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  • 1. Agudo, Antonio
    et al.
    Cayssials, Valerie
    Bonet, Catalina
    Tjønneland, Anne
    Overvad, Kim
    Boutron-Ruault, Marie-Christine
    Affret, Aurélie
    Fagherazzi, Guy
    Katzke, Verena
    Schübel, Ruth
    Trichopoulou, Antonia
    Karakatsani, Anna
    La Vecchia, Carlo
    Palli, Domenico
    Grioni, Sara
    Tumino, Rosario
    Ricceri, Fulvio
    Panico, Salvatore
    Bueno-de-Mesquita, Bas
    Peeters, Petra H.
    Weiderpass, Elisabete
    Skeie, Guri
    Nøst, Theresa H.
    Lasheras, Cristina
    Rodríguez-Barranco, Miguel
    Amiano, Pilar
    Chirlaque, María-Dolores
    Ardanaz, Eva
    Ohlsson, Bodil
    Dias, Joana A.
    Nilsson, Lena M.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Myte, Robin
    Khaw, Kay-Tee
    Perez-Cornago, Aurora
    Gunter, Marc
    Huybrechts, Inge
    Cross, Amanda J.
    Tsilidis, Kostas
    Riboli, Elio
    Jakszyn, Paula
    Inflammatory potential of the diet and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study2018In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 107, no 4, p. 607-616Article in journal (Refereed)
    Abstract [en]

    Chronic inflammation plays a critical role in the pathogenesis of the 2 major types of gastric cancer. Several foods, nutrients, and nonnutrient food components seem to be involved in the regulation of chronic inflammation. We assessed the association between the inflammatory potential of the diet and the risk of gastric carcinoma, overall and for the 2 major subsites: cardia cancers and noncardia cancers. A total of 476,160 subjects (30% men, 70% women) from the European Investigation into Cancer and Nutrition (EPIC) study were followed for 14 y, during which 913 incident cases of gastric carcinoma were identified, including 236 located in the cardia, 341 in the distal part of the stomach (noncardia), and 336 with overlapping or unknown tumor site. The dietary inflammatory potential was assessed by means of an inflammatory score of the diet (ISD), calculated with the use of 28 dietary components and their corresponding inflammatory scores. The association between the ISD and gastric cancer risk was estimated by HRs and 95% CIs calculated by multivariate Cox regression models adjusted for confounders. The inflammatory potential of the diet was associated with an increased risk of gastric cancer. The HR (95% CI) for each increase in 1 SD of the ISD were 1.25 (1.12, 1.39) for all gastric cancers, 1.30 (1.06, 1.59) for cardia cancers, and 1.07 (0.89, 1.28) for noncardia cancers. The corresponding values for the highest compared with the lowest quartiles of the ISD were 1.66 (1.26, 2.20), 1.94 (1.14, 3.30), and 1.07 (0.70, 1.70), respectively. Our results suggest that low-grade chronic inflammation induced by the diet may be associated with gastric cancer risk. This pattern seems to be more consistent for gastric carcinomas located in the cardia than for those located in the distal stomach. This study is listed on the ISRCTN registry as ISRCTN12136108.

  • 2.
    Aksnes, Dag W.
    et al.
    Nordic Institute for Studies in Innovation, Research & Education (NIFU), Norway.
    Blöcker, Christopher
    Umeå University, Faculty of Science and Technology, Department of Physics.
    Colliander, Cristian
    Umeå University, Faculty of Social Sciences, Department of Sociology. Umeå University, Umeå University Library.
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Kullerud, Lars (Contributor)
    UArctic.
    Larson, Keith (Contributor)
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    SCITE team, (Contributor)
    Arctic Research Trends: Bibliometrics 2016-20222023Report (Other academic)
    Abstract [en]

    This work was conducted by the UArctic Thematic Network on Research Analytics and Bibliometrics. It was supported by Global Affairs Canada through the Global Arctic Leadership Initiative.

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  • 3.
    Aksnes, Dag W.
    et al.
    Nordic Institute for Studies in Innovation, Research & Education (NIFU), Norway.
    Danell, Rickard
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Kullerud, Lars
    University of the Arctic (UArctic).
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Larson, Keith (Contributor)
    Umeå University, Arctic Research Centre at Umeå University.
    Diane, Hirshberg (Editor)
    Institute of Social and Economic Research, University of Alaska Anchorage, United States.
    Arctic research trends: external funding 2016-20222024Report (Other academic)
    Abstract [en]

    This report aims to provide an update to the two studies published in 2016 and 2017 (Osipov et al 2016 & 2017) with the primary task of assessing the global funding landscape around Arctic-related research. While the previous reports were focusing on the periods 2006-2015 and 2007-2016 respectively, this report covers 2016 to 2022, using the funding data from the Dimensions[1] dataset, which includes information from more than 600 funders and 7 million awarded grants with funding totalling $2.4 trillion+ (in US Dollars).

    The key findings of the updated report, based on the available data, highlight the following trends:  

    ·       The fields of Earth Sciences (10.3 percent) and Environmental Science (5.5 percent) are the two largest recipients of Arctic research funding. 

    ·       The US is the largest Arctic research nation in terms of total spending and number of projects started. It also has the most comprehensive coverage of funding sources in the dataset.  

    ·       Canada and Russia are the second and third largest nations in terms of number of projects started, followed by Norway and Sweden.

    ·       UArctic institutions are central actors in Arctic research globally. 

    ·       Researchers from Arctic Council Observer nations are financing a substantial amount of research on the Arctic. In particular, the UK and Japan finance a significant number of projects, followed by Germany and China with considerable numbers of Arctic-related research projects.

    ·       Funding from the European Union holds the position of the eighth-largest funder based on the number of projects awarded. The European Union is characterized by a few projects with large funding.

    ·       The analysis suggests that there is neither growth nor shrinkage in the relative volume of Arctic research funding over the period 2016–2022 in comparison with the growth of the general scientific community.

    ·       Private funders and foundations contribute little to Arctic research. Only one percent of the projects starting in 2016–2022 were funded privately. 

    In general, the largest sources of external public funding for Arctic research come from the United States (US), Russia, Canada, and Norway, with the US being the biggest net contributor. Other kinds of funding, such as base budgets, are not described in this report. In addition, data on the public funding and funding amounts of Arctic research in Russia, Canada, and the Kingdom of Denmark are not always provided by the funders in project profiles, and net value is sometimes not disclosed by the funders themselves. 

    This report specifically investigates projects initiated between 2016 and 2022, providing insights into the contemporary funding landscape of Arctic research. Understanding the geographical and institutional distribution of funding, as well as the specific areas of focus within this funding, holds significance for UArctic and Arctic Council officials. Such insights facilitate their ability to offer informed guidance to their respective members, aiding in the identification of strategic priorities.

    Moreover, gaining insights into the entities funding Arctic research, and those not engaged in such funding, holds importance for UArctic and Arctic Council science officers. Armed with information about Arctic-focused endeavours they can engage with funding bodies, fostering dialogue aimed at enhancing support, and collaboration for such initiatives.

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  • 4. Aleksandrova, Krasimira
    et al.
    Bamia, Christina
    Drogan, Dagmar
    Lagiou, Pagona
    Trichopoulou, Antonia
    Jenab, Mazda
    Fedirko, Veronika
    Romieu, Isabelle
    Bueno-de-Mesquita, H. Bas
    Pischon, Tobias
    Tsilidis, Kostas
    Overvad, Kim
    Tjønneland, Anne
    Bouton-Ruault, Marie-Christine
    Dossus, Laure
    Racine, Antoine
    Kaaks, Rudolf
    Kuehn, Tilman
    Tsironis, Christos
    Papatesta, Eleni-Maria
    Saitakis, George
    Palli, Domenico
    Panico, Salvatore
    Grioni, Sara
    Tumino, Rosario
    Vineis, Paolo
    Peeters, Petra H.
    Weiderpass, Elisabete
    Lukic, Marko
    Braaten, Tonje
    Ramon Quiros, J.
    Lujan-Barroso, Leila
    Sanchez, Mara-Jose
    Chilarque, Maria-Dolores
    Ardanas, Eva
    Dorronsoro, Miren
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University.
    Sund, Malin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Wallström, Peter
    Ohlsson, Bodil
    Bradbury, Kathryn E.
    Khaw, Kay-Tee
    Wareham, Nick
    Stepien, Magdalena
    Duarte-Salles, Talita
    Assi, Nada
    Murphy, Neil
    Gunter, Marc J.
    Riboli, Elio
    Boeing, Heiner
    Trichopoulos, Dimitrios
    The association of coffee intake with liver cancer risk is mediated by biomarkers of inflammation and hepatocellular injury: data from the European Prospective Investigation into Cancer and Nutrition2015In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 102, no 6, p. 1498-1508Article in journal (Refereed)
    Abstract [en]

    Background: Higher coffee intake has been purportedly related to a lower risk of liver cancer. However, it remains unclear whether this association may be accounted for by specific biological mechanisms. Objective: We aimed to evaluate the potential mediating roles of inflammatory, metabolic, liver injury, and iron metabolism biomarkers on the association between coffee intake and the primary form of liver cancer-hepatocellular carcinoma (HCC). Design: We conducted a prospective nested case-control study within the European Prospective Investigation into Cancer and Nutrition among 125 incident HCC cases matched to 250 controls using an incidence-density sampling procedure. The association of coffee intake with HCC risk was evaluated by using multivariable-adjusted conditional logistic regression that accounted for smoking, alcohol consumption, hepatitis infection, and other established liver cancer risk factors. The mediating effects of 21 biomarkers were evaluated on the basis of percentage changes and associated 95% CIs in the estimated regression coefficients of models with and without adjustment for biomarkers individually and in combination. Results: The multivariable-adjusted RR of having >= 4 cups (600mL) coffee/d compared with <2 cups (300 mL)/d was 0.25 (95% CI: 0.11, 0.62; P-trend = 0.006). A statistically significant attenuation of the association between coffee intake and HCC risk and thereby suspected mediation was confirmed for the inflammatory biomarker IL-6 and for the biomarkers of hepatocellular injury glutamate dehydrogenase, alanine aminotransferase, aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), and total bilirubin, which-in combination-attenuated the regression coefficients by 72% (95% CI: 7%, 239%). Of the investigated biomarkers, IL-6, AST, and GGT produced the highest change in the regression coefficients: 40%, 56%, and 60%, respectively. Conclusion: These data suggest that the inverse association of coffee intake with HCC risk was partly accounted for by biomarkers of inflammation and hepatocellular injury.

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  • 5. Allard, Christina
    et al.
    Axelsson, Per
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Brännlund, Isabelle
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Cocq, Coppélie
    Umeå University, Faculty of Arts, Department of language studies.
    Hjortfors, Lis-Mari
    Umeå University, Faculty of Arts, Department of language studies. Umeå University, Faculty of Arts, Centre for Sami Research.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences.
    Ledman, Anna-Lill
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Löf, Annette
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Johansson Lönn, Eva
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Moen, Jon
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University.
    Nordin, Gabriella
    Umeå University, Arctic Research Centre at Umeå University.
    Nordlund, Christer
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Norlin, Björn
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Outakoski, Hanna
    Umeå University, Faculty of Arts, Department of language studies.
    Reimerson, Elsa
    Umeå University, Faculty of Social Sciences, Department of Political Science.
    Sandström, Camilla
    Umeå University, Faculty of Social Sciences, Department of Political Science.
    Sandström, Moa
    Umeå University, Faculty of Arts, Centre for Sami Research. Umeå University, Faculty of Arts, Department of language studies.
    Sehlin MacNeil, Kristina
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Sköld, Peter
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Stoor, Krister
    Umeå University, Faculty of Arts, Department of language studies.
    Storm Mienna, Christina
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Svonni, Charlotta
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Vinka, Mikael
    Össbo, Åsa
    Umeå University, Faculty of Arts, Department of language studies.
    Rasbiologiskt språkbruk i statens rättsprocess mot sameby2015In: Dagens Nyheter, ISSN 1101-2447Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Statens hantering av forskningsresultat i rättsprocessen med Girjas sameby utgör ett hot mot Sverige som rättsstat och kunskapsnation. Åratal av svensk och internationell forskning underkänns och man använder ett språkbruk som skulle kunna vara hämtat från rasbiologins tid. Nu måste staten ta sitt ansvar och börja agera som en demokratisk rättsstat, skriver 59 forskare.

  • 6.
    Anne, Ouma
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Sámi traditional medicine and complementary and alternative medicine: a descriptive study of use within the Sámi population of Sweden2023In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 82, no 1, article id 2222908Article in journal (Refereed)
    Abstract [en]

    Traditional medicine has been practised for millennia in the Sámi population, based on a Sámi worldview and cosmology, which includes natural remedies, prayers, drums and yoik singing. During the Christianisation of the Sámi during the seventeenth and eighteenth centuries, these practices were condemned. In recent years, however, a revival of Sámi culture has occurred and so has the practice of Sámi traditional medicine (STM) and the use of complementary alternative medicine (CAM). The aim of this study is to map the prevalence and use of STM and CAM among Sámi in Sweden today. The study population consisted of 3641 Sámi from the whole of Sweden, who had participated in the population-based cross-sectional survey Sámi Health on Equal Terms (SámiHET) in 2021. Our results show that women are more prone to use both STM and CAM than men and that younger persons are more likely to use STM and CAM than elderly persons. STM is more often used in the northern parts of Sápmi compared to the southern parts as well as a lower use of CAM in the north. This might be due to the stronger Sámi identity and easier access to traditional Sámi healers/helpers in the north as well as limited access to CAM services.

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  • 7. Asli, Lene A.
    et al.
    Braaten, Tonje
    Olsen, Anja
    Tjonneland, Anne
    Overvad, Kim
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Renstrom, Frida
    Umeå University, Faculty of Medicine, Department of Biobank Research. Department of Clinical Sciences, Lund University, Sweden.
    Lund, Eiliv
    Skeie, Guri
    Potato consumption and risk of pancreatic cancer in the HELGA cohort2018In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 119, no 12, p. 1408-1415Article, review/survey (Refereed)
    Abstract [en]

    Potatoes have been a staple food in many countries throughout the years. Potatoes have a high glycaemic index (GI) score, and high GI has been associated with several chronic diseases and cancers. Still, the research on potatoes and health is scarce and contradictive, and we identified no prospective studies that had investigated the association between potatoes as a single food and the risk of pancreatic cancer. The aim of this study was to prospectively investigate the association between potato consumption and pancreatic cancer among 114 240 men and women in the prospective HELGA cohort, using Cox proportional hazard models. Information on diet (validated FFQ's), lifestyle and health was collected by means of a questionnaire, and 221 pancreatic cancer cases were identified through cancer registries. The mean follow-up time was 11.4 (95 % CI 0.3, 169) years. High consumption of potatoes showed a non-significantly higher risk of pancreatic cancer in the adjusted model (hazard ratio (HR) 1.44; 95 % CI 0.93, 2.22, P-for trend 0.030) when comparing the highest v. the lowest quartile of potato consumption. In the sex-specific analyses, significant associations were found for females (HR 2.00; 95 % CI 1.07, 3.72, P-for trend 0.020), but not for males (HR 1.01; 95 % CI 0.56, 1.84, P-for trend 0.34). In addition, we explored the associations by spline regression, and the absence of dose-response effects was confirmed. In this study, high potato consumption was not consistently associated with a higher risk of pancreatic cancer. Further studies with larger populations are needed to explore the possible sex difference.

