Original Communication
European Journal of Clinical Nutrition (2005) 59, 1397–1408. doi:10.1038/sj.ejcn.1602253; published online 14 September 2005
Plasma carotenoids as biomarkers of intake of fruits and vegetables: ecological-level correlations in the European Prospective Investigation into Cancer and Nutrition (EPIC)
Guarantor: E Riboli.
Contributors: ER is overall coordinator of the EPIC study, which he designed and implemented in collaboration with his team at IARC and the principal investigators in the collaborating centres. NS developed the 24-h recall system and the food consumption database in collaboration with the EPIC centres. WA, NS, PF and ER constituted the writing group in charge of conducting statistical data analyses and preparing the manuscript. ALvK and JPS were in charge of laboratory analyses of carotenoids in plasma samples. The other authors supervised the collection and analysis of dietary data and the collection of blood samples in the participating study centres, and provided comments and suggestions on the final manuscript.
None of the authors have any conflict of interest in carrying out this study.
W K Al-Delaimy1,30, N Slimani1, P Ferrari1, T Key2, E Spencer2, I Johansson3,4, G Johansson4, I Mattisson5, E Wirfalt5, S Sieri6, A Agudo7, E Celentano8, D Palli9, C Sacerdote10, R Tumino11, M Dorronsoro12, M C Ocké13, H B Bueno-De-Mesquita13, K Overvad14, Ma D Chirlaque15, A Trichopoulou16, A Naska16, A Tjonneland17, A Olsen17, E Lund18, G Skeie18, E Ardanaz19, E Kesse20, M-C Boutron-Ruault20,21, F Clavel-Chapelon20, S Bingham22, A A Welch23, C Martinez-Garcia24, G Nagel25, J Linseisen25, J R Quirós26, P H M Peeters27, C H van Gils27, H Boeing28, A L van Kappel1,31, J-P Steghens29 and E Riboli1
- 1Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
- 2Cancer Research UK, Radcliffe Infirmary, University of Oxford, Oxford, UK
- 3Department of Odontology and Cariology, Umeå University, Umeå, Sweden
- 4Department of Nutritional Research, Umeå University, Umeå, Sweden
- 5Department of Medicine, Surgery & Orthopaedics, Lund University, Malmö, Sweden
- 6Epidemiology Unit, National Cancer Institute, Milan, Italy
- 7Department of Epidemiology, Catalan Institute of Oncology (ICO), Hospitalet de Llobregat, Barcelona, Spain
- 8National Cancer Institute, PASCALE Foundation, Naples, Italy
- 9Molecular & Nutritional Epidemiology Unit, CSPO, Scientific Institute of Tuscany, Florence, Italy
- 10University of Turin and CPO-Piemonte, Turin, Italy
- 11Cancer Registry, Azienda Ospedaliera 'Civile – MP Arezzo', Ragusa, Italy
- 12Public Health Office of Guipuzkoa, Health Council of Basque Country, San Sebastian, Spain
- 13National Institute of Public Health and the Environment (RIVM), Bilthoven, Netherlands
- 14Department of Clinical Epidemiology, Aalborg Hospital and Aarhus University Hospital, Aarhus, Denmark and Department of Epidemiology and Social Medicine, University of Aarhus, Aarhus, Denmark
- 15Department of Epidemiology, Council for Health and Social Affairs of Murcia, Murcia, Spain
- 16University of Athens Medical School, Athens, Greece
- 17Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
- 18Institute of Community Medicine, University of Tromsø, Tromsø, Norway
- 19Institute of Public Health of Navarra, Pamplona, Spain
- 20INSERM U XR 521, Institut Gustave Roussy, Villejuif, France
- 21INSERM, U 557, ISTNA, CNAM, Paris, France
- 22MRC Dunn Human Nutrition Unit, Cambridge, UK
- 23Strangeways Research Laboratory, University of Cambridge, Cambridge, UK
- 24Andalusian School of Public Health, Granada, Spain
- 25Division of Clinical Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- 26Regional Office of Public Health of Asturias, Oviedo, Spain
- 27Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, Netherlands
- 28German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
- 29Biochemistry Laboratory, Hôpital Edouard Herriot, Lyon, France
Correspondence: E Riboli, Nutrition and Hormones Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France. E-mail: nth@iarc.fr
30Current address: Cancer Prevention and Control, University of California at San Diego, La Jolla, USA.
31Current address: Cryo Bio System, Paris, France.
Received 15 June 2004; Revised 13 June 2005; Accepted 29 June 2005; Published online 14 September 2005.
Abstract
Objective:
The aim of this study was to assess the ability of a single 24-h dietary recall (24HDR) and food questionnaires (FQ) to predict plasma carotenoid levels at the ecological level by assessing the relationship between mean plasma carotenoid levels and mean intake of fruit and vegetables measured by 24HDR and FQ across 16 European regions.
Design:
A random subsample of 3089 subjects was included, stratified by age and gender. They provided blood samples and dietary information between 1992 and 2000 as part of the European Prospective Investigation into Cancer and Nutrition.
Results:
Using Spearman's correlation coefficients, the correlations between mean regional 24HDR fruit and vegetable variables and corresponding mean plasma carotenoid levels were generally higher than the correlations using FQ means. The highest correlation was between the 24HDR citrus fruit variable and beta-cryptoxanthin (r=0.90). For 24HDR, total fruits and vegetables were highly correlated with lutein, zeaxanthin, and beta-cryptoxanthin (r=0.83–0.87), while vegetables were more closely related with lutein (r=0.69) and zeaxanthin (r=0.68), and fruits correlated with zeaxanthin (r=0.87) and beta-cryptoxanthin (r=0.84). Root vegetables (r=0.81) and total carrots (r=0.71) were well correlated with alpha-carotene. In the multivariate models adjusting for age, body mass index, and season, and using observations of means stratified by sex and region, the association was generally higher for 24HDR compared to FQ.
Conclusion:
Mean regional intakes of fruits and vegetables in several European countries were closely correlated with corresponding mean plasma levels of individual carotenoids. Fruits and vegetables measured by 24HDR were generally better able to predict plasma carotenoids at the ecological level.
Keywords:
carotenoids, fruits and vegetables, plasma, ecology, food frequency questionnaires, 24-h dietary recall, EPIC
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