Suchergebnisse

Aims: The hypothesis of 'metabolically healthy obesity' implies that, in the absence of metabolic dysfunction, individuals with excess adiposity are not at greater cardiovascular risk. We tested this hypothesis in a large pan-European prospective study. Methods and results: We conducted a case-cohort analysis in the 520 000-person European Prospective Investigation into Cancer and Nutrition study ('EPIC-CVD'). During a median follow-up of 12.2 years, we recorded 7637 incident coronary heart disease (CHD) cases. Using cut-offs recommended by guidelines, we defined obesity and overweight using body mass index (BMI), and metabolic dysfunction ('unhealthy') as >_ 3 of elevated blood pressure, hypertriglyceridaemia, low HDL-cholesterol, hyperglycaemia, and elevated waist circumference. We calculated hazard ratios (HRs) and 95% confidence intervals (95% CI) within each country using Prentice-weighted Cox proportional hazard regressions, accounting for age, sex, centre, education, smoking, diet, and physical activity. Compared with metabolically healthy normal weight people (reference), HRs were 2.15 (95% CI: 1.79; 2.57) for unhealthy normal weight, 2.33 (1.97; 2.76) for unhealthy overweight, and 2.54 (2.21; 2.92) for unhealthy obese people. Compared with the reference group, HRs were 1.26 (1.14; 1.40) and 1.28 (1.03; 1.58) for metabolically healthy overweight and obese people, respectively. These results were robust to various sensitivity analyses. Conclusion: Irrespective of BMI, metabolically unhealthy individuals had higher CHD risk than their healthy counterparts. Conversely, irrespective of metabolic health, overweight and obese people had higher CHD risk than lean people. These findings challenge the concept of 'metabolically healthy obesity', encouraging population-wide strategies to tackle obesity. ; European Union (EU) HEALTH-F2-2012-279233 ; European Research Council (ERC) 268834 ; Medical Research Council UK (MRC) G0800270 MR/L003120/1 MR/M012190/1 ; British Heart Foundation SP/09/002 RG/08/014 RG13/13/30194 ; National Institute for Health Research (NIHR) ; Regional Government of Asturias ; Hellenic Health Foundation ; German Cancer Aid, German Cancer Research Centre, German Federal Ministry of Education and Research ; Cancer Research UK 570/A16491 ; Regione Sicilia ; Associazione Iblea per la Ricerca Epidemiologica (A.I.R.E.) - ONLUS Ragusa ; Associazione Volontari Italiani Sangue AVIS Ragusa ; Compagnia di San Paolo ; Human Genetics Foundation-Torino (HuGeF) ; British Heart Foundation RG/13/13/30194 RG/08/014/24067 ; Cancer Research UK 16491 ; Medical Research Council UK (MRC) MR/L003120/1 G0800270 MC_UU_12015/1 ; National Institute for Health Research (NIHR) NF-SI-0512-10135 NF-SI-0512-10165 ; Novo Nordisk Foundation NNF17OC0026936

There is uncertainty about the relevance of animal foods to the pathogenesis of ischemic heart disease (IHD). We examined meat, fish, dairy products, and eggs and risk for IHD in the pan-European EPIC cohort (European Prospective Investigation Into Cancer and Nutrition). Risk for IHD was positively associated with consumption of red and processed meat and inversely associated with consumption of yogurt, cheese, and eggs, although the associations with yogurt and eggs may be influenced by reverse causation bias. It is not clear whether the associations with red and processed meat and cheese reflect causality, but they were consistent with the associations of these foods with plasma non–high-density lipoprotein cholesterol and for red and processed meat with systolic blood pressure, which could mediate such effects. ; Analyses were supported by the UK Medical Research Council (MR/M012190/1), Cancer Research UK (C8221/A19170 and 570/A16491), and the Wellcome Trust (Our Planet Our Health, Livestock Environment and People 205212/Z/16/Z). The project (EPIC-CVD) has been supported by the European Union Framework 7 (HEALTH-F2-2012–279233), the European Research Council (268834), the UK Medical Research Council (G0800270 and MR/L003120/1), the British Heart Foundation (SP/09/002, RG/08/014, and RG13/13/30194), and the UK National Institute of Health Research. The coordination of EPIC is financially supported by the European Commission and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, and Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center, Federal Ministry of Education and Research, Deutsche Krebshilfe, Deutsches Krebsforschungszentrum, and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Italian Association for Research on Cancer, National Research Council (Italy) and Ministero dell'Istruzione dell'Università e della Ricerca "Dipartimenti di