  • 8. Bamia, C.
    et al.
    Lagiou, P.
    Jenab, M.
    Aleksandrova, K.
    Fedirko, V.
    Trichopoulos, D.
    Overvad, K.
    Tjonneland, A.
    Olsen, A.
    Clavel-Chapelon, F.
    Boutron-Ruault, M-C
    Kvaskoff, M.
    Katzke, V. A.
    Kuehn, T.
    Boeing, H.
    Noethlings, U.
    Palli, D.
    Sieri, S.
    Panico, S.
    Tumino, R.
    Naccarati, A.
    Bueno-de-Mesquita, H. B(As)
    Peeters, P. H. M.
    Weiderpass, E.
    Skeie, G.
    Quiros, J. R.
    Agudo, A.
    Chirlaque, M-D
    Sanchez, M-J
    Ardanaz, E.
    Dorronsoro, M.
    Ericson, U.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Arctic Research Centre at Umeå University.
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Khaw, K-T
    Wareham, N.
    Key, T. J.
    Travis, R. C.
    Ferrari, P.
    Stepien, M.
    Duarte-Salles, T.
    Norat, T.
    Murphy, N.
    Riboli, E.
    Trichopoulou, A.
    Fruit and vegetable consumption in relation to hepatocellular carcinoma in a multi-centre, European cohort study2015In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 112, no 7, p. 1273-1282Article in journal (Refereed)
    Abstract [en]

    Background:Vegetable and/or fruit intakes in association with hepatocellular carcinoma (HCC) risk have been investigated in case-control studies conducted in specific European countries and cohort studies conducted in Asia, with inconclusive results. No multi-centre European cohort has investigated the indicated associations. Methods: In 486 799 men/women from the European Prospective Investigation into Cancer and nutrition, we identified 201 HCC cases after 11 years median follow-up. We calculated adjusted hazard ratios (HRs) for HCC incidence for sex-specific quintiles and per 100 g d(-1) increments of vegetable/fruit intakes. Results: Higher vegetable intake was associated with a statistically significant, monotonic reduction of HCC risk: HR (100 g d(-1) increment): 0.83; 95% CI: 0.71-0.98. This association was consistent in sensitivity analyses with no apparent heterogeneity across strata of HCC risk factors. Fruit intake was not associated with HCC incidence: HR (100 g d(-1) increment): 1.01; 95% CI: 0.92-1.11. Conclusions: Vegetable, but not fruit, intake is associated with lower HCC risk with no evidence for heterogeneity of this association in strata of important HCC risk factors. Mechanistic studies should clarify pathways underlying this association. Given that HCC prognosis is poor and that vegetables are practically universally accessible, our results may be important, especially for those at high risk for the disease.

  • 9. Bamia, Christina
    et al.
    Lagiou, Pagona
    Jenab, Mazda
    Trichopoulou, Antonia
    Fedirko, Veronika
    Aleksandrova, Krasimira
    Pischon, Tobias
    Overvad, Kim
    Olsen, Anja
    Tjønneland, Anne
    Boutron-Ruault, Marie-Christine
    Fagherazzi, Guy
    Racine, Antoine
    Kuhn, Tilman
    Boeing, Heiner
    Floegel, Anna
    Benetou, Vasiliki
    Palli, Domenico
    Grioni, Sara
    Panico, Salvatore
    Tumino, Rosario
    Vineis, Paolo
    Bueno-de-Mesquita, H B As
    Dik, Vincent K
    Bhoo-Pathy, Nirmala
    Uiterwaal, Cuno S P M
    Weiderpass, Elisabete
    Lund, Eiliv
    Quirós, J Ramón
    Zamora-Ros, Raul
    Molina-Montes, Esther
    Chirlaque, Maria-Dolores
    Ardanaz, Eva
    Dorronsoro, Miren
    Lindkvist, Björn
    Wallström, Peter
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Arctic Research Centre at Umeå University.
    Sund, Malin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Khaw, Kay-Tee
    Wareham, Nick
    Bradbury, Kathryn E
    Travis, Ruth C
    Ferrari, Pietro
    Duarte-Salles, Talita
    Stepien, Magdalena
    Gunter, Marc
    Murphy, Neil
    Riboli, Elio
    Trichopoulos, Dimitrios
    Coffee, tea and decaffeinated coffee in relation to hepatocellular carcinoma in a European population: multicentre, prospective cohort study2015In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 136, no 8, p. 1899-1908Article in journal (Refereed)
    Abstract [en]

    Inverse associations of coffee and/or tea in relation to hepatocellular carcinoma (HCC) risk have been consistently identified in studies conducted mostly in Asia where consumption patterns of such beverages differ from Europe. In the European Prospective Investigation into Cancer and nutrition (EPIC), we identified 201 HCC cases among 486,799 men/women, after a median follow-up of 11 years. We calculated adjusted hazard ratios (HRs) for HCC incidence in relation to quintiles/categories of coffee/tea intakes. We found that increased coffee and tea intakes were consistently associated with lower HCC risk. The inverse associations were substantial, monotonic and statistically significant. Coffee consumers in the highest compared to the lowest quintile had lower HCC risk by 72% [HR: 0.28; 95% confidence intervals (CIs): 0.16-0.50, p-trend < 0.001]. The corresponding association of tea with HCC risk was 0.41 (95% CI: 0.22-0.78, p-trend = 0.003). There was no compelling evidence of heterogeneity of these associations across strata of important HCC risk factors, including hepatitis B or hepatitis C status (available in a nested case-control study). The inverse, monotonic associations of coffee intake with HCC were apparent for caffeinated (p-trend = 0.009), but not decaffeinated (p-trend = 0.45) coffee for which, however, data were available for a fraction of subjects. Results from this multicentre, European cohort study strengthen the existing evidence regarding the inverse association between coffee/tea and HCC risk. Given the apparent lack of heterogeneity of these associations by HCC risk factors and that coffee/tea are universal exposures, our results could have important implications for high HCC risk subjects.

  • 10. Berendsen, Agnes A M
    et al.
    Kang, Jae H
    van de Rest, Ondine
    Jankovic, Nicole
    Kampman, Ellen
    Kiefte-de Jong, Jessica C
    Franco, Oscar H
    Ikram, M Arfan
    Pikhart, Hynek
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Brenner, Hermann
    Boffetta, Paolo
    Rafnsson, Snorri Bjorn
    Gustafson, Deborah
    Kyrozis, Andreas
    Trichopoulou, Antonia
    Feskens, Edith J M
    Grodstein, Francine
    de Groot, Lisette C P G M
    Association of Adherence to a Healthy Diet with Cognitive Decline in European and American Older Adults: A Meta-Analysis within the CHANCES Consortium2017In: Dementia and Geriatric Cognitive Disorders, ISSN 1420-8008, E-ISSN 1421-9824, Vol. 43, no 3-4, p. 215-227Article in journal (Refereed)
    Abstract [en]

    AIM: To examine the association between a healthy diet, assessed by the Healthy Diet Indicator (HDI), and cognitive decline in older adults. METHODS: Data from 21,837 participants aged ≥55 years from 3 cohorts (Survey in Europe on Nutrition and the Elderly, a Concerted Action [SENECA], Rotterdam Study [RS], Nurses' Health Study [NHS]) were analyzed. HDI scores were based on intakes of saturated fatty acids, polyunsaturated fatty acids, mono- and disaccharides, protein, cholesterol, fruits and vegetables, and fiber. The Telephone Interview for Cognitive Status in NHS and Mini-Mental State Examination in RS and SENECA were used to assess cognitive function from multiple repeated measures. Using multivariable-adjusted, mixed linear regression, mean differences in annual rates of cognitive decline by HDI quintiles were estimated. RESULTS: Multivariable-adjusted differences in rates in the highest versus the lowest HDI quintile were 0.01 (95% CI -0.01, 0.02) in NHS, 0.00 (95% CI -0.02, 0.01) in RS, and 0.00 (95% CI -0.05, 0.05) in SENECA with a pooled estimate of 0.00 (95% CI -0.01, 0.01), I2 = 0%. CONCLUSIONS: A higher HDI score was not related to reduced rates of cognitive decline in European and American older adults.

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  • 11. Bhoo-Pathy, Nirmala
    et al.
    Peeters, Petra H. M.
    Uiterwaal, Cuno S. P. M.
    Bueno-de-Mesquita, H. Bas
    Bulgiba, Awang M.
    Bech, Bodil Hammer
    Overvad, Kim
    Tjønneland, Anne
    Olsen, Anja
    Clavel-Chapelon, Francoise
    Fagherazzi, Guy
    Perquier, Florence
    Teucher, Birgit
    Kaaks, Rudolf
    Schuetze, Madlen
    Boeing, Heiner
    Lagiou, Pagona
    Orfanos, Philippos
    Trichopoulou, Antonia
    Agnoli, Claudia
    Mattiello, Amalia
    Palli, Domenico
    Tumino, Rosario
    Sacerdote, Carlotta
    van Duijnhoven, Franzel J. B.
    Braaten, Tonje
    Lund, Eiliv
    Skeie, Guri
    Redondo, Maria-Luisa
    Buckland, Genevieve
    Sanchez Perez, Maria Jose
    Chirlaque, Maria-Dolores
    Ardanaz, Eva
    Amiano, Pilar
    Wirfalt, Elisabet
    Wallstrom, Peter
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Khaw, Kay-Tee
    Wareham, Nick
    Allen, Naomi E.
    Key, Timothy J.
    Rinaldi, Sabina
    Romieu, Isabelle
    Gallo, Valentina
    Riboli, Elio
    van Gils, Carla H.
    Coffee and tea consumption and risk of pre- and postmenopausal breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study2015In: Breast Cancer Research, ISSN 1465-5411, E-ISSN 1465-542X, Vol. 17, article id 15Article in journal (Refereed)
    Abstract [en]

    Introduction: Specific coffee subtypes and tea may impact risk of pre- and post-menopausal breast cancer differently. We investigated the association between coffee (total, caffeinated, decaffeinated) and tea intake and risk of breast cancer. Methods: A total of 335,060 women participating in the European Prospective Investigation into Nutrition and Cancer (EPIC) Study, completed a dietary questionnaire from 1992 to 2000, and were followed-up until 2010 for incidence of breast cancer. Hazard ratios (HR) of breast cancer by country-specific, as well as cohort-wide categories of beverage intake were estimated. Results: During an average follow-up of 11 years, 1064 premenopausal, and 9134 postmenopausal breast cancers were diagnosed. Caffeinated coffee intake was associated with lower risk of postmenopausal breast cancer: adjusted HR = 0.90, 95% confidence interval (CI): 0.82 to 0.98, for high versus low consumption; P-trend = 0.029. While there was no significant effect modification by hormone receptor status (P = 0.711), linear trend for lower risk of breast cancer with increasing caffeinated coffee intake was clearest for estrogen and progesterone receptor negative (ER-PR-), postmenopausal breast cancer (P = 0.008). For every 100 ml increase in caffeinated coffee intake, the risk of ER-PR- breast cancer was lower by 4% (adjusted HR: 0.96, 95% CI: 0.93 to 1.00). Non-consumers of decaffeinated coffee had lower risk of postmenopausal breast cancer (adjusted HR = 0.89; 95% CI: 0.80 to 0.99) compared to low consumers, without evidence of dose-response relationship (P-trend = 0.128). Exclusive decaffeinated coffee consumption was not related to postmenopausal breast cancer risk, compared to any decaffeinated-low caffeinated intake (adjusted HR = 0.97; 95% CI: 0.82 to 1.14), or to no intake of any coffee (HR: 0.96; 95%: 0.82 to 1.14). Caffeinated and decaffeinated coffee were not associated with premenopausal breast cancer. Tea intake was neither associated with pre- nor post-menopausal breast cancer. Conclusions: Higher caffeinated coffee intake may be associated with lower risk of postmenopausal breast cancer. Decaffeinated coffee intake does not seem to be associated with breast cancer.

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  • 12.
    Bodén, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Myte, Robin
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Harlid, Sophia
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Shivappa, Nitin
    Hébert, James R
    van Guelpen, Bethany
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology. Umeå University, Faculty of Medicine, Wallenberg Centre for Molecular Medicine at Umeå University (WCMM).
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    The inflammatory potential of diet in determining cancer risk: a prospective investigation of two dietary pattern scores2019In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 4, article id e0214551Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Inflammation-related mechanisms may contribute to the link between diet and cancer. We sought to investigate the inflammatory impact of diet on cancer risk using the Dietary inflammatory index (DII) and an adapted Mediterranean diet score (MDS).

    METHODS: This population-based, prospective cohort study used self-reported dietary data from the Västerbotten Intervention Programme, including 100,881 participants, of whom 35,393 had repeated measures. Associations between dietary patterns and cancer risk were evaluated using Cox proportional hazards regression. We also used restricted cubic splines to test for potential non-linear associations.

    RESULTS: A total of 9,250 incident cancer cases were diagnosed during a median follow-up of 15 years. The two dietary patterns were moderately correlated to each other and had similar associations with cancer risk, predominantly lung cancer in men (DII per tertile decrease: Hazard ratio (HR) 0.81 (0.66-0.99), MDS per tertile increase: HR 0.86 (0.72-1.03)), and gastric cancer in men (DII: 0.73 (0.53-0.99), MDS: 0.73 (0.56-0.96)). Associations were, in general, found to be linear. We found no longitudinal association between 10-year change in diet and cancer risk.

    CONCLUSION: We confirm small, but consistent and statistically significant associations between a more anti-inflammatory or healthier diet and reduced risk of cancer, including a lower risk of lung and gastric cancer in men. The dietary indexes produced similar associations with respect to the risk of cancer.

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  • 13.
    Bodén, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Van Guelpen, Bethany
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Andersson, Jonas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Shivappa, Nitin
    Hebert, James R
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Dietary inflammatory index and risk of first myocardial infarction: a prospective population-based study2017In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 16, article id 21Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Chronic, low-grade inflammation is an established risk factor for cardiovascular disease. The inflammatory impact of diet can be reflected by concentrations of inflammatory markers in the bloodstream and the inflammatory potential of diet can be estimated by the dietary inflammatory index (DII(TM)), which has been associated with cardiovascular disease risk in some previous studies. We aimed to examine the association between the DII and the risk of first myocardial infarction (MI) in a population-based study with long follow-up.

    METHOD: We conducted a prospective case-control study of 1389 verified cases of first MI and 5555 matched controls nested within the population-based cohorts of the Northern Sweden Health and Disease Study (NSHDS), of which the largest is the ongoing Västerbotten Intervention Programme (VIP) with nearly 100 000 participants during the study period. Median follow-up from recruitment to MI diagnosis was 6.4 years (6.2 for men and 7.2 for women). DII scores were derived from a validated food frequency questionnaire (FFQ) administered in 1986-2006. Multivariable conditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI), using quartile 1 (most anti-inflammatory diet) as the reference category. For validation, general linear models were used to estimate the association between the DII scores and two inflammatory markers, high-sensitivity C-reactive protein (hsCRP) and interleukin 6 (IL-6) in a subset (n = 605) of the study population.

    RESULTS: Male participants with the most pro-inflammatory DII scores had an increased risk of MI [ORQ4vsQ1 = 1.57 (95% CI 1.21-2.02) P trend = 0.02], which was essentially unchanged after adjustment for potential confounders, including cardiovascular risk factors [ORQ4vsQ1 = 1.50 (95% CI 1.14-1.99), P trend = 0.10]. No association was found between DII and MI in women. An increase of one DII score unit was associated with 9% higher hsCRP (95% CI 0.03-0.14) and 6% higher IL-6 (95% CI 0.02-0.11) in 605 controls with biomarker data available.

    CONCLUSION: A pro-inflammatory diet was associated with an elevated risk of first myocardial infarction in men; whereas for women the relationship was null. Consideration of the inflammatory impact of diet could improve prevention of cardiovascular disease.

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  • 14.
    Brandén, Jennie
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Burman, Monica
    Umeå University, Faculty of Social Sciences, Unit of Police Work.
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Stoor, Jon Petter
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Våld mot samiska kvinnor2024Report (Other academic)
    Abstract [sv]

    I den här rapporten presenterar vi resultat från forskningsprojektet ”Våld mot samiska kvinnor” som 2021-2024 genomförts av forskargruppen Lávvuo vid Umeå Universitet, på uppdrag av Sámediggi (Sametinget i Sverige).

