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

Research output: Contribution to journalArticlepeer-review

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 (HRQ4 vs .Q1, 1.29; 95% CI, 1.00-1.68) and PUFA intakes (HRQ4 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

Original languageEnglish
Pages (from-to)65-73
Number of pages9
JournalInternational Journal of Cancer
Volume138
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

Keywords

  • differentiated thyroid carcinomas
  • EPIC
  • glycemic index
  • macronutrients
  • total energy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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