PubMed Health⌕ Search

Biomedical subjects

Sheila Bingham

Publications and source records attributed to Sheila Bingham.

70 records · Page 4Linked to original sources
PubMed2004

Residential area deprivation predicts fruit and vegetable consumption independently of individual educational level and occupational social class: a cross sectional population study in the Norfolk cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk).

STUDY OBJECTIVE: To investigate the independent association between individual and area based socioeconomic measures and fruit and vegetable consumption. DESIGN: Cross sectional population based study. SETTING AND PARTICIPANTS: 22,562 men and women aged 39-79 years living in the general community in Norfolk, United Kingdom, recruited using general practice age-sex registers. OUTCOME MEASURES: Fruit and vegetable intake assessed using a food frequency questionnaire. MAIN RESULTS: Being in a manual occupational social class, having no educational qualifications, and living in a deprived area all independently predicted significantly lower consumption of fruit and vegetables. The effect of residential area deprivation was predominantly in those in manual occupational social class and no educational qualifications. CONCLUSIONS: Understanding some of the community level barriers to changing health related behaviours may lead to more effective interventions to improving health in the whole community, particularly those who are most vulnerable.

Adult↗
PubMed2004

Preliminary communication: glycated hemoglobin, diabetes, and incident colorectal cancer in men and women: a prospective analysis from the European prospective investigation into cancer-Norfolk study.

BACKGROUND: Increasing evidence suggests that abnormal glucose metabolism may be associated with increased risk of colorectal cancer. METHODS: We examined the relationship between known diabetes and glycated hemoglobin (HbA1c) concentrations measured in 1995 to 1997 and subsequent incident colorectal cancer after 6 years follow-up in 9,605 men and women ages 45 to 79 years in the European Prospective Investigation into Cancer-Norfolk Study. RESULTS: Among individuals not known to have cancer at the baseline survey, there were 67 incident colorectal cancers. HbA1c concentration appeared continuously related to incident colorectal cancer risk, with lowest rates observed in those with HbA1c below 5%. Known diabetes was also associated with incident colorectal cancer, with relative risk (RR) 3.18 and 95% confidence interval (CI) 1.36-7.40 (P < 0.01) adjusting for age and sex and RR 2.78 and 95% CI 1.10-7.00 (P = 0.03) adjusting for age, sex, body mass index, and smoking compared with those without known diabetes. The RR (95% CI) of incident colorectal cancer per 1% absolute increase in HbA1c was 1.34 (1.12-1.59; P < 0.001). HbA1c concentrations appeared to explain the increased colorectal cancer risk associated with diabetes in multivariate models. CONCLUSIONS: Known diabetes was associated with approximately 3-fold risk of colorectal cancer in this analysis; this increased risk was largely explained by HbA1c concentrations, which appears continuously related to colorectal cancer risk across the population distribution.

Aged↗
PubMed2004

Association of nut and seed intake with colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition.

A link between unsaturated fatty acids or phytonutrients and reduced risk of colorectal cancer has been suggested. However, the effects of higher intake of dietary sources of these nutrients, such as the nuts and seeds food group, are less clear. The objective of this study was to determine the effects of nut and seed intake on colorectal cancer risk within the European Prospective Investigation into Cancer and Nutrition study, a large prospective cohort study involving 10 European countries. Total nut and seed intake was determined from country-specific dietary questionnaires. The data set included 478,040 subjects (141,988 men, 336,052 women) with a total of 855 (327 men, 528 women) colon and 474 (215 men, 259 women) rectal cancer cases. A multivariate Cox proportional hazards model, stratified by center and controlled for fruit intake, dietary fiber, energy, height, weight, sex, age, physical activity, and smoking, was used. The data show no association between higher intake of nuts and seeds and risk of colorectal, colon, and rectal cancers in men and women combined, but a significant inverse association was observed in subgroup analyses for colon cancer in women at the highest (>6.2 g/d) versus the lowest (nonconsumers; hazard ratio, 0.69; 95% confidence interval, 0.50-0.95) category of intake and for the linear effect of log-transformed intake (hazard ratio, 0.89; 95% confidence interval, 0.80-0.98), with no associations in men. It is not evident from this data why there may be a stronger association in women or why it may be limited to the colon, suggesting that much further research is necessary.

Adult↗
PubMed2003

Application of biofluid 1H nuclear magnetic resonance-based metabonomic techniques for the analysis of the biochemical effects of dietary isoflavones on human plasma profile.

