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Article ; Online: Ultra processed foods and cancer-authors' reply.

Freisling, Heinz / Córdova, Reynalda / Aune, Dagfinn / Wagner, Karl-Heinz

The Lancet regional health. Europe

2024 Volume 38, Page(s) 100865

Language	English
Publishing date	2024-02-12
Publishing country	England
Document type	Journal Article
ISSN	2666-7762
ISSN (online)	2666-7762
DOI	10.1016/j.lanepe.2024.100865
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Article ; Online: Body mass index and incident cardiometabolic conditions in relation to obesity-related cancer risk: A population-based cohort study in Catalonia, Spain.

Recalde, Martina / Pistillo, Andrea / Viallon, Vivian / Fontvieille, Emma / Duarte-Salles, Talita / Freisling, Heinz

Cancer medicine

2023 Volume 12, Issue 19, Page(s) 20188–20200

Abstract: Background: We investigated the association between body mass index (BMI) and obesity-related cancer risk among individuals with/without incident hypertension (HTN), type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD) and the joint ... ...

Abstract	Background: We investigated the association between body mass index (BMI) and obesity-related cancer risk among individuals with/without incident hypertension (HTN), type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD) and the joint associations of overweight/obesity (BMI ≥25 kg/m Results: A total of 38,082 individuals developed obesity-related cancers after a median of 8 years of follow-up. The positive association between BMI and obesity-related cancer risk was similar among individuals free of cardiometabolic conditions (hazard ratio, HR per 5 kg/m Conclusions: Public health strategies to reduce overweight can help prevent cancer cases among the general population and individuals with incident HTN/CVD. Further, weight-loss interventions seem to lead to a greater cancer risk reduction among individuals with CVD.
MeSH term(s)	Humans ; Body Mass Index ; Overweight/complications ; Overweight/epidemiology ; Spain/epidemiology ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/complications ; Cohort Studies ; Risk Factors ; Obesity/complications ; Obesity/epidemiology ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Hypertension/epidemiology ; Neoplasms/etiology ; Neoplasms/complications
Language	English
Publishing date	2023-09-28
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2659751-2
ISSN	2045-7634 ; 2045-7634
ISSN (online)	2045-7634
ISSN	2045-7634
DOI	10.1002/cam4.6603
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Article ; Online: Time trends in the incidence of cardiovascular disease, hypertension and diabetes by sex and socioeconomic status in Catalonia, Spain: a population-based cohort study.

Bennett, Matthew / Pistillo, Andrea / Recalde, Martina / Reyes, Carlen / Freisling, Heinz / Duarte-Salles, Talita

BMJ open

2023 Volume 13, Issue 5, Page(s) e066404

Abstract: Objective: We aimed to estimate how longitudinal trends in cardiovascular disease, hypertension and type 2 diabetes mellitus incidence in Catalonia, Spain from 2009 to 2018 may differ by age, sex and socioeconomic deprivation.: Design: Cohort study ... ...

Abstract	Objective: We aimed to estimate how longitudinal trends in cardiovascular disease, hypertension and type 2 diabetes mellitus incidence in Catalonia, Spain from 2009 to 2018 may differ by age, sex and socioeconomic deprivation. Design: Cohort study using prospectively collected data. Setting: Electronic health records from primary healthcare centres in Catalonia, Spain. Participants: 3 247 244 adults (≥40 years). Outcome measures: We calculated the annual incidence (per 1000 persons-year) and incidence rate ratios (IRR) between three time periods of cardiovascular disease, hypertension and type 2 diabetes mellitus to measure trends and changes in incidence during the study period. Results: In 2016-2018 compared with 2009-2012, cardiovascular disease incidence increased in the 40-54 (eg, IRR=1.61, 95% CI: 1.52 to 1.69 in women) and 55-69 age groups. There was no change in cardiovascular disease incidence in women aged 70+ years, and a slight decrease in men aged 70+ years (0.93, 0.90 to 0.95). Hypertension incidence decreased in all age groups for both sexes. Type 2 diabetes mellitus incidence decreased in all age groups for both sexes (eg, 0.72, 0.70 to 0.73 in women aged 55-69 years), except for the 40-54 year age group (eg, 1.09, 1.06 to 1.13 in women). Higher incidence levels were found in the most deprived areas, especially in the 40-54 and 55-69 groups. Conclusions: Overall cardiovascular disease incidence has increased while hypertension and type 2 diabetes mellitus incidence have decreased in the last years in Catalonia, Spain, with differences in trends by age group and socioeconomic deprivation.
MeSH term(s)	Adult ; Male ; Female ; Humans ; Middle Aged ; Cardiovascular Diseases/epidemiology ; Incidence ; Spain/epidemiology ; Diabetes Mellitus, Type 2/epidemiology ; Cohort Studies ; Hypertension/epidemiology ; Social Class
Language	English
Publishing date	2023-05-24
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2022-066404
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Article ; Online: Dried Fruits, Nuts, and Cancer Risk and Survival: A Review of the Evidence and Future Research Directions.

