Format

Send to

Choose Destination
Int J Cancer. 2016 Jan 1;138(1):65-73. doi: 10.1002/ijc.29693. Epub 2015 Jul 30.

Energy and macronutrient intake and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition study.

Author information

1
International Agency for Research on Cancer (IARC), Lyon, France.
2
Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
3
School of Public Health, Imperial College London, London, United Kingdom.
4
Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
5
Department of Etiological Cancer Research, Cancer Registry of Norway, Oslo, Norway.
6
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
7
Department of Genetic Epidemiology, Folkhälsan Research Center, Helsinki, Finland.
8
Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, Villejuif, France.
9
Université Paris Sud, UMRS 1018, Villejuif, France.
10
Institut Gustave Roussy, Villejuif, France.
11
Danish Cancer Society Research Center, Copenhagen, Denmark.
12
Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
13
Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
14
Hellenic Health Foundation, Athens, Greece.
15
Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.
16
Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.
17
Department of Epidemiology, Harvard School of Public Health, Boston, MA.
18
Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy.
19
Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy.
20
Unit of Cancer Epidemiology - CERMS, Department of Medical Sciences, University of Turin and Città Della Salute E Della Scienza Hospital, Turin, Italy.
21
Cancer Registry and Histopathology Unit, "Civic M.P. Arezzo" Hospital, ASP Ragusa, Italy.
22
Dipartimento Di Medicina Clinica E Chirurgia, Federico II University, Naples, Italy.
23
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
24
National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
25
Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
26
Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
27
The Norwegian Scientific Committee for Food Safety (VKM), Oslo, Norway.
28
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
29
Public Health Directorate, Asturias, Spain.
30
Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Barcelona, Spain.
31
Escuela Andaluza De Salud Pública, Instituto De Investigación Biosanitaria (ibs.GRANADA), Hospitales Universitarios De Granada/Universidad De Granada, Granada, Spain.
32
CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain.
33
Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain.
34
Public Health Institute of Navarra, Pamplona, Spain.
35
Public Health Division of Gipuzkoa, BioDonostia Research Institute, Health Department of Basque Region, San Sebastian.
36
Department of Surgery, University Hospital Lund, Lund, Sweden.
37
Department of Surgery, University Hospital Malmö, Malmö, Sweden.
38
Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
39
Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden.
40
Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom.
41
Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
42
MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.

Abstract

Incidence rates of differentiated thyroid carcinoma (TC) have increased in many countries. Adiposity and dietary risk factors may play a role, but little is known on the influence of energy intake and macronutrient composition. The aim of this study was to investigate the associations between TC and the intake of energy, macronutrients, glycemic index (GI) and glycemic load in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,274 middle-age participants (70.2% women) from ten European countries. Dietary data were collected using country-specific validated dietary questionnaires. Total carbohydrates, proteins, fats, saturated, monounsaturated and polyunsaturated fats (PUFA), starch, sugar, and fiber were computed as g/1,000 kcal. Multivariable Cox regression was used to calculate multivariable adjusted hazard ratios (HR) and 95% confidence interval (CI) by intake quartile (Q). After a mean follow-up time of 11 years, differentiated TC was diagnosed in 556 participants (90% women). Overall, we found significant associations only with total energy (HRQ4 vs .Q1 , 1.29; 95% CI, 1.00-1.68) and PUFA intakes (HRQ4 vs .Q1 , 0.74; 95% CI, 0.57-0.95). However, the associations with starch and sugar intake and GI were significantly heterogeneous across body mass index (BMI) groups, i.e., positive associations with starch and GI were found in participants with a BMI ≥ 25 and with sugar intake in those with BMI < 25. Moreover, inverse associations with starch and GI were observed in subjects with BMI < 25. In conclusion, our results suggest that high total energy and low PUFA intakes may increase the risk of differentiated TC. Positive associations with starch intake and GI in participants with BMI ≥ 25 suggest that those persons may have a greater insulin response to high starch intake and GI than lean people.

KEYWORDS:

EPIC; differentiated thyroid carcinomas; glycemic index; macronutrients; total energy

PMID:
26190646
DOI:
10.1002/ijc.29693
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center