TY - JOUR
T1 - Energy and macronutrient intake and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition study
AU - Zamora-Ros, Raul
AU - Rinaldi, Sabina
AU - Tsilidis, Konstantinos K.
AU - Weiderpass, Elisabete
AU - Boutron-Ruault, Marie Christine
AU - Rostgaard-Hansen, Agnetha Linn
AU - Tjønneland, Anne
AU - Clavel-Chapelon, Françoise
AU - Mesrine, Sylvie
AU - Katzke, Verena A.
AU - Kühn, Tilman
AU - Förster, Jana
AU - Boeing, Heiner
AU - Trichopoulou, Antonia
AU - Lagiou, Pagona
AU - Klinaki, Eleni
AU - Masala, Giovanna
AU - Sieri, Sabina
AU - Ricceri, Fulvio
AU - Tumino, Rosario
AU - Mattiello, Amalia
AU - Peeters, Petra H.M.
AU - Bueno-De-Mesquita, H. B.
AU - Engeset, Dagrun
AU - Skeie, Guri
AU - Argüelles, Marcial
AU - Agudo, Antonio
AU - Sánchez, María José
AU - Chirlaque, María Dolores
AU - Barricarte, Aurelio
AU - Chamosa, Saioa
AU - Almquist, Martin
AU - Tosovic, Ada
AU - Hennings, Joakim
AU - Sandström, Maria
AU - Schmidt, Julie A.
AU - Khaw, Kay Thee
AU - Wareham, Nicholas J.
AU - Cross, Amanda J.
AU - Slimani, Nadia
AU - Byrnes, Graham
AU - Romieu, Isabelle
AU - Riboli, Elio
AU - Franceschi, Silvia
PY - 2016
Y1 - 2016
N2 - 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 (HR Q4 vs .Q1 , 1.29; 95% CI, 1.00-1.68) and PUFA intakes (HR Q4 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. What's New? The role of lifestyle factors in the growing numbers of thyroid cancer remains unclear. Here, the authors uncover associations with high total energy intake and low consumption of polyunsaturated fatty acids in a large European cohort (EPIC). They further find positive associations with starch intake and glycemic index only in people with a body mass index equal or larger than 25, possibly implicating an altered insulin response in the etiology of this cancer.
AB - 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 (HR Q4 vs .Q1 , 1.29; 95% CI, 1.00-1.68) and PUFA intakes (HR Q4 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. What's New? The role of lifestyle factors in the growing numbers of thyroid cancer remains unclear. Here, the authors uncover associations with high total energy intake and low consumption of polyunsaturated fatty acids in a large European cohort (EPIC). They further find positive associations with starch intake and glycemic index only in people with a body mass index equal or larger than 25, possibly implicating an altered insulin response in the etiology of this cancer.
KW - Differentiated thyroid carcinomas
KW - EPIC
KW - Glycemic index
KW - Macronutrients
KW - Total energy
U2 - 10.1002/ijc.29693
DO - 10.1002/ijc.29693
M3 - Journal article
C2 - 26190646
AN - SCOPUS:84944232067
SN - 0020-7136
VL - 138
SP - 65
EP - 73
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 1
ER -