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Nutritional methods in the European Prospective Investigation of Cancer in Norfolk
- Sheila A Bingham, Ailsa A Welch, Alison McTaggart, Angela A Mulligan, Shirley A Runswick, Robert Luben, Suzy Oakes, Kay Tee Khaw, Nicholas Wareham, Nicholas E Day
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- Journal:
- Public Health Nutrition / Volume 4 / Issue 3 / June 2001
- Published online by Cambridge University Press:
- 02 January 2007, pp. 847-858
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Objective:
To describe methods and dietary habits of a large population cohort.
Design:Prospective assessment of diet using diet diaries and food-frequency questionnaires, and biomarkers of diet in 24-h urine collections and blood samples.
Setting:Free living individuals aged 45 to 75 years living in Norfolk, UK.
Subjects:Food and nutrient intake from a food-frequency questionnaire on 23 003 men and women, and from a 7-day diet diary from 2117 men and women. Nitrogen, sodium and potassium excretion was obtained from single 24-h urine samples from 300 individuals in the EPIC cohort. Plasma vitamin C was measured for 20 846 men and women.
Results:The food-frequency questionnaire (FFQ) and the food diary were able to determine differences in foods and nutrients between the sexes and were reliable as judged by repeated administrations of each method. Plasma vitamin C was significantly higher in women than men. There were significant (P<0.001) differences in mean intake of all nutrients measured by the two different methods in women but less so in men. The questionnaire overestimated dairy products and vegetables in both men and women when compared with intakes derived from the diary, but underestimated cereal and meat intake in men. There were some consistent trends with age in food and nutrient intakes assessed by both methods, particularly in men. Correlation coefficients between dietary intake assessed from the diary and excretion of nitrogen and potassium in a single 24-h urine sample ranged from 0.36 to 0.47. Those comparing urine excretion and intake assessed from the FFQ were 0.09 to 0.26. The correlations between plasma vitamin C and dietary intake from the first FFQ, 24-h recall or diary were 0.28, 0.35 and 0.40.
Conclusions:EPIC Norfolk is one of the largest epidemiological studies of nutrition in the UK and the largest on which plasma vitamin C has been obtained. Methods for obtaining food and nutrient intake are described in detail. The results shown here for food and nutrient intakes can be compared with results from other population studies utilising different methods of assessing dietary intake. The utility of different methods used in different settings within the main EPIC cohort is described. The FFQ is to be used particularly in pooled analyses of risk from diet in relation to cancer incidence within the larger European EPIC study, where measurement error is more likely to be overcome by large dietary heterogeneity on an international basis. Findings in the UK, where dietary variation between individuals is smaller and hence the need to use a more accurate individual method greater, will be derived from the 7-day diary information on a nested case–control basis. 24-h recalls can be used in the event that diary information should not be forthcoming from some eventual cases. Combinations of results utilising all dietary methods and biomarkers may also be possible.
Apolipoprotein E genotype modulates the effect of black tea drinking on blood lipids and blood coagulation factors: a pilot study
- Alexandre Loktionov, Sheila A. Bingham, Hester Vorster, Johann C. Jerling, Shirley A. Runswick, John H. Cummings
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- Journal:
- British Journal of Nutrition / Volume 79 / Issue 2 / February 1998
- Published online by Cambridge University Press:
- 09 March 2007, pp. 133-139
- Print publication:
- February 1998
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Apolipoprotein E (ApoE) genotype was determined in sixty-five subjects who had taken part in a 4-week randomized crossover trial to compare the effect of six mugs of black tea per day v. placebo on blood lipids and blood coagulation factors. Four ApoE genotype variants (seven E2/E3, forty-five E3/E3, twelve E3/E4 and one E4/E4) were found. ApoE allele frequency was within the range typical for Caucasian populations (ApoE-E2 5·4 %; ApoE-E3 83·8 %; ApoE-E4 10·8 %). Individuals bearing at least one E4 allele had substantially higher levels of serum total cholesterol, LDL cholesterol and triacylglycerols. Mean plasminogen activator inhibitor (PAI-1) activity was higher in ApoE-E4 allele-bearing individuals (E3/E4 + E4/E4, 11·89 (SE 1·27) U/ml; E3/E3, 9·19 (SE 0·80) U/ml; E2/E3, 7·21 (SE 1·04) U/ml, P values of E4-group v. E3 and E2 being respectively 0·093 and 0·030). These unexpected findings imply that elevated PAI-1 activity may be a hitherto unrecognized additional factor involved in the increased cardiovascular disease risk associated with apoE-E4 allele. The interactions between tea drinking and genotype were also examined. In the E3/E3 homozygotes, HDL-cholesterol was significantly reduced in the tea period (mean placebo 1·54 mmol/l v. mean tea 1·50 mmol/l, P = 0·027). In the E2/E3 group, triacylglycerol concentration was significantly reduced (mean placebo 1·18 mmol/l v. mean tea 1·09 mmol/l, P = 0·039). Tea also caused a significant decrease of PAI-1 activity in the subjects with E2/E3 genotype (mean placebo 7·21 U/ml v. mean tea 5.88 U/ml, P = 0·007). In the other two genotype groups, there was no significant effect of tea. The results indicate that tea drinking has a beneficial effect on some cardiovascular disease risk-associated factors, especially in E2 allele-bearing individuals. Dietary intervention may be particularly effective in population groups with certain genetic characteristics.