Association of Emulsifier and Highly Processed Food Intake with Circulating Markers of Intestinal Permeability and Inflammation in the Cancer Prevention Study-3 Diet Assessment Sub-Study

Abstract Objectives Emulsifiers may increase intestinal permeability, inflammation, and colorectal carcinogenesis in animals. Highly processed foods are associated with obesity and may increase risk of chronic diseases, including cancer. We estimated intake of emulsifiers and highly processed foods in participants from the Cancer Prevention Study-3 Diet Assessment Sub-study and examined their association with biomarkers of gut permeability and inflammation. Methods This study included 657 men and women who completed six 24-hr dietary recalls and two fasting blood samples over one year. Antibodies (IgG and IgA) to flagellin and lipopolysaccharide (LPS) and glycoprotein acetyls (GlycA) were measured using enzyme-linked immunosorbent assay and nuclear magnetic resonance, respectively. Total flagellin and LPS were each calculated as the sum of IgG and IgA; total antibody comprised the sum of total flagellin and LPS. Foods containing ≥1 emulsifier were identified from ingredient lists; foods typically containing emulsifiers were coded as such if an ingredient list was not available. We estimated emulsifier intake as 0.5% of total food weight, per FDA guidance. Highly processed foods were defined using the NOVA and Poti et al. classification systems and calculated as % grams of total foods and % kcal of total energy. Multivariable-adjusted generalized linear models were used to estimate associations of emulsifier and processed food quartiles with continuous antibody or inflammatory biomarkers. Results Higher emulsifier intake (g/d) was not associated with total flagellin (P-trend = 0.48), total LPS (P-trend = 0.61), total antibody (P-trend = 0.49), or GlycA (P-trend = 0.16). Higher processed food intake (% kcal/d) was associated with higher total LPS (P-trend = 0.001) and total antibody (P-trend = 0.01) but not with other biomarkers, whereas processed food intake estimated as % g/d was only associated with higher GlycA (P-trend = 0.02). Conclusions Our results suggest highly processed food, but not emulsifier, intake may be associated with gut permeability biomarkers. Additional studies are needed to further understand the relationship between emulsifier and highly processed food intake and intestinal permeability and inflammation. Funding Sources The American Cancer Society funds the creation, maintenance, and updating of the Cancer Prevention Study-3 cohort.

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Identification and Reproducibility of Urinary Metabolomic Biomarkers of Habitual Food Intake in a Cross-Sectional Analysis of the Cancer Prevention Study-3 Diet Assessment Sub-Study

Metabolites ◽

10.3390/metabo11040248 ◽

2021 ◽

Vol 11 (4) ◽

pp. 248

Author(s):

Ying Wang ◽

Rebecca A. Hodge ◽

Victoria L. Stevens ◽

Terryl J. Hartman ◽

Marjorie L. McCullough

Keyword(s):

Cancer Prevention ◽

Biomarker Discovery ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Urine Samples ◽

Food Groups ◽

Prevention Study ◽

Cross Sectional ◽

Diet Assessment ◽

Over Time

Previous cross-sectional metabolomics studies have identified many potential dietary biomarkers, mostly in blood. Few studies examined urine samples although urine is preferred for dietary biomarker discovery. Furthermore, little is known regarding the reproducibility of urinary metabolomic biomarkers over time. We aimed to identify urinary metabolomic biomarkers of diet and assess their reproducibility over time. We conducted a metabolomics analysis among 648 racially/ethnically diverse men and women in the Diet Assessment Sub-study of the Cancer Prevention Study-3 cohort to examine the correlation between >100 food groups/items [101 by a food frequency questionnaire (FFQ), and 105 by repeated 24 h diet recalls (24HRs)] and 1391 metabolites measured in 24 h urine sample replicates, six months apart. Diet–metabolite associations were examined by Pearson’s partial correlation analysis. Biomarkers were evaluated for prediction accuracy assessed using area under the curve (AUC) calculated from the receiver operating characteristic curve and for reproducibility assessed using intraclass correlation coefficients (ICCs). A total of 1708 diet–metabolite associations were identified after Bonferroni correction for multiple comparisons and restricting correlation coefficients to >0.2 or <−0.2 (1570 associations using the FFQ and 933 using 24HRs), 513 unique metabolites correlated with 79 food groups/items. The median ICCs of the 513 putative biomarkers was 0.53 (interquartile range 0.42–0.62). In this study, with comprehensive dietary data and repeated 24 h urinary metabolic profiles, we identified a large number of diet–metabolite correlations and replicated many found in previous studies. Our findings revealed the promise of urine samples for dietary biomarker discovery in a large cohort study and provide important information on biomarker reproducibility, which could facilitate their utilization in future clinical and epidemiological studies.

