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Featured researches published by M. J. Tormo.


British Journal of Cancer | 2008

Animal foods, protein, calcium and prostate cancer risk: the European Prospective Investigation into Cancer and Nutrition

Naomi E. Allen; Timothy J. Key; Paul N. Appleby; Ruth C. Travis; Andrew W. Roddam; Anne Tjønneland; Nina Føns Johnsen; Kim Overvad; J. Linseisen; Sabine Rohrmann; Heiner Boeing; Tobias Pischon; H. B. Bueno-de-Mesquita; Lambertus A. Kiemeney; Giovanna Tagliabue; Domenico Palli; Paolo Vineis; R. Tumino; Antonia Trichopoulou; Christina Kassapa; D. Trichopoulos; E. Ardanaz; Nerea Larrañaga; M. J. Tormo; Clementina González; J. R. Quiros; M. J. Sánchez; S. Bingham; Kay-Tee Khaw; Jonas Manjer

We examined consumption of animal foods, protein and calcium in relation to risk of prostate cancer among 142 251 men in the European Prospective Investigation into Cancer and Nutrition. Associations were examined using Cox regression, stratified by recruitment centre and adjusted for height, weight, education, marital status and energy intake. After an average of 8.7 years of follow-up, there were 2727 incident cases of prostate cancer, of which 1131 were known to be localised and 541 advanced-stage disease. A high intake of dairy protein was associated with an increased risk, with a hazard ratio for the top versus the bottom fifth of intake of 1.22 (95% confidence interval (CI): 1.07–1.41, Ptrend=0.02). After calibration to allow for measurement error, we estimated that a 35-g day−1 increase in consumption of dairy protein was associated with an increase in the risk of prostate cancer of 32% (95% CI: 1–72%, Ptrend=0.04). Calcium from dairy products was also positively associated with risk, but not calcium from other foods. The results support the hypothesis that a high intake of protein or calcium from dairy products may increase the risk for prostate cancer.


Diabetes Care | 2011

Mediterranean diet and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study: the InterAct project.

Dora Romaguera; Marcela Guevara; Teresa Norat; Claudia Langenberg; Nita G. Forouhi; Stephen J. Sharp; Nadia Slimani; Matthias B. Schulze; Brian Buijsse; Genevieve Buckland; Esther Molina-Montes; M. J. Sánchez; Mc Moreno-Iribas; Benedetta Bendinelli; Sara Grioni; Y. T. van der Schouw; Larraitz Arriola; J. W. J. Beulens; Heiner Boeing; F. Clavel-Chapelon; Cottet; F. Crowe; B. de Lauzon-Guillan; Paul W. Franks; Clementina González; G. Hallmans; R. Kaaks; T. Key; Kay-Tee Khaw; Peter Nilsson

OBJECTIVE To study the association between adherence to the Mediterranean dietary pattern (MDP) and risk of developing type 2 diabetes, across European countries. RESEARCH DESIGN AND METHODS We established a case-cohort study including 11,994 incident type 2 diabetic case subjects and a stratified subcohort of 15,798 participants selected from a total cohort of 340,234 participants with 3.99 million person-years of follow-up, from eight European cohorts participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The relative Mediterranean diet score (rMED) (score range 0–18) was used to assess adherence to MDP on the basis of reported consumption of nine dietary components characteristic of the Mediterranean diet. Cox proportional hazards regression, modified for the case-cohort design, was used to estimate the association between rMED and risk of type 2 diabetes, adjusting for confounders. RESULTS The multiple adjusted hazard ratios of type 2 diabetes among individuals with medium (rMED 7–10 points) and high adherence to MDP (rMED 11–18 points) were 0.93 (95% CI 0.86–1.01) and 0.88 (0.79–0.97), respectively, compared with individuals with low adherence to MDP (0–6 points) (P for trend 0.013). The association between rMED and type 2 diabetes was attenuated in people <50 years of age, in obese participants, and when the alcohol, meat, and olive oil components were excluded from the score. CONCLUSIONS In this large prospective study, adherence to the MDP, as defined by rMED, was associated with a small reduction in the risk of developing type 2 diabetes in this European population.


