Paolo Vineis

PurposeTo investigate the role of adiposity in the associations between ultra-processed food (UPF) consumption and head and neck cancer (HNC) and oesophageal adenocarcinoma (OAC) in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.MethodsOur study included 450,111 EPIC participants. We used Cox regressions to investigate the associations between the consumption of UPFs and HNC and OAC risk. A mediation analysis was performed to assess the role of body mass index (BMI) and waist-to-hip ratio (WHR) in these associations. In sensitivity analyses, we investigated accidental death as a negative control outcome.ResultsDuring a mean follow-up of 14.13 ± 3.98 years, 910 and 215 participants developed HNC and OAC, respectively. A 10% g/d higher consumption of UPFs was associated with an increased risk of HNC (hazard ratio [HR] = 1.23, 95% confidence …

Through investigating the combined impact of the environmental exposures experienced by an individual throughout their lifetime, exposome research provides opportunities to understand and mitigate negative health outcomes. While current exposome research is driven by epidemiological studies that identify associations between exposures and effects, new frameworks integrating more substantial population-level metadata, including electronic health and administrative records, will shed further light on characterizing environmental exposure risks. Molecular biology offers methods and concepts to study the biological and health impacts of exposomes in experimental and computational systems. Of particular importance is the growing use of omics readouts in epidemiological and clinical studies. This paper calls for the adoption of mechanistic molecular biology approaches in exposome research as an essential …

Exposure to dichlorodiphenyldichloroethylene (DDE) is suspected to be associated with an increased risk of type 2 diabetes (T2D). Other studies suggested that the fat mass and obesity-associated gene (FTO) is associated with T2D risk, regardless of adiposity. Dichlorodiphenyltrichloroethane (DDT) was used in Brazil until the mid-2000s, but no previous studies investigated the association between diabetes and body concentrations of DDE in that country. We investigated that association in a population of Rio de Janeiro, as well as how the FTO-rs9939609 genotypes might affect it. In this cross-sectional study nested in the Pro-Saude cohort, participants were randomly selected according to age, sex, and educational level at the cohort's baseline up to n= 520. Individuals who self-reported diabetes or presented glycated hemoglobin (HbA1c)≥ 6.5% in the study's phase 4 were considered diabetic. We used logistic regression to estimate the odds ratio of diabetes according to serum levels of DDE, adjusting for age, sex, and total fat mass. We stratified the adjusted odds ratio by FTO-rs9939609 variant genotypes. Serum levels of DDE were associated with a higher chance of having diabetes (OR: 1.43; 95% CI: 1.11–1.84). Across quartiles of DDE concentrations, the dose-response relationship was statistically significant (p-trend= 0.003). The magnitude of the association was higher among individuals with the homozygous allele for the FTO-rs9939609 gene (OR: 3.33; 0.45–24.13). Exposure to DDE may increase the risk of developing diabetes in the Brazilian population, especially in individuals homozygous allele for the FTO-rs9939609 variant.

Gut barrier dysfunction and related inflammation are known to be associated with the development and progression of colorectal cancer (CRC). We investigated associations of 292 single-nucleotide polymorphisms (SNPs) from 27 genes related to endotoxins/lipopolysaccharide (LPS) sensing and tolerance, mucin synthesis, inflammation, and Crohn’s disease with colon and rectal cancer risks. Incident CRC cases (N=1,374; colon=871, rectum=503) were matched 1:1 to controls nested within the European Prospective Investigation into Cancer and Nutrition cohort. Previously measured serum concentrations of gut barrier function and inflammation biomarkers (flagellin/LPS-specific immunoglobulins and C-reactive protein [CRP]) were available for a sub-set of participants (Ncases=1,001; Ncontrols=667). Forty-two unique SNPs from 19 different genes were associated with serum biomarkers at Punadjusted≤0 …

In this study, we aimed to provide novel evidence on the impact of changing lifestyle habits on cancer risk. In the EPIC cohort, 295,865 middle-aged participants returned a lifestyle questionnaire at baseline and during follow-up. At both timepoints, we calculated a healthy lifestyle index (HLI) score based on cigarette smoking, alcohol consumption, body mass index and physical activity. HLI ranged from 0 (most unfavourable) to 16 (most favourable). We estimated the association between HLI change and risk of lifestyle-related cancers—including cancer of the breast, lung, colorectum, stomach, liver, cervix, oesophagus, bladder, and others—using Cox regression models. We reported hazard ratios (HR) with 95% confidence intervals (CI). Median time between the two questionnaires was 5.7 years, median age at follow-up questionnaire was 59 years. After the follow-up questionnaire, we observed 14,933 lifestyle …