Eccellenza" (Project D15D18000410001) to the Department of Medical Sciences (Italy); Dutch Ministry of Public Health, Welfare and Sports, Netherlands Cancer Registry, LK Research Funds, Dutch Prevention Funds, Dutch Zorg Onderzoek Nederland, World Cancer Research Fund; Health Research Fund, PI13/00061 to Granada, PI13/01162 to EPIC-Murcia, regional governments of Andalucía, Asturias, Basque Country, Murcia (No. 6236), and Navarra, Instituto de Salud Carlos III (ISCIII RETIC RD06/0020) (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/ A16491 and C8221/A19170 to EPIC-Oxford), UK Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford, MC_UU_12015/1 (Drs Langenberg and Wareham), and MC_UU_12015/5 (Dr Forouhi), and National Institute for Health Research Biomedical Research Center Cambridge: Nutrition, Diet, and Lifestyle Research Theme (IS-BRC-1215–20014) to the Medical Research Council Epidemiology Unit Cambridge. Dr Bradbury holds the Girdlers' New Zealand Health Research Council Fellowship. Dr Steur received Core Medical Research Council Unit support through the Nutritional Epidemiology Program (MC_UU_12015/5) while at the Medical Research Council Epidemiology Unit and received funding from the Alpro Foundation while at the Cardiovascular Epidemiology Unit. John Danesh holds a British Heart Foundation Professorship, National Institute for Health Research Senior Investigator Award, and European Research Council Senior Investigator Award. The authors assume full responsibility for analyses and interpretation of these data.

All author: Aurora Perez-Cornago, Paul N. Appleby, Tobias Pischon, Konstantinos K. Tsilidis, Anne Tjønneland, Anja Olsen, Kim Overvad, Rudolf Kaaks, Tilman Kühn, Heiner Boeing, Annika Steffen, Antonia Trichopoulou, Pagona Lagiou, Maria Kritikou, Vittorio Krogh, Domenico Palli, Carlotta Sacerdote, Rosario Tumino, H. Bas Bueno-de-Mesquita, Antonio Agudo, Nerea Larrañaga, Elena Molina-Portillo, Aurelio Barricarte, Maria-Dolores Chirlaque, J. Ramón Quirós, Pär Stattin, Christel Häggström, Nick Wareham, Kay-Tee Khaw, Julie A. Schmidt, Marc Gunter, Heinz Freisling, Dagfinn Aune, Heather Ward, Elio Riboli, Timothy J. Key and Ruth C. Travis ; Background: The relationship between body size and prostate cancer risk, and in particular risk by tumour characteristics, is not clear because most studies have not differentiated between high-grade or advanced stage tumours, but rather have assessed risk with a combined category of aggressive disease. We investigated the association of height and adiposity with incidence of and death from prostate cancer in 141,896 men in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Methods: Multivariable-adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average of 13.9 years of follow-up, there were 7024 incident prostate cancers and 934 prostate cancer deaths. Results: Height was not associated with total prostate cancer risk. Subgroup analyses showed heterogeneity in the association with height by tumour grade (Pheterogeneity = 0.002), with a positive association with risk for high-grade but not low-intermediate-grade disease (HR for high-grade disease tallest versus shortest fifth of height, 1.54; 95% CI, 1.18–2.03). Greater height was also associated with a higher risk for prostate cancer death (HR = 1.43, 1.14–1.80). Body mass index (BMI) was significantly inversely associated with total prostate cancer, but there was evidence of heterogeneity by tumour grade (Pheterogeneity = 0.01; HR = 0.89, 0.79–0.99 for low-intermediate grade and HR = 1.32, 1.01–1.72 for highgrade prostate cancer) and stage (Pheterogeneity = 0.01; HR = 0.86, 0.75–0.99 for localised stage and HR = 1.11, 0.92–1.33 for advanced stage). BMI was positively associated with prostate cancer death (HR = 1.35, 1.09–1.68). The results for waist circumference were generally similar to those for BMI, but the associations were slightly stronger for high-grade (HR = 1.43, 1.07–1.92) and fatal prostate cancer (HR = 1.55, 1.23–1.96). Conclusions: The findings from this large prospective study show that men who are taller and who have greater adiposity have an elevated risk of high-grade prostate cancer and prostate cancer death. ; These analyses were supported by Cancer Research UK (C8221/A19170). The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS) PI13/ 00061 (EPIC-Granada) and, PI13/01162 (EPIC-Murcia), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, ISCIII Health Research Funds RD12/0036/0018 (cofounded by FEDER funds/European Regional Development Fund ERDF) (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 for EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (UK).