European Journal of Clinical Nutrition | 2007

Diet, serum insulin-like growth factor-I and IGF-binding protein-3 in European women

Teresa Norat; Laure Dossus; S. Rinaldi; Kim Overvad; Henning Grønbæk; Anne Tjønneland; A. Olsen; F. Clavel-Chapelon; M. C. Boutron-Ruault; Heiner Boeing; Petra H. Lahmann; J. Linseisen; Gabriele Nagel; Antonia Trichopoulou; Dimitrios Trichopoulos; Victoria Kalapothaki; S. Sieri; Domenico Palli; Salvatore Panico; R. Tumino; Carlotta Sacerdote; H. B. Bueno-de-Mesquita; P.H.M. Peeters; C. H. van Gils; Antonio Agudo; Pilar Amiano; E. Ardanoz; Carmen Martinez; Ramón Quirós; M. J. Tormo

Objective:The aim of this study was to examine the relationship of diet with serum insulin-like growth factor-I (IGF-I) and IGF-binding protein-3 in women.Design:Cross-sectional study.Setting and subjects:The population are 2109 women who were control subjects in a case–control study of breast cancer nested in the European Prospective Investigation into Cancer and Nutrition. Control subjects were randomly chosen among risk sets consisting of female cohort members alive and free of cancer (except non-melanoma skin cancer) at the time of diagnosis of the index case. Matching criteria were age at enrolment, follow-up time, time of the day of blood collection and study centre. Diet was measured through validated questionnaires. Serum hormone concentrations were measured by enzyme-linked immunosorbent assays. The relationship between serum IGF-I, IGFBP-3, and intake of nutrients and foods was explored by linear regression in models adjusted for energy intake, age, body mass index, smoking, physical activity, centre and laboratory batch.Results:Serum IGF-I levels were positively related to protein intake (P trend<0.001), but not related to energy, fat or carbohydrate intake. Positive relationships were observed with the intake of milk (P trend=0.007), calcium (P trend<0.001), magnesium (P trend=0.003), phosphorus (P trend<0.001), potassium (P trend=0.002), vitamin B6 (P trend=0.03), vitamin B2 (P trend=0.001) and inverse relationships with vegetables (P trend=0.02) and beta-carotene (P trend=0.02). IGFBP-3 was not related with most of the nutrients and foods in this study.Conclusions:In this population, circulating IGF-I is modestly related with the intake of protein and minerals, and with milk and cheese, while IGFBP-3 does not appear to be related with diet.


International Journal of Obesity | 2006

Body mass index, waist circumference and waist-hip ratio and serum levels of IGF-I and IGFBP-3 in European women

Inger Torhild Gram; Teresa Norat; Sabina Rinaldi; Laure Dossus; Annekatrin Lukanova; B. Téhard; F. Clavel-Chapelon; C. H. van Gils; P.A.H. van Noord; P.H.M. Peeters; H. B. Bueno-de-Mesquita; Gabriele Nagel; J. Linseisen; Petra H. Lahmann; Heiner Boeing; Domenico Palli; C. Sacerdote; Salvatore Panico; R. Tumino; S. Sieri; M. Dorronsoro; J. R. Quiros; C. Navarro; Aurelio Barricarte; M. J. Tormo; Clementina González; Kim Overvad; S. Paaske Johnsen; A. Olsen; Anne Tjønneland

Objective:To examine the relationship between body mass index (BMI) and waist–hip ratio (WHR) with serum levels of insulin-like growth factor-I (IGF-I), and its binding protein (IGFBP)-3.Design:Cross-sectional study on 2139 women participating in a case–control study on breast cancer and endogenous hormones. Data on lifestyle and reproductive factors were collected by means of questionnaires. Body height, weight, waist and hip circumferences were measured. Serum levels of IGF-I and insulin-like binding protein (IGFBP)-3 were measured by enzyme-linked immunosorbent assays. Adjusted mean levels of IGF-I and IGFBP-3 across quintiles of BMI, waist circumference, and WHR were calculated by linear regression. Results were adjusted for potential confounders associated with IGF-I and IGFBP-3.Results:Adjusted mean serum IGF-I values were lower in women with BMI<22.5 kg/m2 or BMI>29.2 kg/m2 compared to women with BMI within this range (Pheterogeneity<0.0001, Ptrend=0.35). Insulin-like growth factor-I was not related to WHR after adjustment for BMI. IGF-binding protein-3 was linearly positively related to waist and WHR after mutual adjustment. The molar ratio IGF-I/IGFBP-3 had a non-linear relation with BMI and a linear inverse relationship with WHR (P trend=0.005).Conclusions:Our data confirm the nonlinear relationship of circulating IGF-I to total adiposity in women. Serum IGFBP-3 was positively related to central adiposity. These suggest that bioavailable IGF-I levels could be lower in obese compared to non-obese women and inversely related to central adiposity.