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Self-Reported Dietary Supplement Use Is Reproducible and Relatively Valid in the Cancer Prevention Study-3 Diet Assessment Substudy

Journal of the Academy of Nutrition and Dietetics ◽

10.1016/j.jand.2021.07.006 ◽

2021 ◽

Author(s):

Terryl J. Hartman ◽

Ying Wang ◽

Rebecca A. Hodge ◽

Diane C. Mitchell ◽

W. Dana Flanders ◽

...

Keyword(s):

Cancer Prevention ◽

Dietary Supplement ◽

Prevention Study ◽

Supplement Use ◽

Diet Assessment ◽

Dietary Supplement Use

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Impact of Diabetes Mellitus and Insulin Use on Survival After Colorectal Cancer Diagnosis: The Cancer Prevention Study-II Nutrition Cohort

Journal of Clinical Oncology ◽

10.1200/jco.2011.38.0303 ◽

2012 ◽

Vol 30 (1) ◽

pp. 53-59 ◽

Cited By ~ 65

Author(s):

Ahmed N. Dehal ◽

Christina C. Newton ◽

Eric J. Jacobs ◽

Alpa V. Patel ◽

Susan M. Gapstur ◽

...

Keyword(s):

Diabetes Mellitus ◽

Colorectal Cancer ◽

Cancer Prevention ◽

Cox Proportional Hazards ◽

Prevention Study ◽

Men And Women ◽

Risk Of Death ◽

Increased Risk ◽

Specific Mortality ◽

Insulin Use

Purpose To examine the association between type 2 diabetes mellitus (T2DM) and survival among patients with colorectal cancer (CRC) and to evaluate whether this association varies by sex, insulin treatment, and durations of T2DM and insulin use. Patients and Methods This study was conducted among 2,278 men and women diagnosed with nonmetastatic colon or rectal cancer between 1992 and 2007 in the Cancer Prevention Study-II Nutrition Cohort, a prospective study of cancer incidence. In 1992 to 1993, participants completed a detailed, self-administrated questionnaire. Vital status and cause of death were ascertained through the end of 2008. Multivariable-adjusted relative risks (RRs) and 95% CIs were estimated using Cox proportional hazards regression. Results Among the 2,278 men and women with nonmetastatic CRC, there were 842 deaths by the end of follow-up (including 377 deaths from CRC and 152 deaths from cardiovascular disease [CVD]). Among men and women combined, compared with patients without T2DM, patients with CRC and T2DM were at higher risk of all-cause mortality (RR, 1.53; 95% CI, 1.28 to 1.83), CRC-specific mortality (RR, 1.29; 95% CI, 0.98 to 1.70), and CVD-specific mortality (RR, 2.16; 95% CI, 1.44 to 3.24), with no apparent differences by sex or durations of T2DM or insulin use. Insulin use, compared with no T2DM, was associated with increased risk of death from all causes (RR, 1.68; 95% CI, 1.22 to 2.31) and CVD (RR, 3.87; 95% CI, 2.12 to 7.08) but not from CRC (RR, 0.58; 95% CI, 0.28 to 1.19). Conclusion Patients with CRC and T2DM have a higher risk of mortality than patients with CRC who do not have T2DM, especially a higher risk of death from CVD.

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Intake of Fatty Acids and Risk of Coronary Heart Disease in a Cohort of Finnish Men: The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study

American Journal of Epidemiology ◽

10.1093/oxfordjournals.aje.a009047 ◽

1997 ◽

Vol 145 (10) ◽

pp. 876-887 ◽

Cited By ~ 347

Author(s):

P. Pietinen ◽

A. Ascherio ◽

P. Korhonen ◽

A. M. Hartman ◽

W. C. Willett ◽

...

Keyword(s):

Fatty Acids ◽

Coronary Heart Disease ◽

Heart Disease ◽

Cancer Prevention ◽

Beta Carotene ◽

Alpha Tocopherol ◽

Prevention Study

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Abstract MP53: Consumption Of Ultra-processed Food Is Associated With Risk Of Coronary Heart Disease In The Atherosclerosis Risk In Communities Study

Circulation ◽

10.1161/circ.143.suppl_1.mp53 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Shutong Du ◽

Hyunju Kim ◽

Josef Coresh ◽

Casey M Rebholz

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Food Intake ◽

Proportional Hazards ◽

Sociodemographic Factors ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Processed Food ◽