Bolling, Bradley W / Aune, Dagfinn / Noh, Hwayoung / Petersen, Kristina S / Freisling, Heinz

Nutrients

2023 Volume 15, Issue 6

Abstract: Dried fruits and nuts contain high amounts of nutrients and phytochemicals-all of which may have anticarcinogenic, anti-inflammatory, and antioxidant properties. This narrative review summarizes the evidence for dried fruits and nuts and cancer incidence, ...

Abstract	Dried fruits and nuts contain high amounts of nutrients and phytochemicals-all of which may have anticarcinogenic, anti-inflammatory, and antioxidant properties. This narrative review summarizes the evidence for dried fruits and nuts and cancer incidence, mortality, and survival and their potential anticancer properties. The evidence for dried fruits in cancer outcomes is limited, but existing studies have suggested an inverse relationship between total dried fruit consumption and cancer risk. A higher consumption of nuts has been associated with a reduced risk of several site-specific cancers in prospective cohort studies, including cancers of the colon, lung, and pancreas, with relative risks per 5 g/day increment equal to 0.75 (95% CI 0.60, 0.94), 0.97 (95% CI 0.95, 0.98), and 0.94 (95% CI 0.89, 0.99), respectively. A daily intake of total nuts of 28 g/day has also been associated with a 21% reduction in the rate of cancer mortality. There is also some evidence that frequent nut consumption is associated with improved survival outcomes among patients with colorectal, breast, and prostate cancer; however, further studies are needed. Future research directions include the investigation of additional cancer types, including rare types of cancer. For cancer prognosis, additional studies with pre- and postdiagnosis dietary assessment are warranted.
MeSH term(s)	Male ; Humans ; Fruit ; Nuts ; Risk ; Diet ; Prospective Studies ; Prostatic Neoplasms
Language	English
Publishing date	2023-03-16
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu15061443
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Article ; Online: Metabolic obesity phenotypes and obesity-related cancer risk in the National Health and Nutrition Examination Survey.

Winn, Maci / Karra, Prasoona / Freisling, Heinz / Gunter, Marc J / Haaland, Benjamin / Litchman, Michelle L / Doherty, Jennifer A / Playdon, Mary C / Hardikar, Sheetal

Endocrinology, diabetes & metabolism

2023 Volume 6, Issue 4, Page(s) e433

Abstract: Introduction: Body mass index (BMI) fails to identify up to one-third of normal weight individuals with metabolic dysfunction who may be at increased risk of obesity-related cancer (ORC). Metabolic obesity phenotypes, an alternate metric to assess ... ...

Abstract	Introduction: Body mass index (BMI) fails to identify up to one-third of normal weight individuals with metabolic dysfunction who may be at increased risk of obesity-related cancer (ORC). Metabolic obesity phenotypes, an alternate metric to assess metabolic dysfunction with or without obesity, were evaluated for association with ORC risk. Methods: National Health and Nutrition Examination Survey participants from 1999 to 2018 (N = 19,500) were categorized into phenotypes according to the metabolic syndrome (MetS) criteria and BMI: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight/obese (MHO) and metabolically unhealthy overweight/obese (MUO). Adjusted multivariable logistic regression models were used to evaluate associations with ORC. Results: With metabolic dysfunction defined as ≥1 MetS criteria, ORC cases (n = 528) had higher proportions of MUNW (28.2% vs. 17.4%) and MUO (62.6% vs. 60.9%) phenotypes than cancer-free individuals (n = 18,972). Compared with MHNW participants, MUNW participants had a 2.2-times higher ORC risk [OR (95%CI) = 2.21 (1.27-3.85)]. MHO and MUO participants demonstrated a 43% and 56% increased ORC risk, respectively, compared to MHNW, but these did not reach statistical significance [OR (95% CI) = 1.43 (0.46-4.42), 1.56 (0.91-2.67), respectively]. Hyperglycaemia, hypertension and central obesity were all independently associated with higher ORC risk compared to MHNW. Conclusions: MUNW participants have a higher risk of ORC than other abnormal phenotypes, compared with MHNW participants. Incorporating metabolic health measures in addition to assessing BMI may improve ORC risk stratification. Further research on the relationship between metabolic dysfunction and ORC is warranted.
MeSH term(s)	Humans ; Overweight ; Nutrition Surveys ; Obesity/complications ; Metabolic Syndrome/epidemiology ; Metabolic Syndrome/etiology ; Metabolic Syndrome/diagnosis ; Phenotype ; Neoplasms/epidemiology ; Neoplasms/etiology
Language	English
Publishing date	2023-06-05
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ISSN	2398-9238
ISSN (online)	2398-9238
DOI	10.1002/edm2.433
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Article ; Online: Longitudinal body mass index and cancer risk: a cohort study of 2.6 million Catalan adults.

