Papers by Alison McTaggart
European Journal of Clinical Nutrition, 2009
Contributors: NS initiated and wrote this paper, taking into account comments from all co-authors... more Contributors: NS initiated and wrote this paper, taking into account comments from all co-authors, and was the overall coordinator of this project and of the EPIC Nutrient DataBase (ENDB) project. CB carried out the statistical analysis and preparation of tables and figures. GD was in charge of recoding dietary data according to the project-specific food reclassification, under the supervision of NS and DATS. DATS acted as an external expert on food chemistry and helped with the reclassification according to food processing methods.
Gut, 2010
Introduction There are plausible biological mechanisms for how excess sucrose intake may initiate... more Introduction There are plausible biological mechanisms for how excess sucrose intake may initiate pancreatic carcinogenesis via an increased insulin release promoting cell proliferation. The aim of this study was to investigate dietary sucrose intake and the risk of pancreatic cancer, in a prospective cohort study using nutrient data from 7-day food diaries (7-DFDs). Methods In EPIC-Norfolk (European Prospective Investigation into Cancer-Norfolk) 25 639 men and women aged 45–74 years were recruited between 1993 and 1997 and completed 7-DFDs. Participants' sucrose intake was calculated from these diaries using a computer programme containing information on 9000 food items. The cohort was monitored for 16 years to identify those who developed pancreatic cancer. Each case was matched with four controls, for age and gender, and conditional logistic regression used to calculate OR and 95% CI adjusted for smoking, diabetes and total energy intake. To look for threshold effect the OR was calculated comparing the highest quintile of sucrose intake with a combination of the lower four quintiles. Results A total of 81 participants (51% men) developed pancreatic cancer (mean age=71.4 years SD=8.6 years) with a median sucrose intake of 44.2 grams per day (range 8.5–140.0 g/day). The highest compared to the lowest quintile intake of sucrose intake doubled the risk of pancreatic cancer, OR 2.27 (95% CI 0.90 to 5.74 p=0.08), with a trend across quintiles OR 1.23 (95% CI 0.99 to 1.53, p=0.07). Comparing the highest intake to a summation of the lowest four levels showed a positive association (OR 1.99, 95% CI 1.05 to 3.78, p=0.04). There was no effect for the intake of total sugars (trend across quintiles OR 0.98, 95% CI 0.77 to 1.26, p=0.90). Conclusion The study showed a positive association of an increased sucrose intake with the risk of pancreatic cancer. These epidemiological findings support plausible mechanisms on how excess sucrose may stimulate pancreatic carcinogenesis. Sucrose intake should be accurately measured in future aetiological studies of pancreatic cancer.
Gut, 2010
Introduction The aetiology of pancreatic cancer is largely unknown although the antioxidants vita... more Introduction The aetiology of pancreatic cancer is largely unknown although the antioxidants vitamin E, vitamin C and selenium may prevent carcinogenesis by preventing free radical induced cell damage. The aim of this study was to investigate whether these micronutrients affect the risk of developing pancreatic cancer, for the first time in a prospective cohort study, using seven-day food diaries (7-DFDs) to estimate anti-oxidant intake. Methods A total of 25 639 men and women aged 45–74 years were recruited between 1993 and 1997 into the European Prospective Investigation into Cancer-Norfolk and completed 7-DFDs. The dietary intakes of vitamin C, vitamin E and selenium were calculated using a computer program containing information on 11 000 food items. The cohort was monitored for 16 years to identify those who developed pancreatic cancer. Each case was matched with four controls for age and sex and conditional logistic regression used to calculate OR and 95% CI for the intake of each antioxidant, adjusted for smoking, diabetes and total energy intake. To look for a threshold effect the OR was calculated comparing the lowest quintile of each antioxidant with a combination of the higher four quintiles. Results During follow-up, 81 participants (51% men) developed pancreatic cancer (mean age=71.4 years, SD=8.6 years). The four highest quintiles of vitamin E were negatively associated with the development of pancreatic cancer, although there was no dose-dependent effect (OR for the fourth highest quintile vs the lowest=0.37, 95% CI 0.16 to 0.88 p=0.03, OR for the fifth quintile=0.46, 95% CI 0.19 to 1.11, p=0.09). The OR for the lowest quintile compared to a summation of the four highest quintiles was 0.45 (95% CI 0.24 to 0.85, p=0.01). No significant associations were found for the dietary intakes of either vitamin C or selenium. Conclusion This is the first prospective epidemiological study, using detailed 7-DFDs, to demonstrate a protective effect of vitamin E in the development of pancreatic cancer. These results suggest vitamin E should be measured in future work on the aetiology of this cancer. Consistent findings together with plausible biological mechanisms would support measures to increase the dietary intake of vitamin E in the population.