This study describes the first metabonomic approach to determining biochemical modifications following dietary intervention in humans. Significant interest in the mechanisms of action of soy isoflavones has predominantly stemmed from in vitro experiments but to date the availability of analytical tools for studying the mechanisms of action in vivo have been limited. Here a metabonomic approach based on chemometric analysis of 1H nuclear magnetic resonance spectra of blood plasma has been used to investigate metabolic changes following dietary intervention with soy isoflavones in healthy premenopausal women under controlled environmental conditions. Clear differences in the plasma lipoprotein, amino acid, and carbohydrate profiles were observed following soy intervention, suggesting a soy-induced alteration in energy metabolism.

Adult↗
PubMed2003

Smoking and the risk of gastric cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC).

Smoking has recently been recognised as causally associated with the development of gastric cancer (GC). However, evidence on the effect by sex, duration and intensity of smoking, anatomic subsite and cessation of smoking is limited. Our objective was to assess the relation between tobacco use and GC incidence in the European Prospective Investigation into Cancer and Nutrition (EPIC). We studied data from 521,468 individuals recruited from 10 European countries taking part in the EPIC study. Participants completed lifestyle questionnaires that included questions on lifetime consumption of tobacco and diet in 1991-1998. Participants were followed until September 2002, and during that period 305 cases of stomach cancer were identified. After exclusions, 274 were eligible for the analysis, using the Cox proportional hazard model. After adjustment for educational level, consumption of fresh fruit, vegetables and preserved meat, alcohol intake and body mass index (BMI), there was a significant association between cigarette smoking and gastric cancer risk: the hazard ratio (HR) for ever smokers was 1.45 (95% confidence interval [CI] = 1.08-1.94). The HR of current cigarette smoking was 1.73 (95% CI = 1.06-2.83) in males and 1.87 (95% CI = 1.12-3.12) in females. Hazard ratios increased with intensity and duration of cigarette smoked. A significant decrease of risk was observed after 10 years of quitting smoking. A preliminary analysis of 121 cases with identified anatomic site showed that current cigarette smokers had a higher HR of GC in the cardia (HR = 4.10) than in the distal part of the stomach (HR = 1.94). In this cohort, 17.6 % (95% CI = 10.5-29.5 %) of GC cases may be attributable to smoking. Findings from this large study support the causal relation between smoking and gastric cancer in this European population. Stomach cancer should be added to the burden of diseases caused by smoking.

Adult↗
PubMed2003

Structure of dietary measurement error: results of the OPEN biomarker study.

Multiple-day food records or 24-hour dietary recalls (24HRs) are commonly used as "reference" instruments to calibrate food frequency questionnaires (FFQs) and to adjust findings from nutritional epidemiologic studies for measurement error. Correct adjustment requires that the errors in the adopted reference instrument be independent of those in the FFQ and of true intake. The authors report data from the Observing Protein and Energy Nutrition (OPEN) Study, conducted from September 1999 to March 2000, in which valid reference biomarkers for energy (doubly labeled water) and protein (urinary nitrogen), together with a FFQ and 24HR, were observed in 484 healthy volunteers from Montgomery County, Maryland. Accounting for the reference biomarkers, the data suggest that the FFQ leads to severe attenuation in estimated disease relative risks for absolute protein or energy intake (a true relative risk of 2 would appear as 1.1 or smaller). For protein adjusted for energy intake by using either nutrient density or nutrient residuals, the attenuation is less severe (a relative risk of 2 would appear as approximately 1.3), lending weight to the use of energy adjustment. Using the 24HR as a reference instrument can seriously underestimate true attenuation (up to 60% for energy-adjusted protein). Results suggest that the interpretation of findings from FFQ-based epidemiologic studies of diet-disease associations needs to be reevaluated.

Adult↗
PubMed2003

Using intake biomarkers to evaluate the extent of dietary misreporting in a large sample of adults: the OPEN study.