The planned National Health Fund (NHF) in Italy for 2024–25 is estimated to be less than 6· 5% of gross domestic product (GDP). 1 This value is substantially lower than the percentage of GDP invested in most health systems in Europe that are founded on the principles of universality, solidarity, and distributive justice. 1 Italy has the highest prevalence of older people in Europe—24% of the population is older than 65 years. 2 There is a gap between available resources and actual needs. The ageing population is projected to increase health-care demand that is not covered by the Italian NHF. Private expenditure in Italy is€ 41 billion per year for health care and€ 25 billion per year for the long-term care of older people. Therefore, total household spending in Italy is€ 66 billion per year, compared with the€ 130 billion Italian NHF budget. This ratio might be a serious threat to the principle of universalism that is the …

Salinity is a widespread problem along the Asian coast, mainly in reclaimed lands where most people live. These low-lying areas are vulnerable to impacts from tropical cyclone induced storm surges. The role of such surges on the long-term salinity of water resources, particularly the salinisation of drinking water ponds, a key water resource, requires further investigation. Here we show, using high-resolution measurements of pond hydrology and numerical modelling, that episodic inundation events cause the widespread salinisation of surface water and groundwater bodies in coastal areas. Sudden salt fluxes in ponds cause salinity build-up in the underlying sediments and become a source of salinity. Rapid clean-up of drinking ponds immediately after a surge event can significantly minimize these salinity impacts, which are likely to increase under climate change. Our study has implications for coastal land use …

Hairdresser is an occupation classified by the International Agency for Research on Cancer as probably carcinogenic (Group 2A) for lung and bladder cancer, but evidence is accumulating on its association with other cancer types. To our knowledge, this is the first study aimed to compare the cancer mortality and premature mortality between hairdressers and other workers in Brazil. Methods: In this exploratory study, information on deaths by selected cancers that occurred in Brazil, from 1996 to 2020, among workers aged 20-70y, with identified occupation was gathered from the Brazilian Mortality Information System. Sociodemographic characteristics, sex-specific mortality ratio, and Years of Potential Life Lost (YPLL) were compared between hairdressers, service workers, and general workers. We used logistic regression models to estimate crude (ORC) and adjusted (ORADJ) odds ratios. Models were adjusted by …

BackgroundReducing socioeconomic inequalities in cancer is a priority for the public health agenda. A systematic assessment and benchmarking of socioeconomic inequalities in cancer across many countries and over time in Europe is not yet available.MethodsCensus-linked, whole-of-population cancer-specific mortality data by socioeconomic position, as measured by education level, and sex were collected, harmonized, analysed, and compared across 18 countries during 1990–2015, in adults aged 40–79. We computed absolute and relative educational inequalities; temporal trends using estimated-annual-percentage-changes; the share of cancer mortality linked to educational inequalities.FindingsEverywhere in Europe, lower-educated individuals have higher mortality rates for nearly all cancer-types relative to their more highly-educated counterparts, particularly for tobacco/infection-related cancers …

Childhood obesity is an increasingly severe public health problem, with a prospective impact on health. We propose an exposome approach to identify actionable risk factors for this condition. Our assumption is that relationships between external exposures and outcomes such as rapid growth, overweight, or obesity in children can be better understood through a “meet-in-the-middle” model. This is based on a combination of external and internal exposome-based approaches, that is, the study of multiple exposures (in our case, dietary patterns) and molecular pathways (metabolomics and epigenetics). This may strengthen causal reasoning by identifying intermediate markers that are associated with both exposures and outcomes. Our biomarker-based studies in the STOP consortium suggest (in several ways, including mediation analysis) that branched-chain amino acids (BCAAs) could be mediators of the …