European journal of clinical nutrition, 2014
In spite of several studies relating dietary patterns to breast cancer risk, evidence so far rema... more In spite of several studies relating dietary patterns to breast cancer risk, evidence so far remains inconsistent. This study aimed to investigate associations of dietary patterns derived with three different methods with breast cancer risk. The Mediterranean Diet Score (MDS), principal components analyses (PCA) and reduced rank regression (RRR) were used to derive dietary patterns in a case-control study of 610 breast cancer cases and 1891 matched controls within four UK cohort studies. Dietary intakes were collected prospectively using 4- to 7-day food diaries and resulting food consumption data were grouped into 42 food groups. Conditional logistic regression models were used to estimate odds ratios (ORs) for associations between pattern scores and breast cancer risk adjusting for relevant covariates. A separate model was fitted for post-menopausal women only. The MDS was not associated with breast cancer risk (OR comparing first tertile with third 1.20 (95% CI 0.92; 1.56)), nor ...
European Journal of Clinical Nutrition, 2009
Objectives: To assess the contribution of out-of-home (OH) energy and nutrient intake to total di... more Objectives: To assess the contribution of out-of-home (OH) energy and nutrient intake to total dietary intake, and to compare out-versus in-home nutrient patterns among 27 centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Between 1995 and 2000, 36 034 participants aged between 35-74 years completed a standardized 24-h dietary recall using a software programme (EPIC-Soft) that recorded the place of food/drink consumption. Eating OH was defined as the consumption of foods and beverages anywhere other than in household premises, irrespective of the place of purchase/
Background: The PTEN tumour suppressor gene and PIK3CA proto-oncogene encode proteins which contr... more Background: The PTEN tumour suppressor gene and PIK3CA proto-oncogene encode proteins which contribute to regulation and propagation of signal transduction through the PI3K/AKT signalling pathway. This study investigates the prevalence of loss of PTEN expression and mutations in both PTEN and PIK3CA in colorectal cancers (CRC) and their associations with tumour clinicopathological features, lifestyle factors and dietary consumptions. Methods: 186 adenocarcinomas and 16 adenomas from the EPIC Norfolk study were tested for PTEN and PIK3CA mutations by DNA sequencing and PTEN expression changes by immunohistochemistry. Dietary and lifestyle data were collected prospectively using seven day food diaries and lifestyle questionnaires. Results: Mutations in exons 7 and 8 of PTEN were observed in 2.2 % of CRC and PTEN loss of expression was identified in 34.9 % CRC. Negative PTEN expression was associated with lower blood low-density lipoprotein concentrations (p = 0.05). PIK3CA mutations w...
Dietary, lifestyle and clinicopathological factors associated with BRAF and K-ras mutations arisi... more Dietary, lifestyle and clinicopathological factors associated with BRAF and K-ras mutations arising in distinct subsets of colorectal cancers in the EPIC Norfolk study Citation for published version:
European journal of …, 2006
Osteoporosis international: a journal established as result …, 2003
We measured the impact of diet, anthropometry, physical activity and lifestyle variables on rates... more We measured the impact of diet, anthropometry, physical activity and lifestyle variables on rates of hip bone mineral density (BMD) loss in 470 white men and 474 white women aged 67-79 years at recruitment dwelling in the community. ...
…, 2010
Professor Rodwell (professionally known as Bingham) read an initial draft of this manuscript, but... more Professor Rodwell (professionally known as Bingham) read an initial draft of this manuscript, but sadly passed away in June 2009.