Public Health Nutrition | 2002

Soy product consumption in 10 European countries: the European Prospective Investigation into Cancer and Nutrition (EPIC) study

L Keinan-Boker; Peeters Phm.; Angela A. Mulligan; C. Navarro; Nadia Slimani; I Mattisson; Eva Lundin; Alison McTaggart; Naomi E. Allen; Kim Overvad; Anne Tjønneland; F. Clavel-Chapelon; J. Linseisen; M Haftenberger; Pagona Lagiou; Victoria Kalapothaki; Alberto Evangelista; Graziella Frasca; H. B. Bueno-de-Mesquita; Y T van der Schouw; Dagrun Engeset; Guri Skeie; M. J. Tormo; E. Ardanaz; Ur Charrondière; E. Riboli

OBJECTIVE The aim of this study was to describe the variation of soy product intake in 10 European countries by using a standardised reference dietary method. A subsidiary aim was to characterise the pattern of soy consumption among a sub-group of participants with a habitual health-conscious lifestyle (HHL), i.e. non-meat eaters who are fish eaters, vegetarians and vegans. DESIGN A 24-hour dietary recall interview (24-HDR) was conducted among a sample (5-12%) of all cohorts in the European Prospective Investigation into Cancer and Nutrition (EPIC). Study participants totalled 35 955 after exclusion of subjects younger than 35 or older than 74 years of age. Soy products were subdivided into seven sub-groups by similarity. Distribution of consumption and crude and adjusted means of intake were computed per soy product group across countries. Intake of soy products was also investigated among participants with an HHL. RESULTS In total, 195 men and 486 women reported consuming soy products in the 24-HDR interview. Although soy product intake was generally low across all countries, the highest intake level was observed in the UK, due to over-sampling of a large number of participants with an HHL. The most frequently consumed soy foods were dairy substitutes in the UK and France and beans and sprouts among mid-European countries. For both genders, the sub-group of soy dairy substitutes was consumed in the highest quantities (1.2 g day-1 for men; 1.9 g day-1 for women). Participants with an HHL differed substantially from others with regard to demographic, anthropometric and nutritional factors. They consumed higher quantities of almost all soy product groups. CONCLUSIONS Consumption of soy products is low in centres in Western Europe. Soy dairy substitutes are most frequently consumed. Participants with an HHL form a distinct sub-group with higher consumptions of fruit, vegetables, legumes, cereals and soy products compared with the other participants.


Cancer Causes & Control | 2005

C-peptide, IGF-I, sex-steroid hormones and adiposity: A cross-sectional study in healthy women within the European Prospective Investigation into Cancer and Nutrition (EPIC)

Irene D. Bezemer; Sabina Rinaldi; Laure Dossus; Carla H. van Gils; Petra H.M. Peeters; Paulus A.H. van Noord; H. Bas Bueno-de-Mesquita; Søren Paaske Johnsen; Kim Overvad; Anja Olsen; Anne Tjønneland; Heiner Boeing; Petra H. Lahmann; Jakob Linseisen; Gabriele Nagel; Naomi E. Allen; Andrew W. Roddam; Sheila Bingham; Kay-Tee Khaw; Emmanuelle Kesse; Bertrand Tehard; Françoise Clavel-Chapelon; Antonio Agudo; Eva Ardanaz; J. R. Quiros; Pilar Amiano; Carmen Martinez-Garcia; M. J. Tormo; Valeria Pala; Salvatore Panico

Objectives: The risk of some cancers is positively associated with body weight, which may influence circulating levels of sex-steroid hormones, insulin and IGF-I. Interrelationships between these hormones and the associations with adiposity were evaluated in healthy women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC).Methods: A cross-sectional analysis was performed on anthropometric and hormonal data from 743 pre- and 1217 postmenopausal women. Body mass index (BMI) and waist circumference were used as indicators of adiposity. C-peptide, Insulin Growth Factor (IGF)-I, Insulin Growth Factor binding protein (IGFBP)-3, androgens, estrogens and sex hormone binding globulin (SHBG) were measured by immunoassays; free sex steroid concentrations were calculated.Results: BMI and waist circumference were positively correlated with estrogens in postmenopausal women and with C-peptide, free testosterone and inversely with SHBG in all women. C-peptide and IGF-I were inversely correlated with SHBG, and positively with free sex steroids in postmenopausal women. IGF-I was positively associated with postmenopausal estrogens and androgen concentrations in all women.Conclusions: Sex-steroid concentrations appear to be regulated along several axes. Adiposity correlated directly with estrogens in postmenopausal women and with insulin, resulting in lower SHBG and increased levels of free sex steroids. Independent of adiposity and insulin, IGF-I was associated with decreased SHBG levels, and increased concentrations of androgens and postmenopausal estrogens.