Recalde, Martina / Pistillo, Andrea / Davila-Batista, Veronica / Leitzmann, Michael / Romieu, Isabelle / Viallon, Vivian / Freisling, Heinz / Duarte-Salles, Talita

Nature communications

2023 Volume 14, Issue 1, Page(s) 3816

Abstract: Single body mass index (BMI) measurements have been associated with increased risk of 13 cancers. Whether life course adiposity-related exposures are more relevant cancer risk factors than baseline BMI (ie, at start of follow-up for disease outcome) ... ...

Abstract	Single body mass index (BMI) measurements have been associated with increased risk of 13 cancers. Whether life course adiposity-related exposures are more relevant cancer risk factors than baseline BMI (ie, at start of follow-up for disease outcome) remains unclear. We conducted a cohort study from 2009 until 2018 with population-based electronic health records in Catalonia, Spain. We included 2,645,885 individuals aged ≥40 years and free of cancer in 2009. After 9 years of follow-up, 225,396 participants were diagnosed with cancer. This study shows that longer duration, greater degree, and younger age of onset of overweight and obesity during early adulthood are positively associated with risk of 18 cancers, including leukemia, non-Hodgkin lymphoma, and among never-smokers, head and neck, and bladder cancers which are not yet considered as obesity-related cancers in the literature. Our findings support public health strategies for cancer prevention focussing on preventing and reducing early overweight and obesity.
MeSH term(s)	Humans ; Adult ; Body Mass Index ; Cohort Studies ; Overweight/complications ; Overweight/epidemiology ; Risk Factors ; Obesity/complications ; Obesity/epidemiology ; Neoplasms/epidemiology
Language	English
Publishing date	2023-06-30
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-023-39282-y
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Article ; Online: Multi-Trait Body Shape Phenotypes and Breast Cancer Risk in Postmenopausal Women: A Causal Mediation Analysis in the UK Biobank Cohort.

Amadou, Amina / Freisling, Heinz / Sedlmeier, Anja M / Bohmann, Patricia / Fontvieille, Emma / Weber, Andrea / Konzok, Julian / Stein, Michael J / Peruchet-Noray, Laia / Jansana, Anna / Noh, Hwayoung / His, Mathilde / Gan, Quan / Baurecht, Hansjörg / Fervers, Béatrice

Journal of epidemiology and global health

2024

Abstract: Body shape phenotypes combining multiple anthropometric traits have been linked to postmenopausal breast cancer (BC). However, underlying biological pathways remain poorly understood. This study investigated to what extent the associations of body shapes ...