The alcohol-breast cancer association has been established using alcohol intake measurements from... more The alcohol-breast cancer association has been established using alcohol intake measurements from Food Frequency Questionnaires (FFQ). For some nutrients diet diary measurements are more highly correlated with true intake compared with FFQ measurements, but it is unknown whether this is true for alcohol. A case-control study (656 breast cancer cases, 1905 matched controls) was sampled from four cohorts in the UK Dietary Cohort Consortium. Alcohol intake was measured prospectively using FFQs and 4-or 7-day diet diaries. Both relied on fixed portion sizes allocated to given beverage types, but those used to obtain FFQ measurements were lower. FFQ measurements were therefore on average lower and to enable fair comparison the FFQ was ''calibrated'' using diet diary portion sizes. Diet diaries gave more zero measurements, demonstrating the challenge of distinguishing never-from episodic-consumers using short term instruments. To use all information, two combined measurements were calculated. The first is an average of the two measurements with special treatment of zeros. The second is the expected true intake given both measurements, calculated using a measurement error model. After confounder adjustment the odds ratio (OR) per 10 g/day of alcohol intake was 1.05 (95 % CI 0.98, 1.13) using diet diaries, and 1.13 (1.02, 1.24) using FFQs. The calibrated FFQ measurement and combined measurements 1 and 2 gave ORs 1.10 (1.03, 1.18), 1.09 (1.01, 1.18), 1.09 (0.99,1.20), respectively. The association was modified by HRT use, being stronger among users versus non-users. In summary, using an alcohol measurement from a diet diary at one time point gave attenuated associations compared with FFQ.
BMC …, 2011
Background: The PTEN tumour suppressor gene and PIK3CA proto-oncogene encode proteins which contr... more Background: The PTEN tumour suppressor gene and PIK3CA proto-oncogene encode proteins which contribute to regulation and propagation of signal transduction through the PI3K/AKT signalling pathway. This study investigates the prevalence of loss of PTEN expression and mutations in both PTEN and PIK3CA in colorectal cancers (CRC) and their associations with tumour clinicopathological features, lifestyle factors and dietary consumptions. Methods: 186 adenocarcinomas and 16 adenomas from the EPIC Norfolk study were tested for PTEN and PIK3CA mutations by DNA sequencing and PTEN expression changes by immunohistochemistry. Dietary and lifestyle data were collected prospectively using seven day food diaries and lifestyle questionnaires. Results: Mutations in exons 7 and 8 of PTEN were observed in 2.2% of CRC and PTEN loss of expression was identified in 34.9% CRC. Negative PTEN expression was associated with lower blood low-density lipoprotein concentrations (p = 0.05). PIK3CA mutations were observed in 7% of cancers and were more frequent in CRCs in females (p = 0.04). Analysis of dietary intakes demonstrated no link between PTEN expression status and any specific dietary factor. PTEN expression negative, proximal CRC were of more advanced Dukes' stage (p = 0.02) and poor differentiation (p < 0.01). Testing of the prevalence of PIK3CA mutations and loss of PTEN expression demonstrated that these two events were independent (p = 0.55). Conclusion: These data demonstrated the frequent occurrence (34.9%) of PTEN loss of expression in colorectal cancers, for which gene mutations do not appear to be the main cause. Furthermore, dietary factors are not associated with loss of PTEN expression. PTEN expression negative CRC were not homogenous, as proximal cancers were associated with a more advanced Dukes' stage and poor differentiation, whereas distal cancers were associated with earlier Dukes' stage.
British Journal of Nutrition, 2014
The aim of the present study was to describe the energy, nutrient and crude v. disaggregated food... more The aim of the present study was to describe the energy, nutrient and crude v. disaggregated food intake measured using 7 d diet diaries (7dDD) for the full baseline Norfolk cohort recruited for the European Prospective Investigation into Cancer (EPIC-Norfolk) study, with emphasis on methodological issues. The first data collection took place between 1993 and 1998 in Norfolk, East Anglia (UK). Of the 30 445 men and women, aged 40–79 years, registered with a general practitioner invited to participate in the study, 25 639 came for a health examination and were asked to complete a 7dDD. Data from diaries with data recorded for at least 1 d were obtained for 99 % members of the cohort; 10 354 (89·8 %) of the men and 12 779 (91·5 %) of the women completed the diet diaries for all 7 d. Mean energy intake (EI) was 9·44 (sd 2·22) MJ/d and 7·15 (sd 1·66) MJ/d, respectively. EI remained approximately stable across the days, but there was apparent under-reporting among the participants, espec...