International Journal of Obesity | 2001

Extremely high prevalence of overweight and obesity in Murcia, a Mediterranean region in south-east Spain

Mt Martínez-Ros; M. J. Tormo; C. Navarro; Chirlaque; D Pérez-Flores

OBJECTIVE: To estimate the prevalence of obesity in the Murcia Region according to age and sex, and to analyse how obesity is related to demographic and socio-economic determinants and to other cardiovascular risk factors of interest to the community.DESIGN: Survey on a representative population sample using multi-stage random sampling with definition of the sample quotas.SUBJECTS: A total of 3091 persons aged 18–65 y residing in the Murcia Region.MEASURMENTS: The following data were collected: socio-economic data; tobacco smoking; recent physical activity; blood pressure; weight; height; and blood analysis to determine plasma lipids. Obesity was defined by body mass index (BMI)≥30. Intense or vigorous physical activity (VPA≥6 equivalents to baseline metabolic rate or METs) was measured in kilocalories per day and reduced to hours per week.RESULTS: In all, 20.5% of the adult population of the Murcia Region is obese, and 40.9% is overweight. In the logistic regression analysis, obesity in men is associated with age and level of education. In women it is associated with age, level of education, living in a non-urban area and being a housewife. When adjusted for socio-economic variables and for other cardiovascular risk factors the effect of age and level of education disappears in men and it is directly associated with hypertension and hypertriglyceridaemia and inversely related to more than 2 h VPA per week. Obesity in women is associated positively with age, hypertension, hypertriglyceridaemia and little VPA, and inversely with level of education.CONCLUSIONS: In the Murcia Region 61.4% of the adult population presents with some form of excess weight. The prevalence of obesity (BMI≥30) is greater in women (23.7%; CI 95% 19.7–27.7) than in men (17.3%; CI 95% 15.3–19.3). The widespread nature of this factor makes it a mass problem that requires generalised interventions to prevent it.


European Journal of Clinical Nutrition | 1999

Dietary intake of vegetables and fruits among adults in five regions of Spain

Antonio Agudo; Pilar Amiano; A Barcos; Aurelio Barricarte; Jm Beguiristain; Chirlaque; M. Dorronsoro; Clementina González; C Lasheras; Carmen Martinez; C. Navarro; G Pera; J. R. Quiros; M Rodríguez; M. J. Tormo

Objective: To assess the consumption of vegetables and fruits (V&F) in adults from five regions in Spain according to sex, age and educational level.Design: Cross-sectional study within the members of the EPIC cohort in Spain.Setting: Three regions of the north of Spain (Asturias, Guipúzcoa and Navarra) and two regions of the south of Spain (Granada and Murcia).Subjects: 41 448 healthy volunteers (15 365 men, 25 813 women), aged 29–69 y.Interventions: Information on habitual diet during the previous year was collected by means of a computerised version of a diet history questionnaire.Results: Among men, the mean daily consumption of vegetables and of fruits was 273.7 g (3.4 servings) and 348.3 g (4.4 servings) respectively. Among women, the corresponding vegetables and fruit intakes per day were 244.4 g (3.1 servings) and 349.4 g (4.4 servings). The total V&F intake tended to increase with age and educational level. Overall, 74% of subjects consumed 400 g/d (5 servings) of vegetables and fruit.Conclusions: Consumption of vegetables and fruits in healthy adults in Spain is considerably higher than in most European countries and the United States; this complies with what is considered to be the Mediterranean diet. Despite some regional differences, there were no clearly differentiated patterns of V&F intake between southern and northern regions within Spain.