    Rapporten består av en kvantitativ och en kvalitativ del, samt fem åtgärdsförslag riktade till Sveriges regering.

    De kvantitativa resultaten i korthet

    Den kvantitativa delen av rapporten baseras på enkätundersökningen Samisk hälsa på lika villkor som genomfördes 2021. Resultaten har jämförts med Sveriges befolkning genom den nationella enkäten Sexuell och reproduktiv hälsa genomförd 2017. 

    Det övergripande mönstret är att kvinnor är betydligt mer utsatta för våld än män, samt att samiska kvinnor 2021 uppger en högre våldsutsatthet än kvinnor i Sverige 2017, för de flesta typer av våld.

    • Över hälften av de samiska kvinnorna har utsatts för sexuellt våld (55,5 procent), sju av tio har utsatts för psykiskt våld (68,5 procent) och nästan var tredje för fysiskt våld (27,9 procent).
    • En större andel samiska kvinnor än kvinnor i Sverige i stort uppger utsatthet för de grövsta formerna av sexuellt våld, såsom våldtäktsförsök (14,1 jämfört med 10,6 procent) och våldtäkt (10,3 jämfört med 7,0 procent).
    • En större andel samiska kvinnor än kvinnor i Sverige i stort uppger utsatthet för psykiskt våld, både sammantaget (68,5 jämfört med 50,9 procent) och vad gäller alla de former av psykiskt våld som undersöktes.
    • Även när det gällde fysiskt våld rapporterade samiska kvinnor (27,9 procent) en högre utsatthet jämfört med kvinnor i Sverige (22,0 procent).
    • Samiska kvinnors utsatthet för våld varierar med både ålder och geografi. Överlag var utsattheten högst bland kvinnor yngre än 45 år. Geografiskt var utsattheten för sexuellt och fysiskt våld högre bland samiska kvinnor i mellersta och södra Sverige, med undantag av Stockholmsområdet. För psykiskt våld hade samiska kvinnor i Jämtland Härjedalen en högre utsatthet.
    • Det finns flera starka samband mellan olika typer av våldsutsatthet och psykisk och fysisk ohälsa. Upprepad våldsutsatthet (fler än en gång) är förenat med ännu högre risk för ohälsa, särskilt psykisk ohälsa. Starkast är detta samband när det gäller stress och självmordstankar.
    • När det gäller diskriminering och rasism uppger en betydande andel av samer i Sverige att de utsatts någon gång i livet. Liksom för andra former av våld i denna undersökning visar analysen att en högre andel samiska kvinnor (44,5 procent) utsatts jämfört med samiska män (37,0 procent).
    • HBTQ-samer är mer våldsutsatta än andra samer. Detta gäller sexuellt våld (64,6 jämfört med 30,9 procent), psykiskt våld (81,7 jämfört med 58,4 procent) och fysiskt våld (43,8 jämfört med 25,5 procent).

    De kvalitativa resultaten i korthet

    Den kvalitativa delen baseras på intervjuer med professionella som arbetar inom samhällets stödstrukturer för våldsutsatta i olika delar av den svenska delen av Sápmi.

    • Intervjustudien visar att våld mot samiska kvinnor är en fråga som behöver förstås i relation till den bredare politiska och historiska, koloniala, och könade kontext som våldet utspelar sig i.
    • Frågan om våld mot samiska kvinnor osynliggörs och beskrivs som svår att adressera – både i det samiska samhället och i majoritetssamhället.
    • Kunskapen om det samiska samhället är låg inom samhällets stödstrukturer. Deltagare beskrev att samiska perspektiv saknas i styrdokument kring mäns våld mot kvinnor och i befintlig terminologi. Detta gör att förhållanden i det samiska samhället som kan påverka den våldsutsattas situation negligeras i mötet med samiska klienter, patienter och brukare som utsätts för våld.
    • Frågan om våld mot samiska kvinnor beskrevs som ”känslig” och ”laddad”. Sammantaget framträder ett stigma kring frågan och en oro för att ”göra fel” eller bidra till fördomar och rasism mot samer, både i det samiska samhället och majoritetssamhället.
    • Problemet med våld mot samiska kvinnor beskrevs som svår att adressera inom en redan marginaliserad samisk kontext, där värnandet av samiska kollektiva rättigheter har prioriterats.
    • Det finns en rad särskilda förhållanden knutna till det samiska samhället som är viktiga att ha kunskap om och vara lyhörd för i mötet med våldsutsatta samiska personer och i arbetet för att motverka våld mot samiska kvinnor.
    • Närheten och lokalkännedomen i mindre samhällen beskrevs som styrkor, men samtidigt lyftes utmaningar såsom bristande anonymitet, resurser, kompetens och insatser. Svårigheten att vara anonym och långa geografiska avstånd till samhällets stöd beskrevs som extra påtagligt i det samiska samhället. Stark samhörighet i det samiska samhället beskrevs som positivt men också potentiellt problematiskt när det gäller den utsattas situation.
    • Bristande tillit till myndigheter bland samer är en potentiell barriär för att nå och stötta våldsutsatta samiska kvinnor. Den bristande tilliten relaterades till både historiska och samtida erfarenheter av okunskap, förtryck, rasism och diskriminering.
    • Deltagare beskrev ojämställdhet och tystnad kring våld mot kvinnor i det samiska samhället, och att våld mot kvinnor ofta hanteras internt. Tystnaden knöts till en lojalitet med samiska män, ett ideal att samiska kvinnor ska vara starka och klara sig själva, samt en vilja att skydda familjen och det samiska kollektivet.
    • Ett centralt hinder för utsatta kvinnor att lämna en våldsam relation beskrevs vara rädslan för att uppbrottet skulle innebära förlust av deras samiska sammanhang. Ens samiska identitet beskrevs till exempel som nära knuten till platsen och markerna och därmed som svår att upprätthålla vid flytt till en annan ort för att söka skydd.

    Åtgärdsförslag till Sveriges regering

    Baserat på de utvecklingsbehov som identifierats genom detta forskningsprojekt utmynnar rapporten i fem åtgärdsförslag riktade till den svenska regeringen.

    1. Uppdra åt Sametinget att följa upp och samordna arbetet för att motverka våld mot samiska kvinnor.
    2. Utforma en nationell policy för att motverka våld mot samiska kvinnor.
    3. Utveckla stödstrukturer för våldsutsatta samiska kvinnor och flickor.
    4. Genomför kortsiktiga utbildningsinsatser.
    5. Säkra långsiktig kunskapsproduktion och kompetenshöjning.
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  • 15.
    Brandén, Jennie
    et al.
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Social Sciences, Department of Political Science. Lávvuo – forskning och utbildning för samisk hälsa, Umeå universitet, Umeå, Sverige..
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Lávvuo – forskning och utbildning för samisk hälsa, Umeå universitet, Umeå, Sverige..
    Burman, Monica
    Umeå University, Faculty of Social Sciences, Police Education Unit at Umeå University. Lávvuo – forskning och utbildning för samisk hälsa, Umeå universitet, Umeå, Sverige..
    Stoor, Jon Petter A.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Institutionen för Epidemiologi och Global Hälsa, Lávvuo – forskning och utbildning för samisk hälsa, Umeå universitet, Umeå, Sverige; Senter for Samisk Helseforskning, Institutt for Samfunnsmedisin, UiT – Norges Arktiske Universitet, Tromsø, Norge.
    Utsatthet för sexuellt våld bland samiska kvinnor i Sverige: den Samiska HLV studien 20212023In: Tidsskrift for kjønnsforskning, ISSN 0809-6341, E-ISSN 1891-1781, Vol. 47, no 2-3, p. 113-129Article in journal (Refereed)
    Abstract [en]

    The issue of sexual violence has in recent years gained increased attention in Sápmi. Based on the population-basedstudy «Sámi Health on Equal Terms» (SámiHET) 2021, this paper examines exposure to sexual violence among Sámiwomen and men in Sweden, compared to women and men in the Swedish population. The analysis shows that sexualviolence against women constitutes a significant problem in the Sámi society, to at least the same extent as in the restof Sweden. Sámiwomen report a significantly higher exposure to several forms of sexual violence compared towomenin Sweden, including exposure to rape and attempted rape. The analysis also shows that Sámi women are more likelyto seek healthcare and report to the police after sexual abuse, which nuances the image of a passive silence surroundingsexual violence in Sápmi. Drawing on Indigenous feminist perspectives, the article highlights how gendered andcolonial power relations interact in terms of vulnerability to sexual violence in Sweden and that the position of beinga Sámi woman increases exposure to sexual violence, while being a Sámi man does not. In sum, the results show thatboth gender and Sámi Indigeneity affect exposure to sexual violence, which points to the need to include Sámi perspectivesin future research on, and political efforts against, sexual violence.

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  • 16. Buckland, G
    et al.
    Ros, M M
    Roswall, N
    Bueno-de-Mesquita, H B
    Travier, N
    Tjonneland, A
    Kiemeney, L A
    Sacerdote, C
    Tumino, R
    Ljungberg, Börje
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
    Gram, I T
    Weiderpass, E
    Skeie, G
    Malm, J
    Ehrnström, R
    Chang-Claude, J
    Mattiello, A
    Agnoli, C
    Peeters, P H
    Boutron-Ruault, M C
    Fagherazzi, G
    Clavel-Chapelon, F
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Amiano, P
    Trichopoulou, A
    Oikonomou, E
    Tsiotas, K
    Sánchez, M J
    Overvad, K
    Quirós, J R
    Chirlaque, M D
    Barricarte, A
    Key, T J
    Allen, N E
    Khaw, K T
    Wareham, N
    Riboli, E
    Kaaks, R
    Boeing, H
    Palli, D
    Romieu, I
    Romaguera, D
    Gonzalez, C A
    Adherence to the Mediterranean diet and risk of bladder cancer in the EPIC cohort study2014In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 134, no 10, p. 2504-2511Article in journal (Refereed)
    Abstract [en]

    There is growing evidence of the protective role of the Mediterranean diet (MD) on cancer. However, to date no epidemiological study has investigated the influence of the MD on bladder cancer. We evaluated the association between adherence to the MD and risk of urothelial cell bladder cancer (UCC), according to tumor aggressiveness, in the European Prospective Investigation into Cancer and Nutrition (EPIC). The analysis included 477,312 participants, recruited from ten European countries between 1991 and 2000. Information from validated dietary questionnaires was used to develop a relative Mediterranean diet score (rMED), including nine dietary components. Cox regression models were used to assess the effect of the rMED on UCC risk, while adjusting for dietary energy and tobacco smoking of any kind. Stratified analyses were performed by sex, BMI, smoking status, European region and age at diagnosis. During an average follow-up of 11 years, 1,425 participants (70.9% male) were diagnosed with a first primary UCC. There was a negative but non-significant association between a high versus low rMED score and risk of UCC overall (HR: 0.84 [95% CI 0.69, 1.03]) and risk of aggressive (HR: 0.88 [95% CI 0.61, 1.28]) and non-aggressive tumors (HR: 0.78 [95% CI 0.54, 1.14]). Although there was no effect modification in the stratified analyses, there was a significant 34% (p = 0.043) decreased risk of UCC in current smokers with a high rMED score. In EPIC, the MD was not significantly associated with risk of UCC, although we cannot exclude that a MD may reduce risk in current smokers.

  • 17. Caini, Saverio
    et al.
    Masala, Giovanna
    Saieva, Calogero
    Kvaskoff, Marina
    Sacerdote, Carlotta
    Savoye, Isabelle
    Hemmingsson, Oskar
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Bech, Bodil Hammer
    Overvad, Kim
    Tjonneland, Anne
    Petersen, Kristina E. N.
    Mancini, Francesca Romana
    Boutron-Ruault, Marie-Christine
    Cervenka, Iris
    Kaaks, Rudolf
    Kuehn, Tilman
    Boeing, Heiner
    Floegel, Anna
    Trichopoulou, Antonia
    Valanou, Elisavet
    Kritikou, Maria
    Tagliabue, Giovanna
    Panico, Salvatore
    Tumino, Rosario
    Bueno-de-Mesquita, H. B(as)
    Peeters, Petra H.
    Veierod, Marit B.
    Ghiasvand, Reza
    Lukic, Marko
    Ramon Quiros, Jose
    Chirlaque, Maria-Dolores
    Ardanaz, Eva
    Salamanca Fernandez, Elena
    Larranaga, Nerea
    Zamora-Ros, Raul
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Ljuslinder, Ingrid
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Jirstrom, Karin
    Sonestedt, Emily
    Key, Timothy J.
    Wareham, Nick
    Khaw, Kay-Tee
    Gunter, Marc
    Huybrechts, Inge
    Murphy, Neil
    Tsilidis, Konstantinos K.
    Weiderpass, Elisabete
    Palli, Domenico
    Coffee, tea and melanoma risk: findings from the European Prospective Investigation into Cancer and Nutrition2017In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 140, no 10, p. 2246-2255Article in journal (Refereed)
    Abstract [en]

    What's new? Laboratory studies suggest that coffee and tea protect against melanoma, but epidemiological findings are inconsistent. Here the authors studied more than 400,000 participants within the European Prospective Investigation into Cancer and Nutrition (EPIC) and confirmed an inverse association between caffeinated coffee consumption and melanoma risk. No association was found with decaffeinated coffee or tea. Interestingly, drinking coffee only protected men, but not women, from developing the often fatal skin cancer, raising interesting questions about gender-specific hormones or coffee habits influencing this association. In vitro and animal studies suggest that bioactive constituents of coffee and tea may have anticarcinogenic effects against cutaneous melanoma; however, epidemiological evidence is limited to date. We examined the relationships between coffee (total, caffeinated or decaffeinated) and tea consumption and risk of melanoma in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a multicentre prospective study that enrolled over 500,000 participants aged 25-70 years from ten European countries in 1992-2000. Information on coffee and tea drinking was collected at baseline using validated country-specific dietary questionnaires. We used adjusted Cox proportional hazards regression models to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for the associations between coffee and tea consumption and melanoma risk. Overall, 2,712 melanoma cases were identified during a median follow-up of 14.9 years among 476,160 study participants. Consumption of caffeinated coffee was inversely associated with melanoma risk among men (HR for highest quartile of consumption vs. non-consumers 0.31, 95% CI 0.14-0.69) but not among women (HR 0.96, 95% CI 0.62-1.47). There were no statistically significant associations between consumption of decaffeinated coffee or tea and the risk of melanoma among both men and women. The consumption of caffeinated coffee was inversely associated with melanoma risk among men in this large cohort study. Further investigations are warranted to confirm our findings and clarify the possible role of caffeine and other coffee compounds in reducing the risk of melanoma.

  • 18.
    Carson, Dean B.
    et al.
    Umeå University, Arctic Research Centre at Umeå University. Centre for Tourism and Regional Opportunities, Central Queensland University, Cairns, Australia.
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Carson, Doris A.
    Umeå University, Faculty of Social Sciences, Department of Geography.
    The mining resource cycle and settlement demography in Malå, Northern Sweden2020In: Polar Record, ISSN 0032-2474, E-ISSN 1475-3057, Vol. 56, article id e10Article in journal (Refereed)
    Abstract [en]

    Research on the demographic impacts of mining in sparsely populated areas has focused primarily on relatively large towns. Less attention has been paid to smaller villages, which may experience different impacts because of their highly concentrated economies and their small populations, making them more vulnerable to demographic “boom and bust” effects. This paper examines demographic change in four small villages in northern Sweden, which are located close to several mining projects but have evolved through different degrees of integration with or separation from mining. Using a longitudinal “resource cycle” perspective, the demographic trajectories of the villages are compared to understand how different types of settlement and engagement with mining have led to different demographic outcomes in the long term. While the four villages experienced similar trajectories in terms of overall population growth and decline, their experiences in relation to more nuanced indicators, including age and gender distributions and population mobilities, were different, and potential reasons for this are discussed. Due to data limitations, however, the long-term demographic consequences of mining for local Sami people remain unclear. The paper problematises this research gap in light of general concerns about mining impacts on traditional Sami livelihoods.

