Aims/hypothesis Consumption of sugar-sweetened beverages has been shown, largely in American populations, to increase type 2 diabetes incidence. We aimed to evaluate the association of consumption of sweet beverages (juices and nectars, sugarsweetened soft drinks and artificially sweetened soft drinks) with type 2 diabetes incidence in European adults. Methods We established a case-cohort study including 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 participants selected from eight European cohorts participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. After exclusions, the final sample size included 11,684 incident cases and a subcohort of 15,374 participants. Cox proportional hazards regression models (modified for the case-cohort design) and random-effects meta-analyses were used to estimate the association between sweet beverage consumption (obtained from validated dietary questionnaires) and type 2 diabetes incidence.Results In adjusted models, one 336 g (12 oz) daily increment in sugar-sweetened and artificially sweetened soft drink consumption was associated with HRs for type 2 diabetes of 1.22 (95% CI 1.09, 1.38) and 1.52 (95% CI 1.26, 1.83), respectively. After further adjustment for energy intake and BMI, the association of sugar-sweetened soft drinks with type 2 diabetes persisted (HR 1.18, 95% CI 1.06, 1.32), but the association of artificially sweetened soft drinks became statistically not significant (HR 1.11, 95% CI 0.95, 1.31). Juice and nectar consumption was not associated with type 2 diabetes incidence. Conclusions/interpretation This study corroborates the association between increased incidence of type 2 diabetes and high consumption of sugar-sweetened soft drinks in European adults.

Our results suggest that a higher level of PA reduces abdominal adiposity independent of baseline and changes in body weight and is thus a useful strategy for preventing chronic diseases and premature deaths.

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Aims/hypothesis A diet rich in meat has been reported to contribute to the risk of type 2 diabetes. The present study aims to investigate the association between meat consumption and incident type 2 diabetes in the EPIC-InterAct study, a large prospective case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods During 11.7 years of follow-up, 12,403 incident cases of type 2 diabetes were identified among 340,234 adults from eight European countries. A centre-stratified random subsample of 16,835 individuals was selected in order to perform a case-cohort design. Prentice-weighted Cox regression analyses were used to estimate HR and 95% CI for incident diabetes according to meat consumption. Results Overall, multivariate analyses showed significant positive associations with incident type 2 diabetes for increasing consumption of total meat (50 g increments: HR 1.08; 95% CI 1.05, 1.12), red meat (HR 1.08; 95% CI 1.03, 1.13) and processed meat (HR 1.12; 95% CI 1.05, 1.19), and a borderline positive association with meat iron intake. Effect modifications by sex and class of BMI were observed. In men, the results of the overall analyses were confirmed. In women, the association with total and red meat persisted, although attenuated, while an association with poultry consumption also emerged (HR 1.20; 95% CI 1.07, 1.34). These associations were not evident among obese participants. Conclusions/interpretation This prospective study confirms a positive association between high consumption of total and red meat and incident type 2 diabetes in a large cohort of European adults.

We investigated the associations between dietary intake of folate and vitamin B2, MTHFR C677T genotype, and colorectal adenomas in a Dutch case-control study. Data of cases with at least one histologically confirmed colorectal adenoma (n = 768) and controls with no history of any type of colorectal polyp (n = 709) were included. Dietary intake was assessed using a food-frequency questionnaire. Multivariable models included age and, if appropriate, dietary folate and calcium intake. The adjusted odds ratio (OR) and 95% confidence interval (CI) for the highest compared with the lowest sex-specific tertile of intake were 1.32 (95% CI, 1.01-1.73) for folate and 0.51 (95% CI, 0.36-0.73) for vitamin B2. Folate seemed to be a risk factor, especially when vitamin B2 intake was low; vitamin B2 was inversely associated with adenomas, especially with relatively high folate intake. No association was observed between MTHFR C677T genotype and colorectal adenomas. The inverse association between vitamin B2 intake and colorectal adenoma risk seemed to be more pronounced among those with the MTHFR TT genotype. We conclude that this study does not provide evidence for a decreased colorectal adenoma risk for subjects with high dietary intake of folate. It suggests, however, an inverse association between vitamin B2 and colorectal adenomas, which may be more relevant for those with the MTHFR TT genotype. (Cancer Epidemiol Biomarkers Prev 2005;14(6):1562 -6)

PURPOSE: We assessed the association between smoking cessation and prospective weight change in the European population of the European Prospective Investigation into Cancer and NutritionPhysical Activity, Nutrition, Alcohol, Cessation of smoking, Eating out of home And obesity (EPIC-PANACEA) project. METHODS: The study involved more than 300,000 healthy volunteers, recruited between 1992 and 2000 in 9 European countries, who provided data on anthropometry and smoking habits at baseline and after a follow-up of 5years on average. Adjusted mixed-effects linear regression models were used to obtain sex-specific summary estimates of the association between the change in smoking status and the annual change in weight. RESULTS: Smoking cessation tends to be followed by weight gain; when compared to stable smokers, annual weight gain was higher in men (0.44kg (95%CI: 0.36; 0.52)) and women (0.46kg (95%CI: 0.41; 0.52)) who stopped smoking during follow-up. When smokers who stopped smoking at least 1year before recruitment were compared to never smokers, no major differences in annual weight gain were observed. The excess weight gain following smoking cessation appears to mainly occur in the first years following the cessation. CONCLUSIONS: When considering the benefits of smoking cessation, such findings strengthen the need for promoting cessation offering information on weight gain control and support to weight-concerned smokers in order to remove a barrier to quitting. Conflict of interest statementThe authors declare that there are no conflicts of interest. Word/character count:Title: 106 chars incl spaces PurposeWe assessed the association between smoking cessation and prospective weight change in the European population of the EPIC-PANACEA project. MethodsThe study involved more than 300,000 healthy volunteers, recruited between 1992 and 2000 in 9 European countries, who provided data on anthropometry and smoking habits at baseline and after a follow-up of five years on average. Adjusted mixed-effects linear regression models were used to obtain sex-specific summary estimates of the association between the change in smoking status and the annual change in weight. ResultsSmoking cessation tends to be followed by weight gain; when compared to stable smokers, annual weight gain was higher in men (0.44 kg (95%CI: 0.36; 0.52)) and women (0.46 kg (95%CI: 0.41; 0.52)) who stopped smoking during follow-up.When smokers who stopped smoking at least one year before recruitment were compared to never smokers, no major differences in annual weight gain were observed.The excess weight gain following smoking cessation appears to mainly occur in the first years following the cessation. ConclusionsWhen considering the benefits of smoking cessation, such findings strengthen the need for promoting cessation offering information on weight gain control and support to weight-concerned smokers in order to remove a barrier to quitting.5

