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@ARTICLE{MoralesBerstein:285526,
      author       = {F. Morales-Berstein and C. Biessy and V. Viallon and A.
                      Goncalves-Soares and C. Casagrande and B. Hémon and N.
                      Kliemann and M. Cairat and J. Blanco Lopez and A. Al Nahas
                      and K. Chang and E. Vamos and F. Rauber and R. Bertazzi Levy
                      and D. Barbosa Cunha and P. Jakszyn and P. Ferrari and P.
                      Vineis and G. Masala and A. Catalano and E. Sonestedt and Y.
                      Borné and V. Katzke$^*$ and R. Bajracharya$^*$ and C.
                      Agnoli and M. Guevara and A. Heath and L. Radoï and F.
                      Mancini and E. Weiderpass and J. M. Huerta and M.-J.
                      Sánchez and A. Tjønneland and C. Kyrø and M. B. Schulze
                      and G. Skeie and M. Lukic and T. Braaten and M. Gunter and
                      C. Millett and A. Agudo and P. Brennan and M. C. Borges and
                      R. C. Richmond and T. G. Richardson and G. Davey Smith and
                      C. L. Relton and I. Huybrechts},
      collaboration = {E. Network},
      title        = {{U}ltra-processed foods, adiposity and risk of head and
                      neck cancer and oesophageal adenocarcinoma in the {E}uropean
                      {P}rospective {I}nvestigation into {C}ancer and {N}utrition
                      study: a mediation analysis.},
      journal      = {European journal of nutrition},
      volume       = {63},
      number       = {2},
      issn         = {1436-6207},
      address      = {Heidelberg},
      publisher    = {Springer},
      reportid     = {DKFZ-2023-02406},
      pages        = {377-396},
      year         = {2024},
      note         = {2024 Mar;63(2):377-396},
      abstract     = {To 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.Our 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.During 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 interval
                      [CI] 1.14-1.34) and OAC (HR = 1.24, $95\%$ CI 1.05-1.47).
                      WHR mediated $5\%$ $(95\%$ CI $3-10\%)$ of the association
                      between the consumption of UPFs and HNC risk, while BMI and
                      WHR, respectively, mediated $13\%$ $(95\%$ CI $6-53\%)$ and
                      $15\%$ $(95\%$ CI $8-72\%)$ of the association between the
                      consumption of UPFs and OAC risk. UPF consumption was
                      positively associated with accidental death in the negative
                      control analysis.We reaffirmed that higher UPF consumption
                      is associated with greater risk of HNC and OAC in EPIC. The
                      proportion mediated via adiposity was small. Further
                      research is required to investigate other mechanisms that
                      may be at play (if there is indeed any causal effect of UPF
                      consumption on these cancers).},
      keywords     = {Adiposity (Other) / Epidemiology (Other) / Food processing
                      (Other) / Head and neck cancer (Other) / Mediation analysis
                      (Other) / NOVA classification (Other) / Oesophageal cancer
                      (Other)},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37989797},
      doi          = {10.1007/s00394-023-03270-1},
      url          = {https://inrepo02.dkfz.de/record/285526},
}