Public Health Nutrition, 2002
Objective: To describe the average consumption of carbohydrate-providing food groups among study ... more Objective: To describe the average consumption of carbohydrate-providing food groups among study centres of the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Of the 27 redefined EPIC study centres, 19 contributed subjects of both genders and eight centres female participants only (men, n ¼ 13 031; women, n ¼ 22 924; after exclusion of subjects under 35 and over 74 years of age from the original 36 900 total). Dietary data were obtained using the 24-hour recall methodology using the EPIC-SOFT software. The major sources of dietary carbohydrate were identified, and 16 food groups were examined. Results: The 10 food groups contributing most carbohydrate were bread; fruit; milk and milk products; sweet buns, cakes and pies; potato; sugar and jam; pasta and rice; vegetables and legumes; crispbread; and fruit and vegetable juices. Consumption of fruits as well as vegetables and legumes was higher in southern compared with northern centres, while soft drinks consumption was higher in the north. Italian centres had high pasta and rice consumption, but breakfast cereal, potato, and sweet buns, cakes and pies were higher in northern centres. In Sweden, lower bread consumption was balanced with a higher consumption of crispbread, and with sweet buns, cakes and pies. Overall, men consumed higher amounts of vegetables and legumes, bread, soft drinks, potatoes, pasta and rice, breakfast cereal and sugar and jam than women, but fruit consumption appeared more frequent in women. Conclusion: The study supports the established idea that carbohydrate-rich foods chosen in northern Europe are different from those in the Mediterranean region. When comparing and interpreting diet-disease relationships across populations, researchers need to consider all types of foods. Keywords Foods Carbohydrates Descriptive epidemiology EPIC study Cancer 24-Hour dietary recall Europe Carbohydrates contribute a major proportion of dietary energy in most populations 1,2. The influences of carbohydrate-rich diets on health and disease may, however, diverge substantially depending on the specific types and food sources of carbohydrate. Dietary carbohydrates are defined as naturally occurring sugars, added sugars, starch, resistant starch and dietary fibre/non-starch polysaccharides (NSP). Plant foods contribute not only dietary carbohydrates, but also a whole array of essential micronutrients and food components, generally identified
Public Health Nutrition, 2002
Objective:The aim of this study was to describe the variation of soy product intake in 10 Europea... more Objective:The aim of this study was to describe the variation of soy product intake in 10 European countries by using a standardised reference dietary method. A subsidiary aim was to characterise the pattern of soy consumption among a sub-group of participants with a habitual health-conscious lifestyle (HHL), i.e. non-meat eaters who are fish eaters, vegetarians and vegans.Design:A 24-hour dietary recall interview (24-HDR) was conducted among a sample (5–12%) of all cohorts (n = 36 900) in the European Prospective Investigation into Cancer and Nutrition (EPIC). Study participants totalled 35 955 after exclusion of subjects younger than 35 or older than 74 years of age. Soy products were subdivided into seven sub-groups by similarity. Distribution of consumption and crude and adjusted means of intake were computed per soy product group across countries. Intake of soy products was also investigated among participants with an HHL.Results:In total, 195 men and 486 women reported consumi...
European Journal of Clinical Nutrition, 2009
Objective: To describe dietary carbohydrate intakes and their food sources among 27 centres in 10... more Objective: To describe dietary carbohydrate intakes and their food sources among 27 centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Between 1995 and 2000, 36 034 subjects, aged between 35-74 years, were administered a standardized, 24-h dietary recall using a computerized interview software programme (EPIC-SOFT). Intakes (g/day) of total carbohydrate, sugars, Guarantor: AE Cust.