All autor: Ju-Sheng ZhengEmail, Stephen J. Sharp, Fumiaki Imamura, Albert Koulman, Matthias B. Schulze, Zheng Ye, Jules Griffin, Marcela Guevara, José María Huerta, Janine Kröger, Ivonne Sluijs, Antonio Agudo, Aurelio Barricarte, Heiner Boeing, Sandra Colorado-Yohar, Courtney Dow, Miren Dorronsoro, Pia T. Dinesen, Guy Fagherazzi, Paul W. Franks, Edith J. M. Feskens, Tilman Kühn, Verena Andrea Katzke, Timothy J. Key, Kay-Tee Khaw, Maria Santucci de Magistris, Francesca Romana Mancini, Elena Molina-Portillo, Peter M. Nilsson, Anja Olsen, Kim Overvad, Domenico Palli, Jose Ramón Quirós, Olov Rolandsson, Fulvio Ricceri, Annemieke M. W. Spijkerman, Nadia Slimani, Giovanna Tagliabue, Anne Tjonneland, Rosario Tumino, Yvonne T. van der Schouw, Claudia Langenberg, Elio Riboli, Nita G. Forouhi and Nicholas J. Wareham ; Background: Accumulating evidence suggests that individual circulating saturated fatty acids (SFAs) are heterogeneous in their associations with cardio-metabolic diseases, but evidence about associations of SFAs with metabolic markers of different pathogenic pathways is limited. We aimed to examine the associations between plasma phospholipid SFAs and the metabolic markers of lipid, hepatic, glycaemic and inflammation pathways. Methods: We measured nine individual plasma phospholipid SFAs and derived three SFA groups (odd-chain: C15:0 + C17:0, even-chain: C14:0 + C16:0 + C18:0, and very-long-chain: C20:0 + C22:0 + C23:0 + C24:0) in individuals from the subcohort of the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study across eight European countries. Using linear regression in 15,919 subcohort members, adjusted for potential confounders and corrected for multiple testing, we examined cross-sectional associations of SFAs with 13 metabolic markers. Multiplicative interactions of the three SFA groups with pre-specified factors, including body mass index (BMI) and alcohol consumption, were tested. Results: Higher levels of odd-chain SFA group were associated with lower levels of major lipids (total cholesterol (TC), triglycerides, apolipoprotein A-1 (ApoA1), apolipoprotein B (ApoB)) and hepatic markers (alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT)). Higher even-chain SFA group levels were associated with higher levels of low-density lipoprotein cholesterol (LDL-C), TC/high-density lipoprotein cholesterol (HDL-C) ratio, triglycerides, ApoB, ApoB/A1 ratio, ALT, AST, GGT and CRP, and lower levels of HDL-C and ApoA1. Very-long-chain SFA group levels showed inverse associations with triglycerides, ApoA1 and GGT, and positive associations with TC, LDL-C, TC/HDL-C, ApoB and ApoB/A1. Associations were generally stronger at higher levels of BMI or alcohol consumption. Conclusions: Subtypes of SFAs are associated in a differential way with metabolic markers of lipid metabolism, liver function and chronic inflammation, suggesting that odd-chain SFAs are associated with lower metabolic risk and even-chain SFAs with adverse metabolic risk, whereas mixed findings were obtained for very-long-chain SFAs. The clinical and biochemical implications of these findings may vary by adiposity and alcohol intake. ; Funding for the InterAct project was provided by the EU FP6 programme (grant number LSHM_CT_2006_037197). In addition, InterAct investigators acknowledge funding from the following agencies: Medical Research Council Epidemiology Unit MC_UU_12015/1 and MC_UU_12015/5, Medical Research Council Human Nutrition Research MC_UP_A090_1006, Cambridge Lipidomics Biomarker Research Initiative (G0800783), and NIHR Biomedical Research Centre Cambridge: Nutrition, Diet, and Lifestyle Research Theme (IS-BRC-1215-20014). IS and