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

Raul Zamora-Ros; Sabina Rinaldi; Konstantinos K. Tsilidis; Elisabete Weiderpass; Marie Christine Boutron-Ruault; Agnetha Linn Rostgaard-Hansen; Anne Tjønneland; Françoise Clavel-Chapelon; Sylvie Mesrine; Verena A. Katzke; Tilman Kühn; Jana Förster; Heiner Boeing; Antonia Trichopoulou; Pagona Lagiou; Eleni Klinaki; Giovanna Masala; Sabina Sieri; Fulvio Ricceri; Rosario Tumino; Amalia Mattiello; Petra H.M. Peeters; H. B. Bueno-De-Mesquita; Dagrun Engeset; Guri Skeie; Marcial Argüelles; Antonio Agudo; María José Sánchez; María Dolores Chirlaque; Aurelio Barricarte; Saioa Chamosa; Martin Almquist; Ada Tosovic; Joakim Hennings; Maria Sandström; Julie A. Schmidt; Kay Thee Khaw; Nicholas J. Wareham; Amanda J. Cross; Nadia Slimani; Graham Byrnes; Isabelle Romieu; Elio Riboli; Silvia Franceschi

doi:10.1002/ijc.29693

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

Raul Zamora-Ros, Sabina Rinaldi, Konstantinos K. Tsilidis, Elisabete Weiderpass, Marie Christine Boutron-Ruault, Agnetha Linn Rostgaard-Hansen, Anne Tjønneland, Françoise Clavel-Chapelon, Sylvie Mesrine, Verena A. Katzke, Tilman Kühn, Jana Förster, Heiner Boeing, Antonia Trichopoulou, Pagona Lagiou, Eleni Klinaki, Giovanna Masala, Sabina Sieri, Fulvio Ricceri, Rosario TuminoAmalia Mattiello, Petra H.M. Peeters, H. B. Bueno-De-Mesquita, Dagrun Engeset, Guri Skeie, Marcial Argüelles, Antonio Agudo, María José Sánchez, María Dolores Chirlaque, Aurelio Barricarte, Saioa Chamosa, Martin Almquist, Ada Tosovic, Joakim Hennings, Maria Sandström, Julie A. Schmidt, Kay Thee Khaw, Nicholas J. Wareham, Amanda J. Cross, Nadia Slimani, Graham Byrnes, Isabelle Romieu, Elio Riboli, Silvia Franceschi^*

^*Corresponding author for this work

14 Citations (Scopus)

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 (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.

Original language	English
Journal	International Journal of Cancer
Volume	138
Issue number	1
Pages (from-to)	65-73
Number of pages	9
ISSN	0020-7136
DOIs	https://doi.org/10.1002/ijc.29693
Publication status	Published - 2016
Externally published	Yes

Keywords

Differentiated thyroid carcinomas
EPIC
Glycemic index
Macronutrients
Total energy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Zamora-Ros, R., Rinaldi, S., Tsilidis, K. K., Weiderpass, E., Boutron-Ruault, M. C., Rostgaard-Hansen, A. L., Tjønneland, A., Clavel-Chapelon, F., Mesrine, S., Katzke, V. A., Kühn, T., Förster, J., Boeing, H., Trichopoulou, A., Lagiou, P., Klinaki, E., Masala, G., Sieri, S., Ricceri, F., ... Franceschi, S. (2016). Energy and macronutrient intake and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition study. International Journal of Cancer, 138(1), 65-73. https://doi.org/10.1002/ijc.29693

Energy and macronutrient intake and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition study. / Zamora-Ros, Raul; Rinaldi, Sabina; Tsilidis, Konstantinos K. et al.

In: International Journal of Cancer, Vol. 138, No. 1, 2016, p. 65-73.

Research output: Contribution to journal › Journal article › Research › peer-review

Zamora-Ros, R, Rinaldi, S, Tsilidis, KK, Weiderpass, E, Boutron-Ruault, MC, Rostgaard-Hansen, AL , Tjønneland, A, Clavel-Chapelon, F, Mesrine, S, Katzke, VA, Kühn, T, Förster, J, Boeing, H, Trichopoulou, A, Lagiou, P, Klinaki, E, Masala, G, Sieri, S, Ricceri, F, Tumino, R, Mattiello, A, Peeters, PHM, Bueno-De-Mesquita, HB, Engeset, D, Skeie, G, Argüelles, M, Agudo, A, Sánchez, MJ, Chirlaque, MD, Barricarte, A, Chamosa, S, Almquist, M, Tosovic, A, Hennings, J, Sandström, M, Schmidt, JA, Khaw, KT, Wareham, NJ, Cross, AJ, Slimani, N, Byrnes, G, Romieu, I, Riboli, E & Franceschi, S 2016, 'Energy and macronutrient intake and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition study', International Journal of Cancer, vol. 138, no. 1, pp. 65-73. https://doi.org/10.1002/ijc.29693

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title = "Energy and macronutrient intake and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition study",

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 (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. ",

keywords = "Differentiated thyroid carcinomas, EPIC, Glycemic index, Macronutrients, Total energy",

author = "Raul Zamora-Ros and Sabina Rinaldi and Tsilidis, {Konstantinos K.} and Elisabete Weiderpass and Boutron-Ruault, {Marie Christine} and Rostgaard-Hansen, {Agnetha Linn} and Anne Tj{\o}nneland and Fran{\c c}oise Clavel-Chapelon and Sylvie Mesrine and Katzke, {Verena A.} and Tilman K{\"u}hn and Jana F{\"o}rster and Heiner Boeing and Antonia Trichopoulou and Pagona Lagiou and Eleni Klinaki and Giovanna Masala and Sabina Sieri and Fulvio Ricceri and Rosario Tumino and Amalia Mattiello and Peeters, {Petra H.M.} and Bueno-De-Mesquita, {H. B.} and Dagrun Engeset and Guri Skeie and Marcial Arg{\"u}elles and Antonio Agudo and S{\'a}nchez, {Mar{\'i}a Jos{\'e}} and Chirlaque, {Mar{\'i}a Dolores} and Aurelio Barricarte and Saioa Chamosa and Martin Almquist and Ada Tosovic and Joakim Hennings and Maria Sandstr{\"o}m and Schmidt, {Julie A.} and Khaw, {Kay Thee} and Wareham, {Nicholas J.} and Cross, {Amanda J.} and Nadia Slimani and Graham Byrnes and Isabelle Romieu and Elio Riboli and Silvia Franceschi",

year = "2016",

doi = "10.1002/ijc.29693",

language = "English",

volume = "138",

pages = "65--73",

journal = "International Journal of Cancer. Supplement",

issn = "0898-6924",

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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 - 0898-6924

VL - 138

SP - 65

EP - 73

JO - International Journal of Cancer. Supplement

JF - International Journal of Cancer. Supplement

IS - 1

ER -

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

Abstract

Keywords

UN SDGs

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