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  • 19.
    Carson, Dean B.
    et al.
    Umeå University, Arctic Research Centre at Umeå University.
    Sköld, Peter
    Umeå University, Arctic Research Centre at Umeå University.
    Carson, Doris A.
    Umeå University, Faculty of Social Sciences, Department of Geography and Economic History.
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University.
    The local demography of resource economies: long term implications of natural resource industries for demographic development in sparsely populated areas2016In: Settlements at the edge: remote human settlements in developed nations / [ed] Andrew Taylor, Dean B. Carson, Prescott C. Ensign, Lee Huskey, Rasmus Ole Rasmussen, Gertrude Saxinger, Cheltenham, UK: Edward Elgar Publishing, 2016, p. 357-378Chapter in book (Other academic)
    Abstract [en]

    Settlements at the Edge examines the evolution, characteristics, functions and shifting economic basis of settlements in sparsely populated areas of developed nations. With a focus on demographic change, the book features theoretical and applied cases which explore the interface between demography, economy, well-being and the environment. This book offers a comprehensive and insightful knowledge base for understanding the role of population in shaping the development and histories of northern sparsely populated areas of developed nations including Alaska (USA), Australia, Canada, Greenland, Norway, Russia, Sweden, Finland and other nations with territories within the Arctic Circle.

  • 20. Dik, Vincent K
    et al.
    Bueno-de-Mesquita, H Bas
    Van Oijen, Martijn GH
    Siersema, Peter D
    Uiterwaal, Cuno SPM
    Van Gils, Carla H
    Van Duijnhoven, Fränzel JB
    Cauchi, Stéphane
    Yengo, Loic
    Froguel, Philippe
    Overvad, Kim
    Bech, Bodil H
    Tjønneland, Anne
    Olsen, Anja
    Boutron-Ruault, Marie-Christine
    Racine, Antoine
    Fagherazzi, Guy
    Kühn, Tilman
    Campa, Daniele
    Boeing, Heiner
    Aleksandrova, Krasimira
    Trichopoulou, Antonia
    Peppa, Eleni
    Oikonomou, Eleni
    Palli, Domenico
    Grioni, Sara
    Vineis, Paolo
    Tumino, Rosaria
    Panico, Salvatore
    Peeters, Petra HM
    Weiderpass, Elisabete
    Engeset, Dagrun
    Braaten, Tonje
    Dorronsoro, Miren
    Chirlaque, María-Dolores
    Sánchez, María-José
    Barricarte, Aurelio
    Zamora-Ros, Raul
    Argüelles, Marcial
    Jirström, Karin
    Wallström, Peter
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Arctic Research Centre at Umeå University.
    Ljuslinder, Ingrid
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology. Umeå University, Arctic Research Centre at Umeå University.
    Travis, Ruth C
    Khaw, Kay-Tee
    Wareham, Nick
    Freisling, Heinz
    Licaj, Idlir
    Jenab, Mazda
    Gunter, Marc J
    Murphy, Neil
    Romaguera-Bosch, Dora
    Riboli, Elio
    Coffee and tea consumption, genotype based CYP1A2 and NAT2 activity, and colorectal cancer risk: results from the EPIC cohort study2014In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 135, no 2, p. 401-412Article in journal (Refereed)
    Abstract [en]

    Coffee and tea contain numerous antimutagenic and antioxidant components and high levels of caffeine that may protect against colorectal cancer (CRC). We investigated the association between coffee and tea consumption and CRC risk and studied potential effect modification by CYP1A2 and NAT2 genotypes, enzymes involved in the metabolization of caffeine. Data from 477,071 participants (70.2% female) of the European Investigation into Cancer and Nutrition (EPIC) cohort study were analyzed. At baseline (1992-2000) habitual (total, caffeinated and decaffeinated) coffee and tea consumption was assessed with dietary questionnaires. Cox proportional hazards models were used to estimate adjusted hazard ratio's (HR) and 95%-confidence intervals (95%-CI). Potential effect modification by genotype-based CYP1A2 and NAT2 activity was studied in a nested case-control set of 1,252 cases and 2,175 controls. After a median follow-up of 11.6 years, 4,234 participants developed CRC (mean age 64.7±8.3 years). Total coffee consumption (high vs. non/low) was not associated with CRC risk (HR 1.06, 95%-CI 0.95-1.18) or subsite cancers, and no significant associations were found for caffeinated (HR 1.10, 95%-CI 0.97-1.26) and decaffeinated coffee (HR 0.96, 95%-CI 0.84-1.11) and tea (HR 0.97, 95%-CI 0.86-1.09). High coffee and tea consuming subjects with slow CYP1A2 or NAT2 activity had a similar CRC risk compared to non/low coffee and tea consuming subjects with a fast CYP1A2 or NAT2 activity, which suggest that caffeine metabolism does not affect the link between coffee and tea consumption and CRC risk. This study shows that coffee and tea consumption is not likely to be associated with overall CRC.

  • 21. Dik, Vincent K
    et al.
    Murphy, Neil
    Siersema, Peter D
    Fedirko, Veronika
    Jenab, Mazda
    Kong, So Y
    Hansen, Camilla P
    Overvad, Kim
    Tjønneland, Anne
    Olsen, Anja
    Dossus, Laure
    Racine, Antoine
    Bastide, Nadia
    Li, Kuanrong
    Kühn, Tilman
    Boeing, Heiner
    Aleksandrova, Krasimira
    Trichopoulou, Antonia
    Trichopoulos, Dimitrios
    Barbitsioti, Antonia
    Palli, Domenico
    Contiero, Paolo
    Vineis, Paolo
    Tumino, Rosaria
    Panico, Salvatore
    Peeters, Petra H M
    Weiderpass, Elisabete
    Skeie, Guri
    Hjartåker, Anette
    Amiano, Pilar
    Sánchez, María-José
    Fonseca-Nunes, Ana
    Barricarte, Aurelio
    Chirlaque, María-Dolores
    Redondo, Maria-Luisa
    Jirström, Karin
    Manjer, Jonas
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Arctic Research Centre at Umeå University.
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Bradbury, Kathryn E
    Khaw, Kay-Tee
    Wareham, Nicholas
    Cross, Amanda J
    Riboli, Elio
    Bueno-de-Mesquita, H Bas
    Prediagnostic intake of dairy products and dietary calcium and colorectal cancer survival-results from the EPIC Cohort Study2014In: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 23, no 9, p. 1813-1823Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: We investigated whether prediagnostic reported intake of dairy products and dietary calcium is associated with colorectal cancer survival.

    METHODS: Data from 3,859 subjects with colorectal cancer (42.1% male; mean age at diagnosis, 64.2 ± 8.1 years) in the European Investigation into Cancer and Nutrition cohort were analyzed. Intake of dairy products and dietary calcium was assessed at baseline (1992-2000) using validated, country-specific dietary questionnaires. Multivariable Cox regression models were used to calculate HR and corresponding 95% confidence intervals (CI) for colorectal cancer-specific death (n = 1,028) and all-cause death (n = 1,525) for different quartiles of intake.

    RESULTS: The consumption of total dairy products was not statistically significantly associated with risk of colorectal cancer-specific death (adjusted HR Q4 vs. Q1, 1.17; 95% CI, 0.97-1.43) nor that of all-cause death (Q4 vs. Q1, 1.16; 95% CI, 0.98-1.36). Multivariable-adjusted HRs for colorectal cancer-specific death (Q4 vs. Q1) were 1.21 (95% CI, 0.99-1.48) for milk, 1.09 (95% CI, 0.88-1.34) for yoghurt, and 0.93 (95% CI, 0.76-1.14) for cheese. The intake of dietary calcium was not associated with the risk of colorectal cancer-specific death (adjusted HR Q4 vs. Q1, 1.01; 95% CI, 0.81-1.26) nor that of all-cause death (Q4 vs. Q1, 1.01; 95% CI, 0.84-1.21).

    CONCLUSIONS: The prediagnostic reported intake of dairy products and dietary calcium is not associated with disease-specific or all-cause risk of death in patients diagnosed with colorectal cancer.

    IMPACT: The impact of diet on cancer survival is largely unknown. This study shows that despite its inverse association with colorectal cancer risk, the prediagnostic intake of dairy and dietary calcium does not affect colorectal cancer survival.

  • 22. Dossus, Laure
    et al.
    Franceschi, Silvia
    Biessy, Carine
    Navionis, Anne-Sophie
    Travis, Ruth C
    Weiderpass, Elisabete
    Scalbert, Augustin
    Romieu, Isabelle
    Tjønneland, Anne
    Olsen, Anja
    Overvad, Kim
    Boutron-Ruault, Marie-Christine
    Bonnet, Fabrice
    Fournier, Agnès
    Fortner, Renee T
    Kaaks, Rudolf
    Aleksandrova, Krasimira
    Trichopoulou, Antonia
    La Vecchia, Carlo
    Peppa, Eleni
    Tumino, Rosario
    Panico, Salvatore
    Palli, Domenico
    Agnoli, Claudia
    Vineis, Paolo
    Bueno-de-Mesquita, H B As
    Peeters, Petra H
    Skeie, Guri
    Zamora-Ros, Raul
    Chirlaque, María-Dolores
    Ardanaz, Eva
    Sánchez, Maria-Jose
    Ramón Quirós, Jose
    Dorronsoro, Miren
    Sandström, Maria
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Schmidt, Julie A
    Khaw, Kay-Tee
    Tsilidis, Konstantinos K
    Aune, Dagfinn
    Riboli, Elio
    Rinaldi, Sabina
    Adipokines and inflammation markers and risk of differentiated thyroid carcinoma: The EPIC study2018In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 142, no 7, p. 1332-1342Article in journal (Refereed)
    Abstract [en]

    Other than the influence of ionizing radiation and benign thyroid disease, little is known about the risk factors for differentiated thyroid cancer (TC) which is an increasing common cancer worldwide. Consistent evidence shows that body mass is positively associated with TC risk. As excess weight is a state of chronic inflammation, we investigated the relationship between concentrations of leptin, adiponectin, C-reactive protein, interleukin (IL)-6, IL-10 and tumor necrosis factor (TNF)-α and the risk of TC. A case-control study was nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study and included 475 first primary incident TC cases (399 women and 76 men) and 1,016 matched cancer-free cohort participants. Biomarkers were measured in serum samples using validated and highly sensitive commercially available immunoassays. Odds ratios (ORs) of TC by levels of each biomarker were estimated using conditional logistic regression models, adjusting for BMI and alcohol consumption. Adiponectin was inversely associated with TC risk among women (ORT3vs.T1  = 0.69, 95% CI: 0.49-0.98, Ptrend  = 0.04) but not among men (ORT3vs.T1  = 1.36, 95% CI: 0.67-2.76, Ptrend  = 0.37). Increasing levels of IL-10 were positively associated with TC risk in both genders and significantly so in women (ORT3vs.T1  = 1.59, 95% CI: 1.13-2.25, Ptrend  = 0.01) but not in men (ORT3vs.T1  = 1.78, 95% CI: 0.80-3.98, Ptrend  = 0.17). Leptin, CRP, IL-6 and TNF-α were not associated with TC risk in either gender. These results indicate a positive association of TC risk with IL-10 and a negative association with adiponectin that is probably restricted to women. Inflammation may play a role in TC in combination with or independently of excess weight.

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  • 23.
    Dresse, Menayit Tamrat
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Stoor, Jon Petter A.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Centre for Sámi Health Research, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway.
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Prevalence and factors associated with healthcare avoidance during the COVID-19 pandemic among the Sámi in Sweden: the SámiHET study2023In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 82, no 1, article id 2213909Article in journal (Refereed)
    Abstract [en]

    The aim of this population-based cross-sectional study was to assess the prevalence of healthcare avoidance during the COVID-19 pandemic and its associated factors among the Sámi population in Sweden. Data from the “Sámi Health on Equal Terms” (SámiHET) survey conducted in 2021 were used. Overall, 3,658 individuals constituted the analytical sample. Analysis was framed using the social determinants of health framework. The association between healthcare avoidance and several sociodemographic, material, and cultural factors was explored through log-binomial regression analyses. Sampling weights were applied in all analyses. Thirty percent of the Sámi in Sweden avoided healthcare during the COVID-19 pandemic. Sámi women (PR: 1.52, 95% CI: 1.36–1.70), young adults (PR: 1.22, 95% CI:1.05–1.47), Sámi living outside Sápmi (PR: 1.17, 95% CI: 1.03–1.34), and those having low income (PR: 1.42, 95% CI:1.19–1.68) and experiencing economic stress (PR: 1.48, 95% CI: 1.31–1.67) had a higher prevalence of healthcare avoidance. The pattern shown in this study can be useful for planning future pandemic responses, which should address healthcare avoidance, particularly among the identified vulnerable groups, including the active participation of the Sámi themselves.

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  • 24.
    Dudarev, Alexey A
    et al.
    Northwest Public Health Research Center, St. Petersburg, Russia.
    Alloyarov, Pavel R
    Northwest Public Health Research Center, St. Petersburg, Russia.
    Chupakhin, Valery S
    Northwest Public Health Research Center, St. Petersburg, Russia.
    Dushkina, Eugenia V
    Northwest Public Health Research Center, St. Petersburg, Russia.
    Sladkova, Yuliya N
    Northwest Public Health Research Center, St. Petersburg, Russia.
    Dorofeyev, Vitaliy M
    Dubna City Hospital, Moscow oblast, Russia.
    Kolesnikova, Tatijana A
    Northwest Public Health Research Center, St. Petersburg, Russia.
    Fridman, Kirill B
    Northwest Public Health Research Center, St. Petersburg, Russia.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Arctic Research Centre at Umeå University.
    Evengård, Birgitta
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases. Umeå University, Arctic Research Centre at Umeå University.
    Food and water security issues in Russia I: Food security in the general population of the Russian Arctic, Siberia and the Far East2013In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 72, p. 1-10, article id 21848Article in journal (Refereed)
    Abstract [en]

    Background. Problems related to food security in Russian Arctic (dietary imbalance, predominance ofcarbohydrates, shortage of milk products, vegetables and fruits, deficit of vitamins and microelements,chemical, infectious and parasitic food contamination) have been defined in the literature. But no standardprotocol of food security assessment has been used in the majority of studies.

    Objectives. Our aim was to obtain food security indicators, identified within an Arctic collaboration,for selected regions of the Russian Arctic, Siberia and the Far East, and to compare food safety in theseterritories.

    Study design and methods. In 18 regions of the Russian Arctic, Siberia and the Far East, the followingindicators of food security were analyzed: food costs, food consumption, and chemical and biological foodcontamination for the period 2000-2011.

    Results. Food costs in the regions are high, comprising 2343% of household income. Only 4 out of 10 foodgroups (fish products, cereals, sugar, plant oil) are consumed in sufficient amounts. The consumption of milkproducts, eggs, vegetables, potatoes, fruits (and berries) is severely low in a majority of the selected regions.There are high levels of biological contamination of food in many regions. The biological and chemicalcontamination situation is alarming, especially in Chukotka. Only 7 food pollutants are under regularcontrol; among pesticides, only DDT. Evenki AO and Magadan Oblast have reached peak values in foodcontaminants compared with other regions. Mercury in local fish has not been analyzed in the majority of theregions. In 3 regions, no monitoring of DDToccurs. Aflatoxins have not been analyzed in 5 regions. Nitrateshad the highest percentage in excess of the hygienic threshold in all regions. Excesses of other pollutants indifferent regions were episodic and as a rule not high.

