Dietary intakes and food sources of phytoestrogens in the European Prospective Investigation into Cancer and Nutrition (EPIC) 24-hour dietary recall cohort.

BACKGROUND/OBJECTIVES: Phytoestrogens are estradiol-like natural compounds found in plants that have been associated with protective effects against chronic diseases, including some cancers, cardiovascular diseases and osteoporosis. The purpose of this study was to estimate the dietary intake of phytoestrogens, identify their food sources and their association with lifestyle factors in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. SUBJECTS/METHODS: Single 24-hour dietary recalls were collected from 36,037 individuals from 10 European countries, aged 35-74 years using a standardized computerized interview programe (EPIC-Soft). An ad hoc food composition database on phytoestrogens (isoflavones, lignans, coumestans, enterolignans and equol) was compiled using data from available databases, in order to obtain and describe phytoestrogen intakes and their food sources across 27 redefined EPIC centres. RESULTS: Mean total phytoestrogen intake was the highest in the UK health-conscious group (24.9 mg/day in men and 21.1 mg/day in women) whereas lowest in Greece (1.3 mg/day) in men and Spain-Granada (1.0 mg/day) in women. Northern European countries had higher intakes than southern countries. The main phytoestrogen contributors were isoflavones in both UK centres and lignans in the other EPIC cohorts. Age, body mass index, educational level, smoking status and physical activity were related to increased intakes of lignans, enterolignans and equol, but not to total phytoestrogen, isoflavone or coumestan intakes. In the UK cohorts, the major food sources of phytoestrogens were soy products. In the other EPIC cohorts the dietary sources were more distributed, among fruits, vegetables, soy products, cereal products, non-alcoholic and alcoholic beverages. CONCLUSIONS: There was a high variability in the dietary intake of total and phytoestrogen subclasses and their food sources across European regions.

Nutrition in the age-related disablement process.

The transition from independence to disability in older adults is characterized by detectable changes in body composition and physical function. Epidemiologic studies have shown that weight loss, reduced caloric intake and the reduced intake of specific nutrients are associated with such changes. The mechanisms underlying these associations remain unclear, and different hypotheses have been suggested, including the reduction of the antioxidant effects of some nutrients. Changes in muscle mass and quality might play a central role in the pathway linking malnutrition, its biological and molecular consequences, and function. A different approach aims at assessing diets by dietary patterns, which capture intercorrelations of nutrients within a diet, rather than by selective foods or nutrients: epidemiologic evidence suggests that some types of diet, such as the Mediterranean diet, might prevent negative functional outcomes in older adults. However, despite a theoretical and empirical basis, intervention studies using nutritional supplementation have shown inconclusive results in preventing functional impairment and disability. The present work is the result of a review and consensus effort of a European task force on nutrition in the elderly, promoted by the International Association of Gerontology and Geriatrics (IAGG) European Region. After the critical review of different aspects related to the role of nutrition in the transition from independence to disability, we propose future lines for research, including the determination of levels of inadequacy and target doses of supplements, the study of interactions (between nutrients within a diet and with other lifestyle aspects), and the association with functional outcomes.

Plasma carotenoid levels in relation to the Mediterranean diet in Greece.

In the context of the Greek segment of the European Prospective Investigation into Cancer and Nutrition (EPIC), we conducted a cross-sectional study to examine the effects of the intake of plant foods central in the traditional Mediterranean diet on plasma levels of alpha-carotene, beta-carotene, lycopene, beta-cryptoxanthin, and lutein-zeaxanthin. Study subjects were a random sample of 45 men and 68 women, aged 30-82 years, from the Greek EPIC cohort of 27,953 volunteers. Linear regression models were fitted, with the carotenoid blood levels as dependent variables. Independent variables were selected food items, as well as body mass index, controlling for energy intake and a set of demographic factors. Body mass index was inversely associated with plasma levels of the studied carotenoids. The association was highly significant for alpha-carotene and beta-carotene, significant for lutein-zeaxanthin, and borderline significant (p approximately 0.07) for lycopene. Tomato intake was significantly positively associated with plasma lycopene, and beta-carotene. Other fruity vegetables and non-fruity vegetables were significantly positively associated, the former with alpha-carotene and the latter with both alpha- and beta-carotene plasma levels. Fruits showed a highly significant positive association with plasma beta-cryptoxanthin, as well as with beta-carotene. No association was found between the intake of olive oil or other added lipids and plasma carotenoids. We conclude that among the studied components of the Mediterranean diet, fruits and vegetables tend to increase levels of some carotenoids, but olive oil has no apparent effect.