chemical preservatives. Processed meat is usually composed of pork or beef or, less frequently, poultry. It can also contain offal or meat by-products such as blood. Processed meat products include bacon, ham, sausages, salami, corned beef, jerky, hot dogs, lunch meat, canned meat, chicken nuggets, and meat-based sauces. Meat processing includes all the processes that change fresh meat with the exception of simple mechanical processes such as cutting, grinding or mixing.
Phytosterols are phytosteroids, similar to cholesterol, that serve as structural components of biological membranes of plants. They encompass plant sterols and stanols. More than 250 sterols and related compounds have been identified. Free phytosterols extracted from oils are insoluble in water, relatively insoluble in oil, and soluble in alcohols.
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The China Study: The Most Comprehensive Study of Nutrition Ever Conducted and the Startling Implications for Diet, Weight Loss and Long-term Health is a book by T. Colin Campbell and his son, Thomas M. Campbell II. The book argues for health benefits of a whole food plant-based diet. It was first published in the United States in January 2005 and had sold over one million copies as of October 2013, making it one of America's best-selling books about nutrition.
5 A Day is any of various national campaigns in developed countries such as the United States, the United Kingdom, France, and Germany, to encourage the consumption of at least five portions of fruit and vegetables each day, following a recommendation by the World Health Organization that individuals consume "a minimum of 400g of fruit and vegetables per day ." A meta-analysis of the many studies of this issue was published in 2017 and found that consumption of double the minimum recommendation – 800g or ten a day – provided an increased protection against all forms of mortality. In some places, people are being encouraged to aim for not just five portions a day, but seven.
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Cancer prevention is the practice of taking active measures to decrease the incidence of cancer and mortality. The practice of prevention is dependent upon both individual efforts to improve lifestyle and seek preventive screening, and socioeconomic or public policy related to cancer prevention. Globalized cancer prevention is regarded as a critical objective due to its applicability to large populations, reducing long term effects of cancer by promoting proactive health practices and behaviors, and its perceived cost-effectiveness and viability for all socioeconomic classes.
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