    Conclusion. Improvement of the food supply and food accessibility in the regions of the Russian Arctic,Siberia and the Far East is of utmost importance. Both quantitative and qualitative control of chemical andbiological contaminants in food is insufficient and demands radical enhancement aimed at improving foodsecurity.

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  • 25. Dudarev, Alexey
    et al.
    Dorofeyey, Vitaliy
    Dushkina, Eugenia
    Alloyarov, Pavel
    Chupakhin, Valery
    Sladkova, Yuliya
    Kolesnikova, Tatjana
    Fridman, Kirill
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Evengård, Birgitta
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
    Food and water security issues in Russia III: food- and waterborne diseases in the Russian Arctic, Siberia and the Far East, 2000-20112013In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 72, p. 21856-Article in journal (Refereed)
    Abstract [en]

    Background. The food- and waterborne disease situation in Russia requires special attention. Poor quality of centralized water supplies and sewage systems, biological and chemical contamination of drinking water, as well as contamination of food products, promote widespread infectious diseases, significantly exceeding nationwide rates in the population living in the two-thirds of Russian northern territories.Objectives. The general aim was to assess the levels of food- and waterborne diseases in selected regions of Russian Arctic, Siberia and the Far East (for the period 2000ᅵ2011), and to compare disease levels among regions and with national levels in Russia.Study design and methods. This study is the first comparative assessment of the morbidity in these fields of the population of 18 selected regions of Russian Arctic, Siberia and the Far East, using official statistical sources. The incidences of infectious and parasitic food- and waterborne diseases among the general population (including indigenous peoples) have been analyzed in selected regions (per 100,000 of population, averaged for 2000ᅵ2011).Results. Among compulsory registered infectious and parasitic diseases, there were high rates and widespread incidences in selected regions of shigellosis, yersiniosis, hepatitis A, tularaemia, giardiasis, enterobiasis, ascariasis, diphyllobothriasis, opistorchiasis, echinococcosis and trichinellosis.Conclusion. Incidences of infectious and parasitic food- and waterborne diseases in the general population of selected regions of the Russian Arctic, Siberia and the Far East (2000ᅵ2011) are alarmingly high. Parallel solutions must be on the agenda, including improvement of sanitary conditions of cities and settlements in the regions, modernization of the water supply and of the sewage system. Provision and monitoring of the quality of the drinking water, a reform of the general healthcare system and the epidemiological surveillance (including gender-divided statistics), enhancement of laboratory diagnostics and the introduction of preventive actions are urgently needed.

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    FWS Russia III
  • 26. Dudarev, Alexey
    et al.
    Dushkina, Eugenia
    Sladkova, Yuliya
    Alloyarov, Pavel
    Chupakhin, Valeriy
    Dorofeyey, Vitaliy
    Kolesnikova, Tatijana
    Fridman, Kirill
    Evengård, Birgitta
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases. Umeå University, Arctic Research Centre at Umeå University.
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Food and water security issues in Russia II: Water security in general population of Russian Arctic, Siberia and Far East, 2000-20112013In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 72, p. 22646-Article in journal (Refereed)
    Abstract [en]

    Background. Poor state of water supply systems, shortage of water purification facilities and disinfection systems, low quality of drinking water generally in Russia and particularly in the regions of the Russian Arctic, Siberia and Far East have been defined in the literature. However, no standard protocol of water security assessment has been used in the majority of studies.Study design and methods. Uniform water security indicators collected from Russian official statistical sources for the period 2000ᅵ2011 were used for comparison for 18 selected regions in the Russian Arctic, Siberia and Far East. The following indicators of water security were analyzed: water consumption, chemical and biological contamination of water reservoirs of Categories I and II of water sources (centralized ᅵ underground and surface, and non-centralized) and of drinking water.Results. Water consumption in selected regions fluctuated from 125 to 340 L/person/day. Centralized water sources (both underground and surface sources) are highly contaminated by chemicals (up to 40ᅵ80%) and biological agents (up to 55% in some regions), mainly due to surface water sources. Underground water sources show relatively low levels of biological contamination, while chemical contamination is high due to additional water contamination during water treatment and transportation in pipelines. Non-centralized water sources are highly contaminated (both chemically and biologically) in 32ᅵ90% of samples analyzed. Very high levels of chemical contamination of drinking water (up to 51%) were detected in many regions, mainly in the north-western part of the Russian Arctic. Biological contamination of drinking water was generally much lower (2.5ᅵ12%) everywhere except Evenki AO (27%), and general and thermotolerant coliform bacteria predominated in drinking water samples from all regions (up to 17.5 and 12.5%, correspondingly). The presence of other agents was much lower: Coliphages ᅵ 0.2ᅵ2.7%, Clostridia spores, Giardia cysts, pathogenic bacteria, Rotavirus ᅵ up to 0.8%. Of a total of 56 chemical pollutants analyzed in water samples from centralized water supply systems, 32 pollutants were found to be in excess of hygienic limits, with the predominant pollutants being Fe (up to 55%), Cl (up to 57%), Al (up to 43%) and Mn (up to 45%).Conclusion. In 18 selected regions of the Russian Arctic, Siberia and Far East Category I and II water reservoirs, water sources (centralized ᅵ underground, surface; non-centralized) and drinking water are highly contaminated by chemical and biological agents. Full-scale reform of the Russian water industry and water security system is urgently needed, especially in selected regions.

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    FWS Russia II
  • 27. Ek, Weronica E.
    et al.
    Tobi, Elmar W.
    Ahsan, Muhammad
    Lampa, Erik
    Ponzi, Erica
    Kyrtopoulos, Soterios A.
    Georgiadis, Panagiotis
    Lumey, L. H.
    Heijmans, Bastiaan T.
    Botsivali, Maria
    Bergdahl, Ingvar A.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Karlsson, Torgny
    Rask-Andersen, Mathias
    Palli, Domenico
    Ingelsson, Erik
    Hedman, Åsa K.
    Nilsson, Lena M.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Vineis, Paolo
    Lind, Lars
    Flanagan, James M.
    Johansson, Åsa
    Tea and coffee consumption in relation to DNA methylation in four European cohorts2017In: Human Molecular Genetics, ISSN 0964-6906, E-ISSN 1460-2083, Vol. 26, no 16, p. 3221-3231Article in journal (Refereed)
    Abstract [en]

    Lifestyle factors, such as food choices and exposure to chemicals, can alter DNA methylation and lead to changes in gene activity. Two such exposures with pharmacologically active components are coffee and tea consumption. Both coffee and tea has been suggested to play an important role in modulating disease-risk in humans by suppressing tumour progression, decreasing inflammation and influencing estrogen metabolism. These mechanisms may be mediated by changes in DNA methylation.To investigate if DNA methylation in blood is associated with coffee and tea consumption we performed a genome-wide DNA methylation study for coffee and tea consumption in four European cohorts (N = 3,096). DNA methylation was measured from whole blood at 421,695 CpG sites distributed throughout the genome and analysed in men and women both separately and together in each cohort. Meta-analyses of the results and additional regional-level analyses were performed.After adjusting for multiple testing, the meta-analysis revealed that two individual CpG-sites, mapping to DNAJC16 and TTC17, were differentially methylated in relation to tea consumption in women. No individual sites were associated in men or in the sex-combined analysis for tea or coffee. The regional analysis revealed that 28 regions were differentially methylated in relation to tea consumption in women. These regions contained genes known to interact with estradiol metabolism and cancer. No significant regions were found in the sex-combined and male-only analysis for either tea or coffee consumption.

  • 28. Engeset, D.
    et al.
    Skeie, G.
    Olsen, A.
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Dietary patterns and whole grain in Scandinavia. The HELGA project2013In: Annals of Nutrition and Metabolism, ISSN 0250-6807, E-ISSN 1421-9697, Vol. 63, no Supplement 1, p. 341-341Article in journal (Other academic)
    Abstract [en]

    Background and objectives: In the recent years a trendwithin nutrition epidemiology has been to assess overall dietaryquality, often by identifying dietary patterns. The HELGAstudy population is based on samples of existing cohorts fromthe three Scandinavian countries. All three cohorts are part ofthe EPIC study. The aim of this study is to find a typical wholegrain pattern in Scandinavia and see if the pattern is similar inthe three countries.Methods: The associations among the variables were investigatedby factor analysis.Results: Both Norway and Sweden had two breakfast patternsand one dinner pattern. Both the countries had a healthybreakfast pattern including food items commonly consideredhealthy, such as fruit, yoghurt and breakfast cereals. However,coarse bread was the main item in a more traditional pattern for Norway, while it was a part of the healthy pattern inSweden. The second breakfast pattern in Sweden included unhealthyitems like white bread, cakes, sweets, soft drinks andalcohol. The dinner pattern was almost equal in Sweden andNorway. Denmark differed from the other Scandinavian countriesconcerning dietary patterns. Only one breakfast patternwas found. This pattern had some similarities with the traditionalNorwegian pattern, but scored high on all whole grainitems while in Norway only wheat had a high score. Two dinnerpatterns are seen for Denmark, the healthier one includesfruit and vegetables, fish and poultry, the second includes meatand meat products, ice cream and alcohol.Conclusions: When comparing dietary patterns from thethree Scandinavian countries, we find both differences andsimilarities. The main whole grain item used in Norway andSweden seems to be wheat, while rye is more dominant in Denmark.

  • 29. Engeset, Dagrun
    et al.
    Hofoss, Dag
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Olsen, Anja
    Tjønneland, Anne
    Skeie, Guri
    Dietary patterns and whole grain cereals in the Scandinavian countries: differences and similarities. The HELGA project2015In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 18, no 5, p. 905-915Article in journal (Refereed)
    Abstract [en]

    Objective: To identify dietary patterns with whole grains as a main focus to see if there is a similar whole grain pattern in the three Scandinavian countries; Denmark, Sweden and Norway. Another objective is to see if items suggested for a Nordic Food Index will form a typical Nordic pattern when using factor analysis. Setting: The HELGA study population is based on samples of existing cohorts: the Norwegian Women and Cancer Study, the Swedish Vasterbotten cohort and the Danish Diet, Cancer and Health study. The HELGA study aims to generate knowledge about the health effects of whole grain foods. Subjects: The study included a total of 119 913 participants. Design: The associations among food variables from FFQ were investigated by principal component analysis. Only food groups common for all three cohorts were included. High factor loading of a food item shows high correlation of the item to the specific diet pattern. Results: The main whole grain for Denmark and Sweden was rye, while Norway had highest consumption of wheat. Three similar patterns were found: a cereal pattern, a meat pattern and a bread pattern. However, even if the patterns look similar, the food items belonging to the patterns differ between countries. Conclusions: High loadings on breakfast cereals and whole grain oat were common in the cereal patterns for all three countries. Thus, the cereal pattern may be considered a common Scandinavian whole grain pattern. Food items belonging to a Nordic Food Index were distributed between different patterns.

  • 30.
    Evengård, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology.
    Destouni, G.
    Department of Physical Geography, And Bolin Centre for Climate Research, Stockholm University, Stockholm, Sweden.
    Kalantari, Z.
    Department of Physical Geography, And Bolin Centre for Climate Research, Stockholm University, Stockholm, Sweden; Dept. of Sustainable Devmt., Environ. Sci. and Engineering, Sustainability Assessment and Management, KTH Royal Institute of Technology, Stockholm, Sweden.
    Albihn, A.
    Department of Chemistry, Environment and Feed Hygiene, National Veterinary Institute, Uppsala, Sweden.
    Björkman, C.
    Department of Ecology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
    Bylund, H.
    Department of Ecology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
    Jenkins, E.
    Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, SK, Saskatoon, Canada.
    Koch, A.
    Greenland Center for Health Research, Ilisimatusarfik-University of Greenland, Nuuk, Greenland; Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
    Kukarenko, N.
    Department of Philosophy and Sociology, Northern Arctic Federal University, Arkhangelsk, Russian Federation.
    Leibovici, D.
    School of Mathematics and Statistics, University of Sheffield, Sheffield, United Kingdom.
    Lemmityinen, J.
    Finnish Meteorological Institute, Helsinki, Finland.
    Menshakova, M.
    Department of Natural Sciences, Murmansk Arctic State University, Murmansk, Russian Federation.
    Mulvad, G.
    Greenland Center for Health Research, Ilisimatusarfik-University of Greenland, Nuuk, Greenland.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Omazic, A.
    Department of Chemistry, Environment and Feed Hygiene, National Veterinary Institute, Uppsala, Sweden.
    Pshenichnaya, N.
    Central Research Institute of Epidemiology, Moscow, Russian Federation.
    Quegan, S.
    School of Mathematics and Statistics, University of Sheffield, Sheffield, United Kingdom.
    Rautio, A.
    Arctic Health, Faculty of Medicine, University of Oulu, Oulu, Finland; Thule Institute, University of the Arctic, Oulu, Finland.
    Revich, B.
    Institute of Economic Forecasting, Russian Academy of Science, Moscow, Russian Federation.
    Rydén, Patrik
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Sjöstedt, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology.
    Tokarevich, N.
    Laboratory of Zoonoses, St Petersburg Pasteur Institute, St Petersburg, Russian Federation.
    Thierfelder, T.
    Department of Energy and Technology, Swedish University of Agricultural Sciences SLU, Uppsala, Sweden.
    Orlov, D.
    Faculty of Geography, Lomonosov Moscow State University, Moscow, Russian Federation.
    Healthy ecosystems for human and animal health: Science diplomacy for responsible development in the Arctic2021In: Polar Record, ISSN 0032-2474, E-ISSN 1475-3057, Vol. 57, article id e39Article in journal (Refereed)
    Abstract [en]

    Climate warming is occurring most rapidly in the Arctic, which is both a sentinel and a driver of further global change. Ecosystems and human societies are already affected by warming. Permafrost thaws and species are on the move, bringing pathogens and vectors to virgin areas. During a five-year project, the CLINF - a Nordic Center of Excellence, funded by the Nordic Council of Ministers, has worked with the One Health concept, integrating environmental data with human and animal disease data in predictive models and creating maps of dynamic processes affecting the spread of infectious diseases. It is shown that tularemia outbreaks can be predicted even at a regional level with a manageable level of uncertainty. To decrease uncertainty, rapid development of new and harmonised technologies and databases is needed from currently highly heterogeneous data sources. A major source of uncertainty for the future of contaminants and infectious diseases in the Arctic, however, is associated with which paths the majority of the globe chooses to follow in the future. Diplomacy is one of the most powerful tools Arctic nations have to influence these choices of other nations, supported by Arctic science and One Health approaches that recognise the interconnection between people, animals, plants and their shared environment at the local, regional, national and global levels as essential for achieving a sustainable development for both the Arctic and the globe.

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  • 31.
    Evengård, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases. Umeå University, Arctic Research Centre at Umeå University.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Arctic Research Centre at Umeå University.
    Destouni, Gia
    Stockholms universitet.
    Säker tillgång till mat och vatten prioriterad fråga för Arktis2013In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 110, no 05, p. CCF7-Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Arktis befinner sig i förändring. Dessa förändringar beror på mänskliga aktiviteter i regionen och på den globala klimatförändringen, som märks först och mest i norr till exempel där den sibiriska tundran övergår i gräsbevuxen terräng. Djur och människor som bor i den här delen av världen är redan påverkade av förändringarna och kommer att förbli så under lång tid framöver. Ursprungsbefolkningar runt om i Arktis samlar sig i protester, nu senast i Kanada. De många ursprungsbefolkningarna i Arktis lever ofta nära naturen och är därför mer sårbara än andra, men även samhällen med god infrastruktur påverkas av miljöförändringar. I Sverige märkte vi nyligen detta, när närmare 100 000 personer i Östersund och Skellefteå med omgivningar vintern 2010–2011 fick koka sitt vatten under månader på grund av att en parasit (Cryptosporidium) kom in i vattnet. Olika slags system behöver kontrolleras regelbundet, så att säkra datatolkningar kan ges till beslutsfattare, för att vidta åtgärder i tid för ökad säkerhet.