.  Bamia C, Halkjær J, Lagiou P, Trichopoulos D, Tjønneland A, Berentzen TL, Overvad K, Clavel‐Chapelon F, Boutron‐Ruault M‐C, Rohrmann S, Linseisen J, Steffen A, Boeing H, May AM, Peeters PH, Bas Bueno‐de‐Mesquita H, van den Berg SW, Dorronsoro M, Barricarte A, Rodriguez Suarez L, Navarro C, González CA, Boffetta P, Pala V, Hallmans G, Trichopoulou A (University of Athens, Athens, Greece; Institute of Cancer Epidemiology, Copenhagen, Denmark; Harvard School of Public Health, Boston, MA, USA; Bureau of Epidemiologic Research, Athens, Greece; Hellenic Health Foundation, Athens, Greece; Institute of Preventive Medicine, Copenhagen, Denmark; Institute of Public Health, Aarhus University, Aarhus, Denmark; Center for Cardiovascular Research, Aalborg, Denmark; Institut Gustave‐Roussy, Paris, France; German Cancer Research Centre, Heidelberg, Germany; Institute of Epidemiology, Potsdam, Germany; German Institute of Human Nutrition Potsdam‐Rehbruecke, Potsdam, Germany; University Medical Center Utrecht, Utrecht, the Netherlands; Public Health and Primary Care, London, UK; National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Public Health Department of Gipuzkoa & Ciberesp, San Sebastian, Spain; Health Institute of Navarra, Pamplona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Health and Healthcare services council, Asturias, Spain; Murcia Regional Health Council, Murcia, Spain; Catalan Institute of Oncology, Barcelona, Spain; International Agency for Research on Cancer, Lyon, France; Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy; and Nutritional Research, Umea, Sweden). Weight change in later life and risk of death amongst the elderly: the European Prospective Investigation into Cancer and Nutrition‐Elderly Network on Ageing and Health study. J Intern Med 2010; 268: 133–144. Objective.  Later life weight change and mortality amongst elders. Design.  Nested case–control study. Setting.  Six countries from the European Investigation into Cancer and nutrition – Elderly, Network on Ageing and Health. Subjects.  A total of 1712 deceased (cases) and 4942 alive (controls) were selected from 34 239 participants, ≥ 60 years at enrolment (1992–2000) who were followed‐up until March 2007. Annual weight change was estimated as the weight difference from recruitment to the most distant from‐date‐of‐death re‐assessment, divided by the respective time. Outcome measures.  Mortality in relation to weight change was examined using conditional logistic regression. Results.  Weight loss >1 kg year−1 was associated with statistically significant increased death risk (OR = 1.65; 95% CI: 1.41–1.92) compared to minimal weight change (±1 kg year−1). Weight gain >1 kg year−1 was also associated with increased risk of death (OR = 1.15; 95% CI: 0.98–1.37), but this was evident and statistically significant only amongst overweight/obese (OR = 1.55; 95% CI: 1.17–2.05). In analyses by time interval since weight re‐assessment, the association of mortality with weight loss wa...

Background: As nuclear receptors and transcription factors have an important regulatory function in adipocyte differentiation and fat storage, genetic variation in these key regulators and downstream pathways may be involved in the onset of obesity. Objective: To explore associations between single nucleotide polymorphisms (SNPs) in candidate genes from regulatory pathways that control fatty acid and glucose metabolism, and repeated measurements of body mass index (BMI) and waist circumference in a large Dutch study population. Methods: Data of 327 SNPs across 239 genes were analyzed for 3575 participants of the Doetinchem cohort, who were examined three times during 11 years, using the Illumina Golden Gate assay. Adjusted random coefficient models were used to analyze the relationship between SNPS and obesity phenotypes. False discovery rate q-values were calculated to account for multiple testing. Significance of the associations was defined as a q-value p0.20. Results: Two SNPs (in NR1H4 and SMARCA2 in women only) were significantly associated with both BMI and waist circumference. In addition, two SNPs (in SIRT1 and SCAP in women only) were associated with BMI alone. A functional SNP, in IL6, was strongly associated with waist. Conclusion: In this explorative study among participants of a large population-based cohort, five SNPs, mainly located in transcription mediator genes, were strongly associated with obesity phenotypes. The results from whole genome and candidate gene studies support the potential role of NR1H4, SIRT1, SMARCA2 and IL6 in obesity. Although replication of our findings and further research on the functionality of these SNPs and underlying mechanism is necessary, our data indirectly suggest a role of GATA transcription factors in weight control.