YTvdS: Verification of diabetes cases was additionally funded by NL Agency grant IGE05012 and an Incentive Grant from the Board of the UMC Utrecht (The Netherlands). AMWS: Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands). PWF: Swedish Research Council, Novo Nordisk, Swedish Heart Lung Foundation, Swedish Diabetes Association. TK: Cancer Research UK C8221/A19170 and C570/A16491 Medical Research Council MR/M012190/1. KO and AT: Danish Cancer Society. JRQ: Asturias Regional Government. RT: AIRE-ONLUS Ragusa, AVIS-Ragusa, Sicilian Regional Government. Additionally, Red Temática de Investigación Cooperativa en Cáncer of the Instituto de Salud Carlos III (ISCIII RTICC RD12/0036/0018), Instituto de Salud Carlos III (PIE14/00045), cofounded by FEDER funds/European Regional Development Fund (ERDF); German Cancer Aid, German Ministry of Research (BMBF); Compagnia di San Paolo; Imperial College Biomedical Research Centre. JSZ is supported by the Cambridge Initiative-Nutrition (RG71466, SJAH/004) and Marie Skłodowska-Curie Fellowships (701708, RG82205, SJAI/051).

Background: Life expectancy is increasing in Europe, yet a substantial proportion of adults still die prematurely before the age of 70 years. We sought to estimate the joint and relative contributions of tobacco smoking, hypertension, obesity, physical inactivity, alcohol and poor diet towards risk of premature death. Methods: We analysed data from 264,906 European adults from the EPIC prospective cohort study, aged between 40 and 70 years at the time of recruitment. Flexible parametric survival models were used to model risk of death conditional on risk factors, and survival functions and attributable fractions (AF) for deaths prior to age 70 years were calculated based on the fitted models. Results: We identified 11,930 deaths which occurred before the age of 70. The AF for premature mortality for smoking was 31 % (95 % confidence interval (CI), 31–32 %) and 14 % (95 % CI, 12–16 %) for poor diet. Important contributions were also observed for overweight and obesity measured by waist-hip ratio (10 %; 95 % CI, 8–12 %) and high blood pressure (9 %; 95 % CI, 7–11 %). AFs for physical inactivity and excessive alcohol intake were 7 % and 4 %, respectively. Collectively, the AF for all six risk factors was 57 % (95 % CI, 55–59 %), being 35 % (95 % CI, 32–37 %) among never smokers and 74 % (95 % CI, 73–75 %) among current smokers. Conclusions: While smoking remains the predominant risk factor for premature death in Europe, poor diet, overweight and obesity, hypertension, physical inactivity, and excessive alcohol consumption also contribute substantially. Any attempt to minimise premature deaths will ultimately require all six factors to be addressed. ; This work was supported by the French Social Affairs & Health Ministry, Department of Health (Direction Générale de la Santé). The work undertaken by David C Muller for this project was performed during the tenure of an IARC-Australia fellowship supported by Cancer Council Australia. Elio Riboli was supported by the Imperial College Biomedical Research Centre funded by the National Institute of Health Research of UK. The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Nordic Centre of Excellence programme on Food, Nutrition and Health. (Norway); Health Research Fund (FIS), PI13/00061 to Granada, Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Scientific Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk) (United Kingdom). The sponsors did not have any input into study design, study conduct, data collection, analysis, or interpretation nor did they influence the preparation, review, or approval of the manuscript.