  • 32. Gunter, Marc J.
    et al.
    Murphy, Neil
    Cross, Amanda J..
    Dossus, Laure
    Dartois, Laureen
    Fagherazzi, Guy
    Kaaks, Rudolf
    Kühn, Tilman
    Boeing, Heiner
    Aleksandrova, Krasimira
    Tjønneland, Anne
    Olsen, Anja
    Overvad, Kim
    Larsen, Sofus Christian
    Redondo Cornejo, Maria Luisa
    Agudo, Antonio
    Sánchez Pérez, María José
    Altzibar, Jone M.
    Navarro, Carmen
    Ardanaz, Eva
    Khaw, Kay-Tee
    Butterworth, Adam
    Bradbury, Kathryn E.
    Trichopoulou, Antonia
    Lagiou, Pagona
    Trichopoulos, Dimitrios
    Palli, Domenico
    Grioni, Sara
    Vineis, Paolo
    Panico, Salvatore
    Tumino, Rosario
    Bueno-de-Mesquita, Bas
    Siersema, Peter
    Leenders, Max
    Beulens, Joline W. J.
    Uiterwaal, Cuno U.
    Wallström, Peter
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Landberg, Rikard
    Weiderpass, Elisabete
    Skeie, Guri
    Braaten, Tonje
    Brennan, Paul
    Licaj, Idlir
    Muller, David C.
    Sinha, Rashmi
    Wareham, Nick
    Riboli, Elio
    Coffee Drinking and Mortality in 10 European Countries: A Multinational Cohort Study2017In: Annals of Internal Medicine, ISSN 0003-4819, E-ISSN 1539-3704, Vol. 167, no 4, p. 236-247Article in journal (Refereed)
    Abstract [en]

    Background: The relationship between coffee consumption and mortality in diverse European populations with variable coffee preparation methods is unclear.

    Objective: To examine whether coffee consumption is associated with all-cause and cause-specific mortality.

    Design: Prospective cohort study.

    Setting: 10 European countries.

    Participants: 521 330 persons enrolled in EPIC (European Prospective Investigation into Cancer and Nutrition).

    Measurements: Hazard ratios (HRs) and 95% CIs estimated using multivariable Cox proportional hazards models. The association of coffee consumption with serum biomarkers of liver function, inflammation, and metabolic health was evaluated in the EPIC Biomarkers subcohort (n = 14 800).

    Results: During a mean follow-up of 16.4 years, 41 693 deaths occurred. Compared with nonconsumers, participants in the highest quartile of coffee consumption had statistically significantly lower all-cause mortality (men: HR, 0.88 [95% CI, 0.82 to 0.95]; P for trend < 0.001; women: HR, 0.93 [CI, 0.87 to 0.98]; P for trend = 0.009). Inverse associations were also observed for digestive disease mortality for men (HR, 0.41 [CI, 0.32 to 0.54]; P for trend < 0.001) and women (HR, 0.60 [CI, 0.46 to 0.78]; P for trend < 0.001). Among women, there was a statistically significant inverse association of coffee drinking with circulatory disease mortality (HR, 0.78 [CI, 0.68 to 0.90]; P for trend < 0.001) and cerebrovascular disease mortality (HR, 0.70 [CI, 0.55 to 0.90]; P for trend = 0.002) and a positive association with ovarian cancer mortality (HR, 1.31 [CI, 1.07 to 1.61]; P for trend = 0.015). In the EPIC Biomarkers subcohort, higher coffee consumption was associated with lower serum alkaline phosphatase; alanine aminotransferase; aspartate aminotransferase; γ-glutamyltransferase; and, in women, C-reactive protein, lipoprotein(a), and glycated hemoglobin levels.

    Limitations: Reverse causality may have biased the findings; however, results did not differ after exclusion of participants who died within 8 years of baseline. Coffee-drinking habits were assessed only once.

    Conclusion: Coffee drinking was associated with reduced risk for death from various causes. This relationship did not vary by country.

    Primary Funding Source: European Commission Directorate-General for Health and Consumers and International Agency for Research on Cancer.

  • 33. Hausner, Vera Helene
    et al.
    Trainor, Sarah F.
    Cook, David
    Fauchald, Per
    Ford, James
    Klokov, Konstantin
    Nikitina, Elena
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Stammler, Florian
    Impacts of climate change and climate extremes on Arctic livelihoods and communities2021In: Amap arctic climate update 2021: key trends and impacts / [ed] AMAP, Tromsö: Arctic Monitoring and Assessment Programme (AMAP) , 2021, 1, p. 107-143Chapter in book (Other academic)
    Abstract [en]

    Key findings:

    • Climate change is impacting the subsistence harvestbased livelihoods of many small Arctic communities, affecting the quality or supply of traditional food and drinking water, including availability of species to be harvested, and altering transportation access.

    • Rain-on-snow, extreme snowfall, and variable freezethaw cycles have resulted in severe impacts for reindeer herders. In 2020, multiple snowstorms combined with a late spring thaw resulted in high newborn calf mortality and, together with other social stresses related to Covid-19, created severe crises for reindeer herders in Fennoscandia.

    • Commercial fisheries are expanding in Arctic shelf ecosystems with warmer oceans and less sea ice. This could benefit local economies and job creation, but may also challenge traditional livelihoods and culture and impact vulnerable Arctic ecosystems. Large uncertainties are associated with the effects of ocean acidification, which could potentially counteract increased commercial fishing opportunities. Commercial fishing is currently prohibited by international agreement in the Central Arctic Ocean.

    • Warmer water is enabling a northward expansion of salmon farming in the ice-free European Arctic. The aquaculture industry brings employment opportunities and positive ripple effects for local economies, but also has environmental and societal costs that need to be considered in marine spatial planning and regulatory measures.

    • Arctic cruise tourism is increasing and is attracted to the wildlife associated with the marginal ice zone. Although increased cruise tourism brings the potential for local economic development, adverse local impacts have been reported, including impacts on culture, local hunting and fishing, crowding, and revenue largely benefitting foreign-based individuals and corporations.

    • Permafrost thaw, flooding, and coastal erosion are causing damage to buildings, roads, and other infrastructure, and pose serious financial and health risks to Arctic residents.

    • Wildfire occurrence near populated regions in North America and Sweden, and throughout Siberia, in the past five years has resulted in significant economic loss from property damage as well as physical and mental health impacts.

    • Fishing, cruise tourism, and increased oil and gas operations near the marginal ice zone could increase demand on search and rescue operations and may represent a considerable risk for vulnerable ecosystems. The extent of ice cover is important for determining the fate of an Arctic oil spill and research indicates longer term and more severe ecological impacts from oil spills in the Arctic than in other regions.

    • Understanding and studying integrated socio-ecological systems, including cumulative and cascading impacts, is important not only in terms of research, but also in terms of risk mitigation, hazard response, climate adaptation,

  • 34.
    Hossain, Kamrul
    et al.
    University of Lapland, Rovaniemi, Finland.
    Nilsson, Lena MariaUmeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.Herrmann, Thora MartinaUniversité de Montréal Département de géographie, Canada.
    Food security in the High North: contemporary challenges across the circumpolar region2021Collection (editor) (Refereed)
    Abstract [en]

    This book explores the challenges facing food security, sustainability, sover-eignty, and supply chains in the Arctic, with a specific focus on Indigenous Peoples.

    Offering multidisciplinary insights with a particular focus on populations in the European High North region, the book highlights the importance of accessible and sustainable traditional foods for the dietary needs of local and Indigenous Peoples. It focuses on foods and natural products that are unique to this region and considers how they play a significant role towards food security and sovereignty. The book captures the tremendous com-plexity facing populations here as they strive to maintain sustainable food systems – both subsistent and commercial – and regain sovereignty over tra-ditional food production policies. A range of issues are explored from food contamination risks, due to increasing human activities in the region, such as mining, to changing livelihoods and gender roles in the maintenance of traditional food security and sovereignty. The book also considers process-ing methods that combine indigenous and traditional knowledge to convert the traditional foods, which are harvested or hunted, into local foods.

    This book offers a broader understanding of food security and sovereignty, and will be of interest to academics, scholars, and policy makers working in food studies, geography and environmental studies, agricultural studies, so-ciology, anthropology, political science, health studies, and biology.

  • 35.
    Hossain, Kamrul
    et al.
    Northern Institute for Environmental and Minority Law (NIEM), Arctic Centre, University of Lapland, Finland.
    Nilsson, Lena MariaUmeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.Herrmann, Thora Martina
    Food security in the high north: contemporary challenges across the circumpolar region2021Collection (editor) (Refereed)
    Abstract [en]

    This book explores the challenges facing food security, sustainability, sovereignty, and supply chains in the Arctic, with a specific focus on Indigenous Peoples. Offering multidisciplinary insights and with a particular focus on populations in the European High North region, the book highlights the importance of accessible and sustainable traditional foods for the dietary needs of local and Indigenous Peoples. It focuses on foods and natural products that are unique to this region and considers how they play a significant role towards food security and sovereignty. The book captures the tremendous complexity facing populations here as they strive to maintain sustainable food systems - both subsistent and commercial - and regain sovereignty over traditional food production policies. A range of issues are explored including food contamination risks, due to increasing human activities in the region, such as mining, to changing livelihoods and gender roles in the maintenance of traditional food security and sovereignty. The book also considers processing methods that combine indigenous and traditional knowledge to convert the traditional foods, that are harvested and hunted, into local foods. This book offers a broader understanding of food security and sovereignty and will be of interest to academics, scholars and policy makers working in food studies; geography and environmental studies; agricultural studies; sociology; anthropology; political science; health studies and biology.

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  • 36.
    Hossain, Kamrul
    et al.
    University of Lapland, Rovaniemi.
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research. Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Herrmann, Thora Martina
    Université de Montréal Département de géographie, Canada.
    Introduction: conceptualizing food (in)security in the High North2021In: Food Security in the High North: contemporary challenges across the circumpolar region / [ed] Kamrul Hossain, Lena Maria Nilsson, and Thora Martina Herrmann, Abingdon: Routledge, 2021, p. 1-12Chapter in book (Other academic)
    Abstract [en]

    This introduction presents an overview of the key concepts discussed in the subsequent chapters of this book. The book uses various other concepts, such as food resilience and traditional and local knowledge in food practices and in traditional food systems. It defines food resilience as ‘capacity over time of a food system and its units at multiple levels, to provide sufficient, appropriate and accessible food to all, in the face of various and even unforeseen disturbances’. The book analyses issues related to Indigenous Peoples, livelihood practices, and traditional knowledge in the context of food production, consumption, and diversity. It explores the value of stockfish for strengthening the local food system and the role of stockfish in enhancing local food security. The book investigate the potential of Indigenous knowledge-based traditional pasture management and a rotational grazing system. It highlights the food insecurity of reindeer herders after the 1986 Chernobyl nuclear accident.

  • 37.
    Johansson, Ingegerd
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Esberg, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Jansson, Jan-Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine. Department of Public Health and Clinical Medicine, Research Unit Skellefteå, Umeå University, 90187 Umeå, Sweden. .
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Winkvist, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden. .
    Dairy Product Intake and Cardiometabolic Diseases in Northern Sweden: A 33-Year Prospective Cohort Study2019In: Nutrients, E-ISSN 2072-6643, Vol. 11, no 284Article in journal (Refereed)
    Abstract [en]

    Dairy products are important constituents of most diets, and their association with adverse health outcomes remains a focus. We characterized dairy food intake and examined associations with the incidence of type 2 diabetes (T2D), myocardial infarction (MI) or stroke among 108,065 Swedish men and women. Hazard ratios (HRs) and 95% CIs were estimated using the multivariable Cox proportional hazards models in a population characterized by high milk tolerance. During a mean follow-up of 14.2 years, 11,641 first-time events occurred. Non-fermented milk intake decreased, whereas butter intake increased over the period. For high intake of non-fermented milk, the HR (95% CI) for developing T2D and MI was 1.17 (1.03, 1.34) and 1.23 (1.10, 1.37), respectively, in men. A greater intake of butter, fermented milk, and cheese tended to be associated with a reduced risk of T2D and/or MI. Non-consumers and those who chose low-fat variants of the targeted dairy products had increased risk for T2D, MI, or stroke compared to those in the non-case group. Generally, effect-sizes were small. This prospective study found that non-fermented milk was associated with an increased risk for developing T2D and MI and that subjects abstaining from dairy products or choosing low-fat variants were at greater risk. However, the overall cardiometabolic risk of non-fermented milk intake was judged as low, since the effect sizes were small.

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  • 38.
    Johansson, Ingegerd
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Esberg, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Jansson, Jan-Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Winkvist, Anna
    Dairy intake revisited - associations between dairy intake and lifestyle related cardio-metabolic risk factors in a high milk consuming population2018In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 17, article id 110Article in journal (Refereed)
    Abstract [en]

    Background: The association between milk and dairy intake and the incidence of cardiometabolic diseases, cancer and mortality has been evaluated in many studies, but these studies have had conflicting results with no clear conclusion on causal or confounding associations. The present study aims to further address this association by cross-sectional and longitudinal evaluation of the associations between exposure to various types of dairy products and metabolic risk markers among inhabitants in northern Sweden while taking other lifestyle factors into account.

    Methods: Respondents in the Vasterbotten Intervention Programme with complete and plausible diet data between 1991 and 2016 were included, yielding 124,934 observations from 90,512 unique subjects. For longitudinal analysis, 27,682 participants with a visit 8-12years after the first visit were identified. All participants completed a validated Food Frequency Questionnaire. Metabolic risk markers, including body mass index (BMI), blood pressure, serum (S) cholesterol and triglycerides, and blood glucose, were measured. Participants were categorized into quintiles by intake of dairy products, and risk (odds ratios, OR) of undesirable levels of metabolic risk markers was assessed in multivariable logistic regression analyses. In longitudinal analyses, intake quintiles were related to desirable levels of metabolic risk markers at both visits or deterioration at follow-up using Cox regression analyses.

    Results: The OR of being classified with an undesirable BMI decreased with increasing quintiles of total dairy, cheese and butter intake but increased with increasing non-fermented milk intake. The OR of being classified with an undesirable S-cholesterol level increased with increasing intake of total dairy, butter and high fat (3%) non-fermented milk, whereas an undesirable S-triglyceride level was inversely associated with cheese and butter intake in women. In longitudinal analyses, increasing butter intake was associated with deterioration of S-cholesterol and blood glucose levels, whereas increasing cheese intake was associated with a lower risk of deterioration of S-triglycerides.

    Conclusions: Confounding factors likely contribute to the demonstrated association between dairy intake and mortality, and other medical conditions and analyses should be stratified by dairy type.

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  • 39.
    Johansson, Ingegerd
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Stegmayr, Birgitta
    The National Board of Welfare, Stockholm, Sweden .
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Department of Medicine, Skellefteå County Hospital, Skellefteå, Sweden.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Winkvist, Anna
    Associations among 25-year trends in diet, cholesterol and BMI from 140,000 observations in men and women in Northern Sweden2012In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 11, article id 40Article in journal (Refereed)
    Abstract [en]

    Background: In the 1970s, men in northern Sweden had among the highest prevalences of cardiovascular diseases (CVD) worldwide. An intervention program combining population- and individual-oriented activities was initiated in 1985. Concurrently, collection of information on medical risk factors, lifestyle and anthropometry started. Today, these data make up one of the largest databases in the world on diet intake in a population- based sample, both in terms of sample size and follow-up period. The study examines trends in food and nutrient intake, serum cholesterol and body mass index (BMI) from 1986 to 2010 in northern Sweden.