Annals of Oncology | 2013

Diabetes mellitus, insulin treatment, diabetes duration, and risk of biliary tract cancer and hepatocellular carcinoma in a European cohort

Sabrina Schlesinger; Krasimira Aleksandrova; Tobias Pischon; Mazda Jenab; Veronika Fedirko; Elisabeth Trepo; Kim Overvad; Nina Roswall; Anne Tjønneland; M. C. Boutron-Ruault; Guy Fagherazzi; Antoine Racine; R. Kaaks; Verena Grote; Heiner Boeing; Antonia Trichopoulou; M. Pantzalis; Maria Kritikou; Amalia Mattiello; S. Sieri; C. Sacerdote; Domenico Palli; R. Tumino; Petra H. Peeters; H. B. Bueno-De-Mesquita; Elisabete Weiderpass; J. R. Quiros; Raul Zamora-Ros; M. J. Sánchez; Larraitz Arriola

BACKGROUND Evidence on associations between self-reported diabetes mellitus, diabetes duration, age at diabetes diagnosis, insulin treatment, and risk of biliary tract cancer (BTC) and hepatocellular carcinoma (HCC), independent of general and abdominal obesity is scarce. PATIENTS AND METHODS We conducted a prospective analysis in the EPIC-cohort study among 363 426 participants with self-reported diabetes data. Multivariable adjusted relative risks and 95% confidence intervals were estimated from Cox regression models. In a nested case-control subset, analyses were carried out in HCV/HBV-negative individuals. RESULTS During 8.5 years of follow-up, 204 BTC cases [including 75 gallbladder cancer (GBC) cases], and 176 HCC cases were identified. Independent of body mass index and waist-to-height ratio diabetes status was associated with higher risk of BTC and HCC [1.77 (1.00-3.13) and 2.17 (1.36-3.47)]. For BTC, the risk seemed to be higher in participants with shorter diabetes duration and those not treated with insulin. Regarding cancer subsites, diabetes was only associated with GBC [2.72 (1.17-6.31)]. The risk for HCC was particularly higher in participants treated with insulin. The results were not appreciably different in HCV/HBV-negative individuals. CONCLUSION(S) This study supports the hypothesis that diabetes is a risk factor for BTC (particularly GBC) and HCC. Further research is required to establish whether diabetes treatment or duration is associated with these cancers.


European Journal of Clinical Nutrition | 2009

Dietary glycaemic index and glycaemic load in the European Prospective Investigation into Cancer and Nutrition

M. M. E. van Bakel; R. Kaaks; Edith J. M. Feskens; Sabine Rohrmann; Ailsa Welch; Valeria Pala; K. Avloniti; Y. T. van der Schouw; Huaidong Du; Jytte Halkjær; M. J. Tormo; Anne E. Cust; Furio Brighenti; Joline W.J. Beulens; Pietro Ferrari; Carine Biessy; Marleen A. H. Lentjes; Elizabeth A. Spencer; Salvatore Panico; Giovanna Masala; H. B. Bueno-de-Mesquita; P.H.M. Peeters; Antonia Trichopoulou; Theodora Psaltopoulou; F. Clavel-Chapelon; Mathilde Touvier; Guri Skeie; Sabina Rinaldi; Emily Sonestedt; Ingegerd Johansson

Objectives:To describe dietary glycaemic index (GI) and glycaemic load (GL) values in the population participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study according to food groups, nutrients and lifestyle characteristics.Methods:Single 24-h dietary recalls (24-HDRs) from 33 566 subjects were used to calculate dietary GI and GL, and an ad hoc database was created as the main reference source. Mean GI and GL intakes were adjusted for age, total energy intake, height and weight, and were weighted by season and day of recall.Results:GI was the lowest in Spain and Germany, and highest in the Netherlands, United Kingdom and Denmark for both genders. In men, GL was the lowest in Spain and Germany and highest in Italy, whereas in women, it was the lowest in Spain and Greece and highest in the UK health-conscious cohort. Bread was the largest contributor to GL in all centres (15–45%), but it also showed the largest inter-individual variation. GL, but not GI, tended to be lower in the highest body mass index category in both genders. GI was positively correlated with starch and intakes of bread and potatoes, whereas it was correlated negatively with intakes of sugar, fruit and dairy products. GL was positively correlated with all carbohydrate components and intakes of cereals, whereas it was negatively correlated with fat and alcohol and with intakes of wine, with large variations across countries.Conclusions:GI means varied modestly across countries and genders, whereas GL means varied more, but it may possibly act as a surrogate of carbohydrate intake.

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Heiner Boeing

Free University of Berlin

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Salvatore Panico

University of Naples Federico II

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R. Tumino

International Agency for Research on Cancer

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Carmen Martinez

Complutense University of Madrid

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