En la actualidad, el impacto de las noticias falseadas ha aumentado de forma exponencial debido, en parte, a la facilidad con que pueden difundirse por medio de las redes sociales. Esto convierte a los jóvenes, usuarios mayoritarios de las redes sociales, en el grupo más expuesto a este tipo de noticias, las cuales suelen incluir información numérica representada de distintas formas. En este trabajo se pretende estudiar el efecto de la representación (frecuencia, gráfica, porcentaje o probabilidad) en que se presenta una determinada información sesgada en el nivel de alfabetización estadística de estudiantes de Bachillerato. Los resultados muestran un bajo nivel de alfabetización estadística de los estudiantes independientemente de la forma en que venga dada la información, con una ligera mejoría en el caso en que la información se presente en forma de frecuencia.

The digital media has acquired an important role during the pandemic, which reflects our need to be competent in detecting news that may be biased. Therefore, the results of a study of 373 Spanish citizens are presented with the aim of analyzing their opinions towards COVID-19 biased news. It is concluded that participants have an indifferent disposition, with a negative tendency, towards the news above mentioned. Nevertheless, it becomes more positive as the political tendency moves towards the left. ; Los medios digitales de comunicación han adquirido un papel fundamental durante la pandemia, reflejando la necesidad de ser competentes para detectar noticias que puedan estar sesgadas. Por ello, se presentan los resultados de un estudio con 373 ciudadanos españoles con el interés de analizar su opinión ante noticias sesgadas sobre la COVID-19. Se concluye que los participantes tienen una disposición indiferente tendiendo a negativa frente a estas noticias, aunque ésta es más positiva a medida que la tendencia política se acerca a la izquierda.

BACKGROUND: Life expectancy is increasing in Europe, yet a substantial proportion of adults still die prematurely before the age of 70 years. We sought to estimate the joint and relative contributions of tobacco smoking, hypertension, obesity, physical inactivity, alcohol and poor diet towards risk of premature death. METHODS: We analysed data from 264,906 European adults from the EPIC prospective cohort study, aged between 40 and 70 years at the time of recruitment. Flexible parametric survival models were used to model risk of death conditional on risk factors, and survival functions and attributable fractions (AF) for deaths prior to age 70 years were calculated based on the fitted models. RESULTS: We identified 11,930 deaths which occurred before the age of 70. The AF for premature mortality for smoking was 31 % (95 % confidence interval (CI), 31–32 %) and 14 % (95 % CI, 12–16 %) for poor diet. Important contributions were also observed for overweight and obesity measured by waist-hip ratio (10 %; 95 % CI, 8–12 %) and high blood pressure (9 %; 95 % CI, 7–11 %). AFs for physical inactivity and excessive alcohol intake were 7 % and 4 %, respectively. Collectively, the AF for all six risk factors was 57 % (95 % CI, 55–59 %), being 35 % (95 % CI, 32–37 %) among never smokers and 74 % (95 % CI, 73–75 %) among current smokers. CONCLUSIONS: While smoking remains the predominant risk factor for premature death in Europe, poor diet, overweight and obesity, hypertension, physical inactivity, and excessive alcohol consumption also contribute substantially. Any attempt to minimise premature deaths will ultimately require all six factors to be addressed. ; This work was supported by the French Social Affairs & Health Ministry, Department of Health (Direction Générale de la Santé). The work undertaken by David C Muller for this project was performed during the tenure of an IARC-Australia fellowship supported by Cancer Council Australia. Elio Riboli was supported by the Imperial College Biomedical Research Centre funded by the National Institute of Health Research of UK. The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Nordic Centre of Excellence programme on Food, Nutrition and Health. (Norway); Health Research Fund (FIS), PI13/00061 to Granada, Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Scientific Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk) (United Kingdom).