    Methods: Cross-sectional information on self-reported food and nutrient intake and measured body weight, height, and serum cholesterol were compiled for over 140,000 observations. Trends and trend breaks over the 25-year period were evaluated for energy-providing nutrients, foods contributing to fat intake, serum cholesterol and BMI.

    Results: Reported intake of fat exhibited two significant trend breaks in both sexes: a decrease between 1986 and 1992 and an increase from 2002 (women) or 2004 (men). A reverse trend was noted for carbohydrates, whereas protein intake remained unchanged during the 25-year period. Significant trend breaks in intake of foods contributing to total fat intake were seen. Reported intake of wine increased sharply for both sexes (more so for women) and export beer increased for men. BMI increased continuously for both sexes, whereas serum cholesterol levels decreased during 1986 - 2004, remained unchanged until 2007 and then began to rise. The increase in serum cholesterol coincided with the increase in fat intake, especially with intake of saturated fat and fats for spreading on bread and cooking.

    Conclusions: Men and women in northern Sweden decreased their reported fat intake in the first 7 years (19861992) of an intervention program. After 2004 fat intake increased sharply for both genders, which coincided with introduction of a positive media support for low carbohydrate-high-fat (LCHF) diet. The decrease and following increase in cholesterol levels occurred simultaneously with the time trends in food selection, whereas a constant increase in BMI remained unaltered. These changes in risk factors may have important effects on primary and secondary prevention of cardiovascular disease (CVD).

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  • 40. Johnsen, Nina F.
    et al.
    Frederiksen, Kirsten
    Christensen, Jane
    Skeie, Guri
    Lund, Eiliv
    Landberg, Rikard
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Nilsson, Lena M.
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Halkjaer, Jytte
    Olsen, Anja
    Overvad, Kim
    Tjonneland, Anne
    Whole-grain products and whole-grain types are associated with lower all-cause and cause-specific mortality in the Scandinavian HELGA cohort2015In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 114, no 4, p. 608-623Article in journal (Refereed)
    Abstract [en]

    No study has yet investigated the intake of different types of whole grain (WG) in relation to all-cause and cause-specific mortality in a healthy population. The aim of the present study was to investigate the intake of WG products and WG types in relation to all-cause and cause-specific mortality in a large Scandinavian HELGA cohort that, in 1992-8, included 120 010 cohort members aged 30-64 years from the Norwegian Women and Cancer Study, the Northern Sweden Health and Disease Study, and the Danish Diet Cancer and Health Study. Participants filled in a FFQ from which data on the intake of WG products were extracted. The estimation of daily intake of WG cereal types was based on country-specific products and recipes. Mortality rate ratios (MRR) and 95% CI were estimated using the Cox proportional hazards model. A total of 3658 women and 4181 men died during the follow-up (end of follow-up was 15 April 2008 in the Danish sub-cohort, 15 December 2009 in the Norwegian sub-cohort and 15 February 2009 in the Swedish sub-cohort). In the analyses of continuous WG variables, we found lower all-cause mortality with higher intake of total WG products (women: MRR 0.89 (95% CI 0.86, 0.91); men: MRR 0.89 (95% CI 0.86, 0.91) for a doubling of intake). In particular, intake of breakfast cereals and non-white bread was associated with lower mortality. We also found lower all-cause mortality with total intake of different WG types (women: MRR 0.88 (95% CI 0.86, 0.92); men: MRR 0.88 (95% CI 0.86, 0.91) for a doubling of intake). In particular, WG oat, rye and wheat were associated with lower mortality. The associations were found in both women and men and for different causes of deaths. In the analyses of quartiles of WG intake in relation to all-cause mortality, we found lower mortality in the highest quartile compared with the lowest for breakfast cereals, non-white bread, total WG products, oat, rye (only men), wheat and total WG types. The MRR for highest v. lowest quartile of intake of total WG products was 0.68 (95% CI 0.62, 0.75, P-trend over quartiles, 0.0001) for women and 0.75 (95% CI 0.68, 0.81, P-trend over quartiles, 0.0001) for men. The MRR for highest v. lowest quartile of intake of total WG types was 0.74 (95% CI 0.67, 0.81, P-trend over quartiles, 0.0001) for women and 0.75 (95% CI 0.68, 0.82, P-trend (over quartiles), 0.0001) for men. Despite lower statistical power, the analyses of cause-specific mortality according to quartiles of WG intake supported these results. In conclusion, higher intake of WG products and WG types was associated with lower mortality among participants in the HELGA cohort. The study indicates that intake of WG is an important aspect of diet in preventing early death in Scandinavia.

  • 41. Key, Timothy J.
    et al.
    Appleby, Paul N.
    Bradbury, Kathryn E.
    Sweeting, Michael
    Wood, Angela
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Kühn, Tilman
    Steur, Marinka
    Weiderpass, Elisabete
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Würtz, Anne Mette Lund
    Agudo, Antonio
    Andersson, Jonas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Arriola, Larraitz
    Boeing, Heiner
    Boer, Jolanda M. A.
    Bonnet, Fabrice
    Boutron-Ruault, Marie-Christine
    Cross, Amanda J.
    Ericson, Ulrika
    Fagherazzi, Guy
    Ferrari, Pietro
    Gunter, Marc
    Huerta, José María
    Katzke, Verena
    Khaw, Kay-Tee
    Krogh, Vittorio
    La Vecchia, Carlo
    Matullo, Giuseppe
    Moreno-Iribas, Conchi
    Naska, Androniki
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University.
    Olsen, Anja
    Overvad, Kim
    Palli, Domenico
    Panico, Salvatore
    Molina-Portillo, Elena
    Quirós, J. Ramón
    Skeie, Guri
    Sluijs, Ivonne
    Sonestedt, Emily
    Stepien, Magdalena
    Tjønneland, Anne
    Trichopoulou, Antonia
    Tumino, Rosario
    Tzoulaki, Ioanna
    van der Schouw, Yvonne T.
    Verschuren, W. M. Monique
    Di Angelantonio, Emanuele
    Langenberg, Claudia
    Forouhi, Nita
    Wareham, Nick
    Butterworth, Adam
    Riboli, Elio
    Danesh, John
    Consumption of Meat, Fish, Dairy Products, Eggs and Risk of Ischemic Heart Disease: A Prospective Study of 7198 Incident Cases Among 409,885 Participants in the Pan-European EPIC Cohort2019In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 139, no 25, p. 2835-2845Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is uncertainty about the relevance of animal foods to the etiology of ischemic heart disease (IHD). We examined meat, fish, dairy products and eggs and risk for IHD in the pan-European EPIC cohort.

    METHODS: A prospective study of 409,885 men and women in nine European countries. Diet was assessed using validated questionnaires, calibrated using 24-hour recalls. Lipids and blood pressure were measured in a subsample. During 12.6 years mean follow up, 7198 participants had a myocardial infarction or died from IHD. The relationships of animal foods with risk were examined using Cox regression with adjustment for other animal foods and relevant covariates.

    RESULTS: The hazard ratio (HR) for IHD was 1.19 (95% CI 1.06-1.33) for a 100 g/d increment in intake of red and processed meat, and this remained significant after excluding the first 4 years of follow-up (HR 1.25 [1.09-1.42]). Risk was inversely associated with intakes of yogurt (HR 0.93 [0.89-0.98] per 100 g/d increment), cheese (HR 0.92 [0.86-0.98] per 30 g/d increment) and eggs (HR 0.93 [0.88-0.99] per 20 g/d increment); the associations with yogurt and eggs were attenuated and non-significant after excluding the first 4 years of follow-up. Risk was not significantly associated with intakes of poultry, fish or milk. In analyses modelling dietary substitutions, replacement of 100 kcal/d from red and processed meat with 100 kcal/d from fatty fish, yogurt, cheese or eggs was associated with approximately 20% lower risk of IHD. Consumption of red and processed meat was positively associated with serum non-HDL cholesterol concentration and systolic blood pressure, and consumption of cheese was inversely associated with serum non-HDL cholesterol.

    CONCLUSIONS: Risk for IHD was positively associated with consumption of red and processed meat, and inversely associated with consumption of yogurt, cheese and eggs, although the associations with yogurt and eggs may be influenced by reverse causation bias. It is not clear whether the associations with red and processed meat and cheese reflect causality, but they were consistent with the associations of these foods with plasma non-HDL cholesterol, and for red and processed meat with systolic blood pressure, which could mediate such effects.

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  • 42. Kliemann, Nathalie
    et al.
    Murphy, Neil
    Viallon, Vivian
    Freisling, Heinz
    Tsilidis, Konstantinos K.
    Rinaldi, Sabina
    Mancini, Francesca R.
    Fagherazzi, Guy
    Boutron-Ruault, Marie-Christine
    Boeing, Heiner
    Schulze, Matthias B.
    Masala, Giovanna
    Krogh, Vittorio
    Sacerdote, Carlotta
    de Magistris, Maria S.
    Bueno-de-Mesquita, Bas
    Weiderpass, Elisabete
    Kuehn, Tilman
    Kaaks, Rudolf
    Jakszyn, Paula
    Redondo-Sanchez, Daniel
    Amiano, Pilar
    Chirlaque, Maria-Dolores
    Gurrea, Aurelio B.
    Ericson, Ulrica
    Drake, Isabel
    Nost, Therese H.
    Aune, Dagfinn
    May, Anne M.
    Tjonneland, Anne
    Dahm, Christina C.
    Overvad, Kim
    Tumino, Rosario
    Quiros, Jose R.
    Trichopoulou, Antonia
    Karakatsani, Anna
    La Vecchia, Carlo
    Nilsson, Lena M.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Riboli, Elio
    Huybrechts, Inge
    Gunter, Marc J.
    Predicted basal metabolic rate and cancer risk in the European Prospective Investigation into Cancer and Nutrition2020In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 147, no 3, p. 648-661Article in journal (Refereed)
    Abstract [en]

    Emerging evidence suggests that a metabolic profile associated with obesity may be a more relevant risk factor for some cancers than adiposity per se. Basal metabolic rate (BMR) is an indicator of overall body metabolism and may be a proxy for the impact of a specific metabolic profile on cancer risk. Therefore, we investigated the association of predicted BMR with incidence of 13 obesity-related cancers in the European Prospective Investigation into Cancer and Nutrition (EPIC). BMR at baseline was calculated using the WHO/FAO/UNU equations and the relationships between BMR and cancer risk were investigated using multivariable Cox proportional hazards regression models. A total of 141,295 men and 317,613 women, with a mean follow-up of 14 years were included in the analysis. Overall, higher BMR was associated with a greater risk for most cancers that have been linked with obesity. However, among normal weight participants, higher BMR was associated with elevated risks of esophageal adenocarcinoma (hazard ratio per 1-standard deviation change in BMR [HR1-SD]: 2.46; 95% CI 1.20; 5.03) and distal colon cancer (HR1-SD: 1.33; 95% CI 1.001; 1.77) among men and with proximal colon (HR1-SD: 1.16; 95% CI 1.01; 1.35), pancreatic (HR1-SD: 1.37; 95% CI 1.13; 1.66), thyroid (HR1-SD: 1.65; 95% CI 1.33; 2.05), postmenopausal breast (HR1-SD: 1.17; 95% CI 1.11; 1.22) and endometrial (HR1-SD: 1.20; 95% CI 1.03; 1.40) cancers in women. These results indicate that higher BMR may be an indicator of a metabolic phenotype associated with risk of certain cancer types, and may be a useful predictor of cancer risk independent of body fatness.

  • 43.
    Knudsen, Markus Dines
    et al.
    Danish Cancer Society, Research Center, Copenhagen, Denmark.
    Kyrø, Cecilie
    Danish Cancer Society, Research Center, Copenhagen, Denmark.
    Olsen, Anja
    Danish Cancer Society, Research Center, Copenhagen, Denmark.
    Dragsted, Lars O
    Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
    Skeie, Guri
    Department of Community Medicine, University of Tromsø, Tromsø, Norway.
    Lund, Eiliv
    Department ofCommunity Medicine, University of Tromsø, Tromsø, Norway.
    Åman, Per
    Department of food Science, Swedish University of Agriculture Science, Uppsala, Sweden.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Arctic Research Centre at Umeå University.
    Bueno-de-Mesquita, H. B.
    National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
    Tjønneland, Anne
    Danish Cancer Society, Research Center, Copenhagen, Denmark.
    Landberg, Rikard
    Department of Food Science, Swedish University of Agriculture Science, Uppsala, Sweden and Nutritional Epidemiology Unit, Institute for Environmental Medicine, Karolinska Institute, Stockholm.
    Self-Reported Whole-Grain Intake and Plasma Alkylresorcinol Concentrations in Combination in Relation to the Incidence of Colorectal Cancer2014In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 179, no 10, p. 1188-1196Article in journal (Refereed)
    Abstract [en]

    Self-reported food frequency questionnaires (FFQs) have occasionally been used to investigate the association between whole-grain intake and the incidence of colorectal cancer, but the results from those studies have been inconsistent. We investigated this association using intakes of whole grains and whole-grain products measured via FFQs and plasma alkylresorcinol concentrations, a biomarker of whole-grain wheat and rye intake, both separately and in combination (Howe's score with ranks). We conducted a nested case-control study in a cohort from a research project on Nordic health and whole-grain consumption (HELGA, 1992-1998). Incidence rate ratios and 95% confidence intervals were calculated using conditional logistic regression. Plasma alkylresorcinol concentrations alone and Howe's score with ranks were inversely associated with the incidence of distal colon cancer when the highest quartile was compared with the lowest (for alkylresorcinol concentrations, incidence rate ratio = 0.34, 95% confidence interval: 0.13, 0.92; for Howe's score with ranks, incidence rate ratio = 0.35, 95% confidence interval: 0.15, 0.86). No association was observed between whole-grain intake and any colorectal cancer (colon, proximal, distal or rectum cancer) when using an FFQ as the measure/exposure variable for whole-grain intake. The results suggest that assessing whole-grain intake using a combination of FFQs and biomarkers slightly increases the precision in estimating the risk of colon or rectal cancer by reducing the impact of misclassification, thereby increasing the statistical power of the study.

  • 44. Kyro, Cecilie
    et al.
    Skeie, Guri
    Loft, Steffen
    Landberg, Rikard
    Christensen, Jane
    Lund, Eiliv
    Nilsson, Lena M.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Palmqvist, Richard
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Tjonneland, Anne
    Olsen, Anja
    Intake of whole grains from different cereal and food sources and incidence of colorectal cancer in the Scandinavian HELGA cohort2013In: Cancer Causes and Control, ISSN 0957-5243, E-ISSN 1573-7225, Vol. 24, no 7, p. 1363-1374Article in journal (Refereed)
    Abstract [en]

    A high intake of whole grains has been associated with a lower incidence of colorectal cancer, but few studies are available on the association with whole grains from different cereals, for example, wheat, rye and oats, and none has addressed these separately. The objective of this study was to investigate the association between whole-grain intake and colorectal cancer. We used data from the large population-based Scandinavian cohort HELGA consisting of 108,000 Danish, Swedish, and Norwegian persons, of whom 1,123 developed colorectal cancer during a median of 11 years of follow-up. Detailed information on daily intake of whole-grain products, including whole-grain bread, crispbread, and breakfast cereals, was available, and intakes of total whole grains and specific whole-grain species (wheat, rye, and oats) were estimated. Associations between these whole-grain variables and the incidence of colorectal cancer were investigated using Cox proportional hazards models. Intake of whole-grain products was associated with a lower incidence of colorectal cancer per 50-g increment (incidence rate ratio [IRR], 0.94; 95 % confidence interval [CI], 0.89, 0.99), and the same tendency was found for total whole-grain intake (IRR pr. 25-g increment, 0.94; 95 % CI, 0.88, 1.01). Intake of whole-grain wheat was associated with a lower incidence of colorectal cancer (IRR for highest versus lowest quartile of intake, 0.66; 95 % CI, 0.51, 0.85), but no statistical significant linear trend was observed (p for trend: 0.18). No significant association was found for whole-grain rye or oats. Whole-grain intake was associated with a lower incidence of colorectal cancer.