BackgroundFood processing has been hypothesised to play a role in cancer development; however, data from large-scale epidemiological studies are scarce. This study investigated the association between dietary intake according to amount of food processing and risk of cancer at 25 anatomical sites using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study.MethodsThis study used data from the prospective EPIC cohort study, which recruited participants between March 18, 1991, and July 2, 2001, from 23 centres in ten European countries. Participant eligibility within each cohort was based on geographical or administrative boundaries. Participants were excluded if they had a cancer diagnosis before recruitment, had missing information for the NOVA food processing classification, or were within the top and bottom 1% for ratio of energy intake to energy requirement. Validated …

The EarlyCDT‐Lung test is a blood‐based autoantibody assay intended to identify high‐risk individuals for low‐dose computed tomography lung cancer screening. However, there is a paucity of evidence on the performance of the EarlyCDT‐Lung test in ever‐smokers. We conducted a nested case‐control study within two prospective cohorts to evaluate the risk‐discriminatory performance of the EarlyCDT‐Lung test using prediagnostic blood samples from 154 future lung cancer cases and 154 matched controls. Cases were selected from those who had ever smoked and had a prediagnostic blood sample <3 years prior to diagnosis. Conditional logistic regression was used to estimate the association between EarlyCDT‐Lung test results and lung cancer risk. Sensitivity and specificity of the EarlyCDT‐Lung test were calculated in all subjects and subgroups based on age, smoking history, lung cancer stage …

PurposeWe investigated longitudinal associations of sedentary behavior, light-intensity physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) with body composition in colorectal cancer (CRC) survivors, between 6 weeks and 24 months post treatment. In addition, we explored whether body composition mediated associations of sedentary behavior and MVPA with fatigue.MethodsA prospective cohort study was conducted in 459 stage I–III CRC patients recruited at diagnosis. Measurements were performed of accelerometer-assessed sedentary time (hours/day), self-reported LPA and MVPA (hours/week), anthropometric assessment of body mass index (BMI), waist circumference and fat percentage (measures of adiposity), and muscle circumference and handgrip strength (measures of muscle mass/function) repeated at 6 weeks, and 6, 12 and 24 months post treatment. Longitudinal associations …

Why this Research Topic of Frontiers in Public Health on “Emerging issues in public health?” Public health has become popular during the COVID-19 pandemic, and a large number of people have learnt the terminology and concepts of the scientific discipline that supports it, epidemiology. However, very few appreciated the involvement of epidemiology and public health in almost every aspect of medicine and beyond medicine, encompassing for example the quality of all medical treatments; the evidence underlying policies to tackle social inequalities; the health impacts of climate changes; and many others.In this Research Topic we present a few examples of applications of the epidemiological and public health methods to address emerging societal issues, that require bright policy solutions. Needless to say, the relationship between science and policy is not straightforward. It would be naïve to think that scientists provide evidence and then this is translated into policy. Policy-making is the integration of science and values and requires trade-offs and people's participation. However, confused and polarized communication of evidence—largely due to the role played by the new media (1)—makes the relationship between science, civil society and politics complex and frustrating. The fragmentary and speedy nature of the world of communication is paralleled by the slow pace of the world of politics. In the meantime, although there is a long and healthy tradition of distancing science from direct political engagement (that is healthy in the sense that the scientist is expected to investigate nature without being swayed by his or her ideological …

Background Pyrethroids are commonly used insecticides in Brazil. Gestational and early childhood exposure to pyrethroids has been linked to adverse health effects, including neurodevelopmental delays, behavioral issues, and endocrine disruption. This study evaluated the exposure of pregnant women and their children to pyrethroid insecticides in Rio de Janeiro, Brazil. Methods Creatinine-adjusted levels of the pyrethroid metabolites 3-phenoxy benzoic acid (3-PBA) and 4-fluoro-3-phenoxybenzyl acid (4-FPBA) were measured in the urine of 142 pregnant women and their children at birth and in the first, third, and 6th months of life. Results The geometric mean (GM) and 95% confidence interval (95% CI) of 3-PBA and 4-FPBA urinary concentrations in pregnant women were 0.50 (0.37–0.67) and 0.37 (0.05–2.90) ng/mg, detected in 47.2 and 10.6%, respectively. Urinary concentrations of 3-PBA in the children were 0.18 (0.15–0.23) ng/mg at birth, 0.36 (0.08–1.56) ng/mg at 1-month-old, 0.68 (0.36–1.27) ng/mg at 3-month-old, and 1.36 (0.77–2.42) ng/mg at 6-month-old, and the detection rates were respectively 10.8, 9.4, 20.9, and 20.7%. Discussion This study is one of the few that has evaluated the urinary concentrations of pyrethroids in newborns and children in their 1st year of life. The results of this study show that children's exposure to pyrethroids significantly increases after birth.