The American Journal of Clinical Nutrition, Aug 1, 2001
Background: The validity of dietary assessment methods should be established before diet-disease ... more Background: The validity of dietary assessment methods should be established before diet-disease associations are reported. Objective: Our objective was to validate a 7-d food diary and a food-frequency questionnaire (FFQ) against independent biomarkers of intake in urine (nitrogen, potassium, and sodium) and blood (plasma ascorbic acid). Design: A total of 146 healthy middle-aged men and women were recruited from the European Prospective Investigation into Cancer UK Norfolk cohort, a free-living cohort of Ϸ25 000 persons. Over a 9-mo period, urinary nitrogen, potassium, and sodium were estimated from 2-6 complete 24-h urine collections in 134 subjects and plasma ascorbic acid was estimated from 2-3 fasting blood samples in 118 subjects. Subjects completed 2 FFQs and two 7-d food diaries. Results: In men and women combined, correlations between 24-h urinary nitrogen excretion and dietary intake from the 7-d food diary were high (r = 0.57-0.67) compared with those for the FFQ (r = 0.21-0.29). Similarly, correlations between urinary potassium and dietary potassium were higher for the 7-d food diary (r = 0.51-0.55) than for the FFQ (r = 0.32-0.34). There was no overall difference in correlations between plasma ascorbic acid and dietary vitamin C between the 7-d food diary (r = 0.40-0.52) and the FFQ (r = 0.44-0.45). Conclusions: These data indicate that, despite increased subject burden, the 7-d food diary provided a better estimate of nitrogen and potassium intakes than did the FFQ in this study population. However, with respect to plasma ascorbic acid, both the FFQ and 7-d food diary provided a similar ranking of subjects according to vitamin C intake.
Iarc Scientific Publications, Feb 1, 2002
Objective: A diet rich in phyto-oestrogens has been suggested to protect against a variety of com... more Objective: A diet rich in phyto-oestrogens has been suggested to protect against a variety of common diseases but UK intake data on phyto-oestrogens or their food sources are sparse. The present study estimates the average intakes of isoflavones, lignans, enterolignans and coumestrol from 7 d food diaries and provides data on total isoflavone, lignan and phyto-oestrogen consumption by food group. Design: Development of a food composition database for twelve phyto-oestrogens and analysis of soya food and phyto-oestrogen consumption in a populationbased study. Setting: Men and women, aged 40-79 years, from the general population participating in the Norfolk arm of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) between 1993 and 1997, with nutrient and food data from 7 d food diaries. Subjects: A subset of 20 437 participants. Results: The median daily phyto-oestrogen intake for all men was 1199 mg (interquartile range 934-1537 mg; mean 1504 mg, SD 1502 mg) and 888 mg for all women (interquartile range 710-1135 mg; mean 1205 mg, SD 1701 mg). In soya consumers, median daily intakes were higher: 2861 mg in men (interquartile range 1304-7269 mg; mean 5051 mg, SD 5031 mg) and 3142 mg in women (interquartile range 1089-7327 mg; mean 5396 mg, SD 6092 mg). In both men and women, bread made the greatest contribution to phyto-oestrogen intake -40?8 % and 35?6 %, respectively. In soya consumers, vegetable dishes and soya/goat's/ sheep's milks were the main contributors -45?7 % and 21?3 % in men and 38?4 % and 33?7 % in women, respectively. Conclusions: The ability to estimate phyto-oestrogen intake in Western populations more accurately will aid investigations into their suggested effects on health.
Free radical biology & medicine, Jan 17, 2015
Dietary intervention studies suggest that flavan-3-ol intake can improve vascular function and re... more Dietary intervention studies suggest that flavan-3-ol intake can improve vascular function and reduce the risk of cardiovascular diseases (CVD). However, results from prospective studies failed to show a consistent beneficial effect. To investigate associations between flavan-3-ol intake and CVD risk in the Norfolk arm of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk). Data was available from 24,885 (11,252 men; 13,633 women) participants, recruited between 1993 and 1997 into the EPIC-Norfolk study. Flavan-3-ol intake was assessed using 7-day food diaries and the FLAVIOLA Flavanol Food Composition database. Missing data for plasma cholesterol and vitamin C were imputed using multiple imputation. Associations between flavan-3-ol intake and blood pressure at baseline were determined using linear regression models. Associations with CVD risk were estimated using Cox regression analyses. Median intake of total flavan-3-ols was 1034mg/d (range: 0-8531mg/d...
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Papers by Alison McTaggart