This paper describes the Observing Protein and Energy Nutrition (OPEN) Study, conducted from September 1999 to March 2000. The purpose of the study was to assess dietary measurement error using two self-reported dietary instruments-the food frequency questionnaire (FFQ) and the 24-hour dietary recall (24HR)-and unbiased biomarkers of energy and protein intakes: doubly labeled water and urinary nitrogen. Participants were 484 men and women aged 40-69 years from Montgomery County, Maryland. Nine percent of men and 7% of women were defined as underreporters of both energy and protein intake on 24HRs; for FFQs, the comparable values were 35% for men and 23% for women. On average, men underreported energy intake compared with total energy expenditure by 12-14% on 24HRs and 31-36% on FFQs and underreported protein intake compared with a protein biomarker by 11-12% on 24HRs and 30-34% on FFQs. Women underreported energy intake on 24HRs by 16-20% and on FFQs by 34-38% and underreported protein intake by 11-15% on 24HRs and 27-32% on FFQs. There was little underreporting of the percentage of energy from protein for men or women. These findings have important implications for nutritional epidemiology and dietary surveillance.

Adult↗
PubMed2003

Comparison of estimated renal net acid excretion from dietary intake and body size with urine pH.

OBJECTIVE: The aim of this study was to examine whether estimated net acid excretion (NAE) from two dietary assessment instruments can predict urine pH in healthy volunteers. DESIGN: The Observing Protein and Energy Nutrition (OPEN) study, which was designed to assess dietary measurement error, included men and women aged 40 to 69 years. Participants were asked to complete two food frequency questionnaires (FFQs) and two 24-hour recalls at approximately three-month intervals, and to return two 24-hour urine samples during the same period. NAE was estimated using a previously described equation. The estimates obtained from the different dietary assessment measures were correlated with actual urine pH. SUBJECTS/SETTING: Four hundred eighty-four subjects were enrolled in the OPEN study. All participants were included in this study on urine pH, given that they had all completed at least one dietary assessment and one urine sample. The study took place in Montgomery County, MD, between September 1999 and March 2000. RESULTS: Correlation coefficients between NAE estimates using the FFQ data and the average of two urine pH measures were -0.34 and -0.39 for women and men, respectively. Removing within-person variance in the urine pH levels resulted in a deattenuated overall correlation of -0.50 for the FFQ. Correlations between the 24-hour recall estimates of NAE were -0.41 and -0.32 for women and men, respectively. For the 24-hour recalls, the deattenuated overall correlation was -0.50. APPLICATION/CONCLUSIONS: Our findings suggest that FFQs provide adequate dietary data to estimate renal NAE and could be used as a surrogate for urinary pH levels in large epidemiologic studies.

Acids↗
PubMed2003

Smoking status and differential white cell count in men and women in the EPIC-Norfolk population.

The total white blood cell (WBC) count is reported to be an independent predictor of mortality in several prospective studies. We investigated the association between total and differential WBC counts and cigarette smoking habit in a cross-sectional population-based study of 6902 men and 8405 women 39-79 years of age participating between July 1994 and 1997 in the European Prospective Investigation of Cancer (EPIC-Norfolk) study. Main outcome measures included WBC, granulocyte, lymphocyte and monocyte counts measured at a baseline health check and self-reported cigarette smoking habit. The age- and body mass index-adjusted mean total WBC counts were 7.8, 6.4, and 6.2x10(3) per ul (P<0.0001) among male current, former and never smokers, respectively, and 7.4, 6.3 and 6.2x10(3) per ul (P<0.0001), respectively, in women. The greatest absolute and percentage differences between smoking groups were observed for the granulocyte count. Current smoking habit had a stronger effect on mean total WBC counts than cumulative exposure as measured by pack years. Among former smokers mean age- and body mass index-adjusted WBC, granulocyte and lymphocyte counts were inversely related to duration of smoking cessation (P< or =0.02). Smokers who had given up less than 12 months previously had WBC counts substantially lower (6.7 and 6.9x10(3) per ul, respectively, in men and women) than current smokers. In conclusion, the total WBC count and its components (particularly the granulocyte count) are strongly associated with cigarette smoking habit. Smoking cessation may have an almost immediate impact at least on pathophysiologic processes such as inflammation that may be indicated by the WBC count. The apparent almost immediate reversibility of effects of smoking on inflammation, as indicated by the WBC count, may help motivate efforts to stop smoking.

Adult↗
PubMed2003

A comparison of a food frequency questionnaire with a 24-hour recall for use in an epidemiological cohort study: results from the biomarker-based Observing Protein and Energy Nutrition (OPEN) study.