  • 45. Landais, Edwige
    et al.
    Moskal, Aurelie
    Mullee, Amy
    Nicolas, Genevieve
    Gunter, Marc J.
    Huybrechts, Inge
    Overvad, Kim
    Roswall, Nina
    Affret, Aurelie
    Fagherazzi, Guy
    Mahamat-Saleh, Yahya
    Katzke, Verena
    Kuehn, Tilman
    La Vecchia, Carlo
    Trichopoulou, Antonia
    Valanou, Elissavet
    Saieva, Calogero
    de Magistris, Maria Santucci
    Sieri, Sabina
    Braaten, Tonje
    Skeie, Guri
    Weiderpass, Elisabete
    Ardanaz, Eva
    Chirlaque, Maria-Dolores
    Garcia, Jose Ramon
    Jakszyn, Paula
    Rodriguez-Barranco, Miguel
    Brunkwall, Louise
    Huseinovic, Ena
    Nilsson, Lena
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Wallström, Peter
    Bueno-de-Mesquita, Bas
    Peeters, Petra H.
    Aune, Dagfinn
    Key, Tim
    Lentjes, Marleen
    Riboli, Elio
    Slimani, Nadia
    Freisling, Heinz
    Coffee and Tea Consumption and the Contribution of Their Added Ingredients to Total Energy and Nutrient Intakes in 10 European Countries: Benchmark Data from the Late 1990s2018In: Nutrients, E-ISSN 2072-6643, Vol. 10, no 6, article id 725Article in journal (Refereed)
    Abstract [en]

    Background: Coffee and tea are among the most commonly consumed nonalcoholic beverages worldwide, but methodological differences in assessing intake often hamper comparisons across populations. We aimed to (i) describe coffee and tea intakes and (ii) assess their contribution to intakes of selected nutrients in adults across 10 European countries.

    Method: Between 1995 and 2000, a standardized 24-h dietary recall was conducted among 36,018 men and women from 27 European Prospective Investigation into Cancer and Nutrition (EPIC) study centres. Adjusted arithmetic means of intakes were estimated in grams (=volume) per day by sex and centre. Means of intake across centres were compared by sociodemographic characteristics and lifestyle factors.

    Results: In women, the mean daily intake of coffee ranged from 94 g/day (similar to 0.6 cups) in Greece to 781 g/day (similar to 4.4 cups) in Aarhus (Denmark), and tea from 14 g/day (similar to 0.1 cups) in Navarra (Spain) to 788 g/day (similar to 4.3 cups) in the UK general population. Similar geographical patterns for mean daily intakes of both coffee and tea were observed in men. Current smokers as compared with those who reported never smoking tended to drink on average up to 500 g/day more coffee and tea combined, but with substantial variation across centres. Other individuals' characteristics such as educational attainment or age were less predictive. In all centres, coffee and tea contributed to less than 10% of the energy intake. The greatest contribution to total sugar intakes was observed in Southern European centres (up to similar to 20%).

    Conclusion: Coffee and tea intake and their contribution to energy and sugar intake differed greatly among European adults. Variation in consumption was mostly driven by geographical region.

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  • 46. Lassale, Camille
    et al.
    Gunter, Marc J.
    Romaguera, Dora
    Peelen, Linda M.
    Van der Schouw, Yvonne T.
    Beulens, Joline W. J.
    Freisling, Heinz
    Muller, David C.
    Ferrari, Pietro
    Huybrechts, Inge
    Fagherazzi, Guy
    Boutron-Ruault, Marie-Christine
    Affret, Aurelie
    Overvad, Kim
    Dahm, Christina C.
    Olsen, Anja
    Roswall, Nina
    Tsilidis, Konstantinos K.
    Katzke, Verena A.
    Kuehn, Tilman
    Buijsse, Brian
    Quiros, Jose-Ramon
    Sanchez-Cantalejo, Emilio
    Etxezarreta, Nerea
    Maria Huerta, Jose
    Barricarte, Aurelio
    Bonet, Catalina
    Khaw, Kay-Tee
    Key, Timothy J.
    Trichopoulou, Antonia
    Bamia, Christina
    Lagiou, Pagona
    Palli, Domenico
    Agnoli, Claudia
    Tumino, Rosario
    Fasanelli, Francesca
    Panico, Salvatore
    Bueno-de-Mesquita, H. Bas
    Boer, Jolanda M. A.
    Sonestedt, Emily
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Renström, Frida
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Weiderpass, Elisabete
    Skeie, Guri
    Lund, Eiliv
    Moons, Karel G. M.
    Riboli, Elio
    Tzoulaki, Ioanna
    Diet Quality Scores and Prediction of All-Cause, Cardiovascular and Cancer Mortality in a Pan-European Cohort Study2016In: PLOS ONE, E-ISSN 1932-6203, Vol. 11, no 7, article id e0159025Article in journal (Refereed)
    Abstract [en]

    Scores of overall diet quality have received increasing attention in relation to disease aetiology; however, their value in risk prediction has been little examined. The objective was to assess and compare the association and predictive performance of 10 diet quality scores on 10-year risk of all-cause, CVD and cancer mortality in 451,256 healthy participants to the European Prospective Investigation into Cancer and Nutrition, followed-up for a median of 12.8y. All dietary scores studied showed significant inverse associations with all outcomes. The range of HRs (95% CI) in the top vs. lowest quartile of dietary scores in a composite model including non-invasive factors (age, sex, smoking, body mass index, education, physical activity and study centre) was 0.75 (0.72-0.79) to 0.88 (0.84-0.92) for all-cause, 0.76 (0.69-0.83) to 0.84 (0.76-0.92) for CVD and 0.78 (0.73-0.83) to 0.91 (0.85-0.97) for cancer mortality. Models with dietary scores alone showed low discrimination, but composite models also including age, sex and other non-invasive factors showed good discrimination and calibration, which varied little between different diet scores examined. Mean C-statistic of full models was 0.73, 0.80 and 0.71 for all-cause, CVD and cancer mortality. Dietary scores have poor predictive performance for 10-year mortality risk when used in isolation but display good predictive ability in combination with other non-invasive common risk factors.

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  • 47. Leenders, Max
    et al.
    Sluijs, Ivonne
    Ros, Martine M
    Boshuizen, Hendriek C
    Siersema, Peter D
    Ferrari, Pietro
    Weikert, Cornelia
    Tjonneland, Anne
    Olsen, Anja
    Boutron-Ruault, Marie-Christine
    Clavel-Chapelon, Franoise
    Nailler, Laura
    Teucher, Birgit
    Li, Kuanrong
    Boeing, Heiner
    Bergmann, Manuela M
    Trichopoulou, Antonia
    Lagiou, Pagona
    Trichopoulos, Dimitrios
    Palli, Domenico
    Pala, Valeria
    Panico, Salvatore
    Tumino, Rosario
    Sacerdote, Carlotta
    Peeters, Petra HM
    van Gils, Carla H
    Lund, Eiliv
    Engeset, Dagrun
    Redondo, Maria Luisa
    Agudo, Antonio
    Sanchez, Maria Jose
    Navarro, Carmen
    Ardanaz, Eva
    Sonestedt, Emily
    Ericson, Ulrika
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Khaw, Kay-Tee
    Warcham, Nicholas J
    Key, Timothy J
    Crowe, Francesca L
    Romieu, Isabelle
    Gunter, Marc J
    Gallo, Valentina
    Overvad, Kim
    Riboli, Elio
    Bueno-de-Mesquita, H Bas
    Fruit and vegetable consumption and mortality European Prospective Investigation Into Cancer and Nutrition2013In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 178, no 4, p. 590-602Article in journal (Refereed)
    Abstract [en]

    In this study, the relation between fruit and vegetable consumption and mortality was investigated within the European Prospective Investigation Into Cancer and Nutrition. Survival analyses were performed, including 451,151 participants from 10 European countries, recruited between 1992 and 2000 and followed until 2010. Hazard ratios, rate advancement periods, and preventable proportions to respectively compare risk of death between quartiles of consumption, to estimate the period by which the risk of death was postponed among high consumers, and to estimate proportions of deaths that could be prevented if all participants would shift their consumption 1 quartile upward. Consumption of fruits and vegetables was inversely associated with all-cause mortality (for the highest quartile, hazard ratio = 0.90, 95% confidence interval (CI): 0.86, 0.94), with a rate advancement period of 1.12 years (95% CI: 0.70, 1.54), and with a preventable proportion of 2.95%. This association was driven mainly by cardiovascular disease mortality (for the highest quartile, hazard ratio = 0.85, 95% CI: 0.77, 0.93). Stronger inverse associations were observed for participants with high alcohol consumption or high body mass index and suggested in smokers. Inverse associations were stronger for raw than for cooked vegetable consumption. These results support the evidence that fruit and vegetable consumption is associated with a lower risk of death.

  • 48.
    Liu-Helmersson, Jing
    et al.
    Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Stoor, Krister
    Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research. Umeå University, Faculty of Arts, Department of language studies.
    瓦尔多的原住民研究—瑞典于默奥大学萨米族人研究中心: [Indigenous Research at Várdduo: Centre for Sami research, Umeå University, Sweden]2022In: Journal of Arctic Studies, Vol. 2, p. 341-351Article in journal (Refereed)
    Abstract [en]

    Várdduo – The Centre for Sami Research was established in the year 2000 under the Faculty of Arts. Umeå University has expanded its Indigenous research area, from Sami languages ​​and culture at the beginning (1975), to four areas today: Education and Language, Health and Living Conditions, Land and Water, Culture and History. This essay introduces the development of indigenous-related research at Umeå University with a focus on the research from Várdduo in the past 20 years. Today Várdduo serves as a hub for active expansion of research related to Indigenous issues at Umeå university to local, national and international arenas. Indigenous research at Umeå University/Várdduo, although still mainly on Sámi issues, has experienced a development characterized by fast growth, diversity, interdisciplinarity and increasing international commitment

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  • 49.
    Liu-Helmersson, Jing
    et al.
    Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Stoor, Krister
    Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Nilsson, Lena Maria
    Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Indigenous research at Várdduo - Centre for Sami research, Umeå University, Sweden2022In: Journal of Arctic studies: V, Liaocheng: The Arctic Studies Center , 2022, Vol. 5, p. 341-351Chapter in book (Refereed)
    Abstract [en]

    Várdduo – The Centre for Sami Research was established in the year 2000 under the Faculty of Arts. Umeå University has expanded its Indigenous research area, from Sami languages ​​and culture at the beginning (1975), to four areas today: Education and Language, Health and Living Conditions, Land and Water, Culture and History. This essay introduces the development of indigenous-related research at Umeå University with a focus on the research from Várdduo in the past 20 years. Today Várdduo serves as a hub for active expansion of research related to Indigenous issues at Umeå university to local, national and international arenas. Indigenous research at Umeå University/Várdduo, although still mainly on Sámi issues, has experienced a development characterized by fast growth, diversity, interdisciplinarity and increasing international commitment. 

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  • 50.
    Llaha, Fjorida
    et al.
    Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
    Cayssials, Valerie
    Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Veterinary Public Health, Faculty of Veterinary, University of the Republic, Montevideo, Uruguay; Department of Quantitative Methods, Faculty of Medicine, University of the Republic, Montevideo, Uruguay.
    Farràs, Marta
    Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
    Agudo, Antonio
    Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
    Sandström, Maria
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Eriksen, Anne Kirstine
    Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
    Tjønneland, Anne
    Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
    Boutron-Ruault, Marie-Christine
    University Paris-Saclay, University of Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut National de la Santé et de la Recherche Médicale (INSERM), Gustave Roussy, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Team “Exposome and Heredity”, Villejuif, France.
    Laouali, Nasser
    University Paris-Saclay, University of Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut National de la Santé et de la Recherche Médicale (INSERM), Gustave Roussy, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Team “Exposome and Heredity”, Villejuif, France.
    Truong, Thérèse
    University Paris-Saclay, University of Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut National de la Santé et de la Recherche Médicale (INSERM), Gustave Roussy, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Team “Exposome and Heredity”, Villejuif, France.
    Le Cornet, Charlotte
    Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
    Katzke, Verena
    Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
    Schulze, Matthias
    Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany.
    Palli, Domenico
    Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - Institute for the Study and Prevention of Cancer, Florence, Italy.
    Krogh, Vittorio
    Epidemiology and Prevention Unit, Fondazione Istituto Nazionale dei Tumori (IRCCS), Milan, Italy.
    Signoriello, Simona
    Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Vanvitelli University, Naples, Italy.
    Tumino, Rosario
    Hyblean Association for Epidemiological Research (AIRE -ONLUS), Ragusa, Italy.
    Ricceri, Fulvio
    Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
    Skeie, Guri
    Department of Community Medicine, Faculty of Health Sciences, University of Tromsø (UiT), The Arctic University of Norway, Tromsø, Norway.
    Jensen, Torill Miriam Enget
    Department of Community Medicine, Faculty of Health Sciences, University of Tromsø (UiT), The Arctic University of Norway, Tromsø, Norway.
    Chen, Sairah Lai Fa
    Department of Community Medicine, Faculty of Health Sciences, University of Tromsø (UiT), The Arctic University of Norway, Tromsø, Norway.
    Lasheras, Cristina
    Department of Functional Biology, Medical School, University of Oviedo, Oviedo, Spain.
    Rodriguez-Barranco, Miguel
    Escuela Andaluza de Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria Granada (ibs.GRANADA), Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
    Amiano, Pilar
    Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain; Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain.
    Huerta, José María
    Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, Biomedical Research Institute of Murcia (IMIB)-Arrixaca, Murcia, Spain.
    Guevara, Marcela
    Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
    Almquist, Martin
    Department of Surgery, Skåne University Hospital, Lund University, Lund, Sweden.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Hennings, Joakim
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Papier, Keren
    Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
    Heath, Alicia
    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
    Weiderpass, Elisabete
    International Agency for Research on Cancer – World Health Organization (IARC-WHO), Lyon, France.
    Rinaldi, Sabina
    International Agency for Research on Cancer – World Health Organization (IARC-WHO), Lyon, France.
    Zamora-Ros, Raul
    Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
    Adherence to mediterranean diet and the risk of differentiated thyroid cancer in a European cohort: the EPIC study2022In: Frontiers in Nutrition, E-ISSN 2296-861X, Vol. 9, article id 982369Article in journal (Refereed)
    Abstract [en]

    Background: The Mediterranean diet (MD) has been proposed as a healthy diet with a potential to lower the incidence of several types of cancer, but there is no data regarding thyroid cancer (TC). We investigated the association between MD adherence, and its components, and the differentiated TC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

    Methods: Over 450,000 men and women from nine European countries were followed up for a mean of 14.1 years, during which 712 differentiated TC cases were identified. Adherence to MD was estimated using the relative MD (rMED) score, an 18-point scale including alcohol, and the adapted rMED (arMED) score, a 16-point scale excluding alcohol. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models adjusted for potential confounding factors.

    Results: Adherence to the arMED score was not associated with the risk of differentiated TC (HRhigh vs. low adherence = 0.94, 95% CI: 0.70–1.25; p-trend 0.27), while a suggestive, but non-statistically significant inverse relationship was observed with rMED (HRhigh vs. low adherence = 0.88, 95% CI: 0.68–1.14; p-trend 0.17). Low meat (HRlow vs. high meat intake = 0.81, 95% CI: 0.67–0.99; p-trend = 0.04) and moderate alcohol (HRmoderate vs. non−moderate intake = 0.88, 95% CI: 0.75–1.03) intake were related with lower differentiated TC risk.

    Conclusions: Our study shows that a high adherence to MD is not strongly related to differentiated TC risk, although further research is required to confirm the impact of MD and, especially, meat intake in TC risk.

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