Metabolomic age models have been proposed for the study of biological aging, however they have not been widely validated. We aimed to assess the performance of newly developed and existing nuclear magnetic resonance spectroscopy (NMR) metabolomic age models for prediction of chronological age (CA), mortality, and age-related disease.

The underlying biological mechanisms causing persistent fatigue complaints after colorectal cancer treatment need further investigation. We investigated longitudinal associations of circulating concentrations of 138 metabolites with total fatigue and subdomains of fatigue between 6 weeks and 2 years after colorectal cancer treatment. Among stage I‐III colorectal cancer survivors (n = 252), blood samples were obtained at 6 weeks, and 6, 12 and 24 months posttreatment. Total fatigue and fatigue subdomains were measured using a validated questionnaire. Tandem mass spectrometry was applied to measure metabolite concentrations (BIOCRATES AbsoluteIDQp180 kit). Confounder‐adjusted longitudinal associations were analyzed using linear mixed models, with false discovery rate (FDR) correction. We assessed interindividual (between‐participant differences) and intraindividual longitudinal associations …

Objectives to provide evidence of the health impacts of climate change in Italy. Design descriptive study. Setting and participants the indicators published in the 2022 Lancet Countdown report were adapted and refined to provide the most recent data relevant to Italy. Main outcome measures twelve indicators were measured, organized within five sections mirroring those of the 2022 Lancet Countdown report: climate change impacts, exposures, and vulnerabilities; adaptation, planning, and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. Results the overall picture depicted by the analysis of the 12 indicators reveals two key findings. First, climate change is already affecting the health of Italian populations, with effects not being uniform across the Country and with the most vulnerable groups being disproportionately at risk. Second, results showed that Italy's mitigation response has been partial, with major costs to human health. Accelerated climate change mitigation through energy system decarbonisation and shifts to more sustainable modes of transport could offer major benefits to health from cleaner air locally and from more active lifestyles, and to climate change from reduction of global warming. The decarbonisation of agricultural systems would similarly offer health co-benefits to Italian population. Conclusions through accelerated action on climate change mitigation, Italy has the opportunity of delivering major and immediate health benefits to its population. Developing a key set of local indicators to monitor the impacts of climate change and evaluate response …

Background The 8q24 locus is enriched in cancer‐associated polymorphisms and, despite containing relatively few protein‐coding genes, it hosts the MYC oncogene and other genetic elements connected to tumorigenesis, including microRNAs (miRNAs). Research on miRNAs may provide insights into the transcriptomic regulation of this multiple cancer‐associated region. Material and methods We profiled all miRNAs located in the 8q24 region in 120 colorectal cancer (CRC) patients and 80 controls. miRNA profiling was performed on cancer/non‐malignant adjacent mucosa, stool, and plasma extracellular vesicles (EVs), and the results validated with The Cancer Genome Atlas (TCGA) data. To verify if the 8q24‐annotated miRNAs altered in CRC were dysregulated in other cancers and biofluids, we evaluated their levels in bladder cancer (BC) cases from the TCGA dataset and in urine and plasma EVs from a …

Adverse socioeconomic circumstances negatively affect the functioning of biological systems, but the underlying mechanisms remain only partially understood. Here, we explore the associations between life-course socioeconomic factors and four markers of epigenetic aging in a population-based setting.We included 684 participants (52 % women, mean age 52.6 ± 15.5 years) from a population and family-based Swiss study. We used nine life-course socioeconomic indicators as the main exposure variables, and four blood-derived, second generation markers of epigenetic aging as the outcome variables (Levine’s DNAmPhenoAge, DunedinPoAm38, GrimAge epigenetic age acceleration (EAA), and the mortality risk score (MS)). First, we investigated the associations between socioeconomic indicators and markers of epigenetic aging via mixed-effect linear regression models, adjusting for age, sex, participant’s …