Abstract	Body shape phenotypes combining multiple anthropometric traits have been linked to postmenopausal breast cancer (BC). However, underlying biological pathways remain poorly understood. This study investigated to what extent the associations of body shapes with postmenopausal BC risk is mediated by biochemical markers. The study included 176,686 postmenopausal women from UK Biobank. Four body shape phenotypes were derived from principal component (PC) analysis of height, weight, body mass index, waist and hip circumferences, and waist-to-hip ratio (WHR). The four-way decomposition of the total effect was used to estimate mediation and interaction effects simultaneously as well as the mediated proportions. After 10.9 years median follow-up, 6,396 incident postmenopausal BC were diagnosed. There was strong evidence of positive associations between PC1 (general obesity) and PC2 (tall, low WHR), and BC risk. The association of PC1 with BC risk was positively mediated by testosterone and negatively by insulin-like growth factor-1 (IGF-1), with the overall proportion mediated (sum of the mediated interaction and pure indirect effect (PIE)) accounting for 11.4% (95% confidence intervals: 5.1 to 17.8%) and -12.2% (-20.5% to -4.0%) of the total effect, respectively. Small proportions of the association between PC2 and BC were mediated by IGF-1 (PIE: 2.8% (0.6 to 4.9%)), and sex hormone-binding globulin (SHBG) (PIE: -6.1% (-10.9% to -1.3%)). Our findings are consistent with differential pathways linking different body shapes with BC risk, with a suggestive mediation through testosterone and IGF-1 in the relationship of a generally obese body shape and BC risk, while IGF-1 and SHBG may mediate a tall/lean body shape-BC risk association.
Language	English
Publishing date	2024-04-10
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2645324-1
ISSN	2210-6014 ; 2210-6014
ISSN (online)	2210-6014
ISSN	2210-6014
DOI	10.1007/s44197-024-00226-4
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Article ; Online: Intentional Weight Loss and Cancer Risk: Never Too Late to Lose Weight.

Arnold, Melina / Freisling, Heinz / Gunter, Marc J

JNCI cancer spectrum

2019 Volume 3, Issue 4, Page(s) pkz059

Language	English
Publishing date	2019-09-13
Publishing country	England
Document type	Editorial ; Comment
ISSN	2515-5091
ISSN (online)	2515-5091
DOI	10.1093/jncics/pkz059
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Article ; Online: Gilbert's syndrome, circulating bilirubin and lung cancer: a genetic advantage?

Freisling, Heinz / Seyed Khoei, Nazlisadat / Viallon, Vivian / Wagner, Karl-Heinz

Thorax

2020 Volume 75, Issue 11, Page(s) 916–917

MeSH term(s)	Bilirubin ; Gilbert Disease ; Humans ; Lung Neoplasms
Chemical Substances	Bilirubin (RFM9X3LJ49)
Language	English
Publishing date	2020-10-06
Publishing country	England
Document type	Editorial ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thoraxjnl-2020-215642
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Article ; Online: Associations of handgrip strength with morbidity and all-cause mortality of cardiometabolic multimorbidity.

Lu, Yanqiang / Li, Guochen / Ferrari, Pietro / Freisling, Heinz / Qiao, Yanan / Wu, Luying / Shao, Liping / Ke, Chaofu

BMC medicine

2022 Volume 20, Issue 1, Page(s) 191

Abstract: Background: Cardiometabolic multimorbidity (CM) is an increasing public health and clinical concern. However, predictors for the development and prognosis of CM are poorly understood. The aims of this study were to investigate the relation between ... ...

Abstract	Background: Cardiometabolic multimorbidity (CM) is an increasing public health and clinical concern. However, predictors for the development and prognosis of CM are poorly understood. The aims of this study were to investigate the relation between handgrip strength (HGS) and the risk of CM and to examine the association of HGS with all-cause mortality risk among patients with CM. Methods: This prospective cohort study involved 493,774 participants from the UK Biobank. CM was defined as the simultaneous occurrence of two or more of the following conditions: type 2 diabetes, stroke, and coronary heart disease (CHD). Cox proportional hazards models were performed to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). Results: During a median follow-up of 12.1 years, 4701 incident CM cases were documented among participants with none cardiometabolic disease at baseline. Compared with the fourth quartile (Q4), the multivariable adjusted HR (95% CI) value of Q1 of HGS for developing CM was 1.46 (1.34-1.60). In participants with one cardiometabolic disease at baseline, participants in Q1 of HGS also possessed higher risk of CM than those in Q4, with HRs (95% CIs) being 1.35 (1.23-1.49) in patients with type 2 diabetes, 1.23 (1.04-1.46) in patients with stroke, and 1.23 (1.11-1.36) in patients with CHD. For participants with CM at recruitment, HGS was also associated with the risk of all-cause mortality (Q1 vs. Q4 HR: 1.57, 95% CI: 1.36-1.80). Conclusions: Our study provided novel evidence that HGS could be an independent predictor of morbidity and all-cause mortality of CM.
MeSH term(s)	Diabetes Mellitus, Type 2/epidemiology ; Hand Strength ; Humans ; Morbidity ; Multimorbidity ; Prospective Studies ; Stroke/epidemiology
Language	English
Publishing date	2022-06-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2131669-7
ISSN	1741-7015 ; 1741-7015
ISSN (online)	1741-7015
ISSN	1741-7015
DOI	10.1186/s12916-022-02389-y
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