title: A food pattern that is predictive of flavonol intake and risk of pancreatic cancer.
abstract: BACKGROUND
  In the Multiethnic Cohort (MEC) study, we showed inverse associations between flavonols and pancreatic cancer risk.
  
  
  OBJECTIVE
  We aimed to define a food pattern associated with intakes of quercetin, kaempferol, and myricetin; to examine the association of that pattern with pancreatic cancer risk; and to investigate the associations in an independent study.
  
  
  METHODS
  Reduced rank regression was applied to dietary data for 183,513 participants in the MEC. A food group pattern was extracted and simplified and applied to dietary data of 424,978 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Dietary intake in both studies was assessed by using specially developed questionnaires. Multivariate Cox proportional hazards models were used to estimate relative risks for pancreatic cancer in the MEC (610 cases) and the EPIC (517 cases) studies.
  
  
  RESULTS
  The food group pattern consisted mainly of tea, fruit, cabbage, and wine. In the MEC, inverse associations with pancreatic cancer in smokers were observed for the food group pattern [relative risk: 0.59 (95% CI: 0.31, 1.12) when extreme quintiles were compared; P for trend = 0.03]. In the EPIC study, the simplified pattern was not associated with pancreatic cancer risk (P for trend = 0.78).
  
  
  CONCLUSIONS
  A food pattern associated with the intake of quercetin, kaempferol, and myricetin was associated with lower pancreatic cancer risk in smokers in a US-based population. However, failure to replicate the associations in an independent study weakens the conclusions and raises questions about the utility of food patterns for flavonols across populations.
authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. ute.noethlings@dife.de
authors.forename: Ute
authors.initials: U
authors.lastname: Nöthlings
authors.forename: Suzanne P
authors.initials: SP
authors.lastname: Murphy
authors.forename: Lynne R
authors.initials: LR
authors.lastname: Wilkens
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Matthias B
authors.initials: MB
authors.lastname: Schulze
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: Dominique S
authors.initials: DS
authors.lastname: Michaud
authors.forename: Andrew
authors.initials: A
authors.lastname: Roddam
authors.forename: Sabine
authors.initials: S
authors.lastname: Rohrmann
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Francoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Sabina
authors.initials: S
authors.lastname: Sieri
authors.forename: Laudina
authors.initials: L
authors.lastname: Rodriguez
authors.forename: Weimin
authors.initials: W
authors.lastname: Ye
authors.forename: Mazda
authors.initials: M
authors.lastname: Jenab
authors.forename: Laurence N
authors.initials: LN
authors.lastname: Kolonel
mesh_terms: D001937:Brassica / Q000737:chemistry; D016022:Case-Control Studies; D015331:Cohort Studies; D016001:Confidence Intervals; D004034:Diet Surveys; D005006:Ethnicity / Q000706:statistics & numerical data*; D005247:Feeding Behavior / Q000208:ethnology; D005260:Female; D005419:Flavonoids / Q000008:administration & dosage / Q000378:metabolism; D044948:Flavonols / Q000008:administration & dosage* / Q000378:metabolism; D005500:Follow-Up Studies; D005638:Fruit / Q000737:chemistry; D006801:Humans; D015994:Incidence; D044949:Kaempferols / Q000008:administration & dosage / Q000378:metabolism; D008297:Male; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011794:Quercetin / Q000008:administration & dosage / Q000378:metabolism; D012306:Risk; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D013662:Tea / Q000737:chemistry; D014920:Wine / Q000032:analysis
chemical_list: D005419:Flavonoids; D044948:Flavonols; D044949:Kaempferols; D013662:Tea; C006552:kaempferol; C040015:myricetin; D011794:Quercetin