BACKGROUND: Most large cohort studies have used a food frequency questionnaire (FFQ) for assessing dietary intake. Several biomarker studies, however, have cast doubt on whether the FFQ has sufficient precision to allow detection of moderate but important diet-disease associations. We use data from the Observing Protein and Energy Nutrition (OPEN) study to compare the performance of a FFQ with that of a 24-hour recall (24HR). METHODS: The OPEN study included 484 healthy volunteer participants (261 men, 223 women) from Montgomery County, Maryland, aged 40-69. Each participant was asked to complete a FFQ and 24HR on two occasions 3 months apart, and a doubly labelled water (DLW) assessment and two 24-hour urine collections during the 2 weeks after the first FFQ and 24HR assessment. For both the FFQ and 24HR and for both men and women, we calculated attenuation factors for absolute energy, absolute protein, and protein density. RESULTS: For absolute energy and protein, a single FFQ's attenuation factor is 0.04-0.16. Repeat administrations lead to little improvement (0.08-0.19). Attenuation factors for a single 24HR are 0.10-0.20, but four repeats would yield attenuations of 0.20-0.37. For protein density a single FFQ has an attenuation of 0.3-0.4; for a single 24HR the attenuation factor is 0.15-0.25 but would increase to 0.35-0.50 with four repeats. CONCLUSIONS: Because of severe attenuation, the FFQ cannot be recommended as an instrument for evaluating relations between absolute intake of energy or protein and disease. Although this attenuation is lessened in analyses of energy-adjusted protein, it remains substantial for both FFQ and multiple 24HR. The utility of either of these instruments for detecting important but moderate relative risks (between 1.5 and 2.0), even for energy-adjusted dietary factors, is questionable.

Adult↗
PubMed2003

Group level validation of protein intakes estimated by 24-hour diet recall and dietary questionnaires against 24-hour urinary nitrogen in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study.

A calibration approach was developed to correct for systematic between-cohort dietary measurement errors in the European Prospective Investigation into Cancer and Nutrition (EPIC), a large multicenter cohort study. To validate the 24-h diet recalls (24-HDRs) as reference measurements for between-cohort calibration, we estimated the agreement between center mean nitrogen (N) and total energy intakes and mean 24-h urinary N. Similar analyses using N and energy intake data from different dietary questionnaires (DQs) used at study baseline were conducted to estimate the effect of the calibration approach. This study was conducted between 1995 and 1999, and involved 1103 volunteers of both genders from 12 centers participating in European Prospective Investigation into Cancer and Nutrition. Pearson's correlation coefficients were weighted for study center sample size. When both genders were considered together (n = 22), the correlation coefficients between the center mean log-transformed urinary estimates and the center mean log-transformed dietary N estimates from the 24-HDRs were 0.86 and 0.94 after exclusion of outliers. The corresponding correlation with the DQs was 0.53. When center mean total energy intakes were regressed on center mean urinary N, the correlation remained slightly higher with 24-HDRs (0.91; 0.95 after exclusion of outliers) than DQs (0.86). When stratified by gender, these correlations were systematically higher in men than women with both dietary methods. The beta regression coefficients were not significantly different from 1 when mean N (or total energy intakes) from 24-HDR or DQ were regressed on urinary estimates, except with N from 24-HDRs in men and, in most cases, after adjustment for age, body mass index, and sex with both genders together. This suggests that overall the systematic bias across centers is of uniform magnitude. Although relatively high correlations were observed between urinary N and both dietary methods in men, the errors in DQs tend to vary in both directions (under- and over-reporting) in contrast with 24-HDRs in women. This observation may have implications on the dietary measurement error characteristics and support the potential benefit of between-cohort calibration.

Calibration↗
PubMed2002

Physical inactivity is associated with lower forced expiratory volume in 1 second : European Prospective Investigation into Cancer-Norfolk Prospective Population Study.

Forced expiratory volume in 1 second (FEV(1)) is a strong risk factor for cardiovascular disease, stroke, lung cancer, and all-cause mortality. One possible explanation for this association is that FEV(1) is a marker of other determinants of mortality risk, such as obesity and physical inactivity. In a population-based cohort study of 12,283 men and women aged 45-74 years from the European Prospective Investigation into Cancer-Norfolk Study recruited in 1993-1997, the cross-sectional association between physical activity and FEV(1) and that between physical activity and change in FEV(1) were analyzed. Indices of physical activity, including participation in vigorous recreational activity, stair climbing, and television viewing, were assessed with a validated questionnaire designed to assess activity in the previous year. Television viewing was negatively associated with FEV(1) in men and women (p < 0.001), whereas stair climbing and participation in vigorous leisure time activities were positively associated with FEV(1) in men and women (p < 0.001). The associations remained after adjustment for known confounders, including age, height, vitamin C, and smoking. Climbing more stairs and participating in vigorous leisure-time activity predicted a slower rate in annual percent decline in FEV(1) (p < 0.004 and p < 0.002, respectively). In conclusion, physical activity is associated with higher levels of FEV(1), whereas television viewing is associated with lower levels.