Cox Proportional Hazards Models ◽

Food And Drink

Introduction: Ultra-processed food defined as food and drink products formulated through sequences of industrial processes, and generally contain non-culinary used additives. Previous studies have linked higher ultra-processed food intake with several cardiometabolic and cardiovascular diseases. However, longitudinal evidence from US populations remains scarce. Hypothesis: We hypothesized that higher intake of ultra-processed food is associated with higher risk of coronary heart disease (CHD). Methods: We selected 12,607 adults aged 44-66 years in 4 US communities from the ARIC study at baseline. Dietary intake data were collected through a validated 66-item food frequency questionnaire. Ultra-processed foods were defined using the NOVA classification and the level of intake was calculated for each participant. We conducted Cox proportional hazards models to study the association between quartiles of ultra-processed food intake and incident CHD. Nonlinearity was assessed by using restricted cubic spline regression. Results: There were 1,899 incident CHD cases documented after an median follow up of 27 years (291,285.2 person-years). Incidence rates were higher in the highest quartile of ultra-processed food intake (71.6 per 10,000 person-years; 95% CI, 65.8-78.0) compared to the lowest quartile (59.7 per 10,000 person-years; 95% CI, 54.3-65.7). Participants in the highest vs. lowest quartile were associated with a 18% higher risk of CHD (Hazard ratio 1.18 [95% CI, 1.04 - 1.34]; P-trend = 0.010) after adjusting for sociodemographic factors and health behaviors. An approximately linear relationship was observed between ultra-processed food intake and risk of CHD after 4 servings/day ( Figure ). Conclusion: In conclusion, higher ultra-processed food intake was associated with a higher risk of coronary heart disease among middle-aged US adults. Further prospective studies are needed to confirm these findings and to investigate the mechanisms by which ultra-processed food may affect health.

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Consumption of ultra-processed foods and the risk of overweight and obesity, and weight trajectories in the French cohort NutriNet-Santé

Proceedings of The Nutrition Society ◽

10.1017/s0029665120003559 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Bernard Srour ◽

Marie Beslay ◽

Caroline Méjean ◽

Benjamin Allès ◽

Thibault Fiolet ◽

...

Keyword(s):

Food Intake ◽

Confidence Interval ◽

Prospective Study ◽

Food Consumption ◽

Overweight And Obesity ◽

Processed Foods ◽

Processed Food ◽

Weight Trajectories ◽

Incident Cases

AbstractIntroductionPrevious epidemiological studies have found associations between the consumption of ultra-processed foods and the risk of obesity-related outcomes, such as post-menopausal breast cancer, cardiovascular diseases, hypertension and mortality. However, only one Spanish prospective study has explored the associations between the consumption of ultra-processed foods and the risk of overweight and obesity. The aim of this study is to investigate the associations between ultra-processed food consumption and the risk of overweight and obesity, as well as the associations between ultra-processed food consumption and weight trajectories, in middle-aged adults included in the French large scale NutriNet-Santé cohort.MethodsOverall, 110260 participants aged at least 18 years from the French NutriNet-Santé cohort (2009–2019) were included. Dietary intakes were collected using repeated 24 hour dietary records, merged with a food composition database of 3300 different products. These were categorized according to their degree of processing by the NOVA classification. Associations between ultra-processed food intake and risks of overweight and obesity were assessed using multivariable Cox proportional hazard models. Associations between ultra-processed food intake and weight trajectories were assessed using multivariable linear mixed models for repeated measures with random slope and intercept. Models were adjusted for known risk factors (sociodemographic, lifestyle, and nutritional factors).ResultsUltra-processed food intake was associated with a higher risk of overweight (n = 7063 incident cases; hazard ratio for an absolute increment of 10 in the percentage of ultra-processed foods in the diet = 1.11 (95% confidence interval 1.08 to 1.14); P < 0.0001, median follow-up: 4.1y, 260304 person-years) and obesity (n = 3066 incident cases; HR = 1.09 (95% confidence interval 1.05 to 1.13); P < 0.0001, median follow-up: 8.0y 365344 person-years). Higher consumers of ultra-processed foods (4th quartile) were more likely to present an increase in body mass index over time (change of BMI/time-unit in Q4 vs Q1 = 0.04, P < 0.0001). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (fruits and vegetables and sugary drinks consumption, intakes of saturated fatty acids, sodium, sugar, dietary fiber or Healthy/Western patterns derived by principal component analysis) and after a large range of sensitivity analyses.ConclusionIn this large observational prospective study, higher consumption of ultra-processed foods in the diet was associated with a higher risk of overweight and obesity. Public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting ultra-processed food consumption.

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