Aged↗
PubMed2002

Analysis of minichromosome maintenance proteins as a novel method for detection of colorectal cancer in stool.

Colorectal cancer is a common disease, and more reliable screening methods are needed for early detection. We aim to develop a non-invasive, stool-based assay that can identify colorectal cancer by detection of minichromosome maintenance protein 2 (MCM2) expression in colonocytes retrieved from the faecal surface. We devised a cell line model to investigate methods and conditions for optimum colonocyte retrieval. In our clinical evaluation study, MCM2-positive cells were retrieved from 37 of 40 patients with symptomatic colorectal cancer, but from none of 25 healthy control individuals. These results suggest that immunocytochemical analysis of retrieved colonocytes might enable accurate detection of colorectal cancer in stool.

Adenocarcinoma↗
PubMed2002

Bias in dietary-report instruments and its implications for nutritional epidemiology.

OBJECTIVE: To evaluate measurement error structure in dietary assessment instruments and to investigate its implications for nutritional studies, using urinary nitrogen excretion as a reference biomarker for protein intake. DESIGN: The dietary assessment methods included different food-frequency questionnaires (FFQs) and such conventional dietary-report reference instruments as a series of 24-hour recalls, 4-day weighed food records or 7-day diaries. SETTING: Six original pilot validation studies within the European Prospective Investigation of Cancer (EPIC), and two validation studies conducted by the British Medical Research Council (MRC) within the Norfolk cohort that later joined as a collaborative component cohort of EPIC. SUBJECTS: A sample of approximately 100 to 200 women and men, aged 35-74 years, from each of eight validation studies. RESULTS: In assessing protein intake, all conventional dietary-report reference methods violated the critical requirements for a valid reference instrument for evaluating, and adjusting for, dietary measurement error in an FFQ. They displayed systematic bias that depended partly on true intake and partly was person-specific, correlated with person-specific bias in the FFQ. Using the dietary-report methods as reference instruments produced substantial overestimation (up to 230%) of the FFQ correlation with true usual intake and serious underestimation (up to 240%) of the degree of attenuation of FFQ-based log relative risks. CONCLUSION: The impact of measurement error in dietary assessment instruments on the design, analysis and interpretation of nutritional studies may be much greater than has been previously estimated, at least regarding protein intake.

Adult↗
PubMed2002

Effect of vegetables, tea, and soy on endogenous N-nitrosation, fecal ammonia, and fecal water genotoxicity during a high red meat diet in humans.

Red meat increases colonic N-nitrosation, and this may explain the positive epidemiological relationship between red meat intake and colorectal cancer risk. Vegetables, tea, and soy have been shown to block N-nitroso compound (NOC) formation and are associated with protection against colorectal cancer. To determine whether these supplements affect fecal NOC excretion during consumption of a high red meat (420 g/day) diet, 11 male volunteers were studied over a randomized series of 15-day dietary periods. Seven of these subjects completed a further dietary period to test the effects of soy (100 g/day). Soy significantly suppressed fecal apparent total NOC (ATNC) concentration (P = 0.02), but supplements of vegetables (400 g/day as 134 g broccoli, 134 g brussels sprouts, and 134 g petits pois) and tea extract (3 g/day) did not affect mean levels of fecal ATNC, nitrogen and ammonia excretion, and fecal water genotoxicity. However, fecal weight was increased (P < 0.001) and associated with reduced transit time (r = 0.594, P < 0.0001), so that contact between ATNC, nitrite, and ammonia and the large bowel mucosa would have been reduced. Longer transit times were associated with elevated fecal ATNC concentrations (r = 0.42, P = 0.002). Fecal nitrite was significantly suppressed during the tea supplement compared with the meat-only (P = 0.0028) and meat + vegetables diets (P = 0.005 for microgram NO2/g).

Adult↗