title: Dietary intake of iron, heme-iron and magnesium and pancreatic cancer risk in the European prospective investigation into cancer and nutrition cohort.
abstract: Several studies support a protective effect of dietary magnesium against type 2 diabetes, but a harmful effect for iron. As diabetes has been linked to pancreatic cancer, intake of these nutrients may be also associated with this cancer. We examined the association between dietary intake of magnesium, total iron and heme-iron and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. In total, 142,203 men and 334,999 women, recruited between 1992 and 2000, were included. After an average follow-up of 11.3 years, 396 men and 469 women developed exocrine pancreatic cancer. Hazard ratios and 95% confidence intervals (CIs) were obtained using Cox regression stratified by age and center, and adjusted for energy intake, smoking status, height, weight, and self-reported diabetes status. Neither intake of magnesium, total iron nor heme-iron was associated with pancreatic cancer risk. In stratified analyses, a borderline inverse association was observed among overweight men (body mass index, ≥ 25 kg/m(2) ) with magnesium (HR(per 100 mg/day increase) = 0.79, 95% CI = 0.63-1.01) although this was less apparent using calibrated intake. In female smokers, a higher intake of heme-iron was associated with a higher pancreatic cancer risk (HR (per 1 mg/day increase) = 1.38, 95% CI = 1.10-1.74). After calibration, this risk increased significantly to 2.5-fold (95% CI = 1.22-5.28). Overall, dietary magnesium, total iron and heme-iron were not associated with pancreatic cancer risk during the follow-up period. Our observation that heme-iron was associated with increased pancreatic cancer risk in female smokers warrants replication in additional study populations.
authors.affiliation: Andalusian School of Public Health. Granada Cancer Registry, Spain.
authors.forename: Esther
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authors.lastname: Molina-Montes
authors.forename: Petra A
authors.initials: PA
authors.lastname: Wark
authors.forename: María-José
authors.initials: MJ
authors.lastname: Sánchez
authors.forename: Teresa
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authors.lastname: Norat
authors.forename: Paula
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authors.lastname: Jakszyn
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authors.lastname: Luján-Barroso
authors.forename: Dominique S
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authors.lastname: Michaud
authors.forename: Francesca
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authors.lastname: Crowe
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authors.forename: Kay-Tee
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authors.lastname: Khaw
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authors.lastname: Wareham
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authors.lastname: Trichopoulou
authors.forename: George
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authors.lastname: Adarakis
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authors.lastname: Katarachia
authors.forename: Guri
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authors.lastname: Skeie
authors.forename: Maria
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authors.lastname: Henningsen
authors.forename: Ann Ragnhild
authors.initials: AR
authors.lastname: Broderstad
authors.forename: Franco
authors.initials: F
authors.lastname: Berrino
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Domenico
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authors.lastname: Palli
authors.forename: Amalia
authors.initials: A
authors.lastname: Mattiello
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
authors.forename: Pilar
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authors.lastname: Amiano
authors.forename: Aurelio
authors.initials: A
authors.lastname: Barricarte
authors.forename: José-María
authors.initials: JM
authors.lastname: Huerta
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Duell
authors.forename: José-Ramón
authors.initials: JR
authors.lastname: Quirós
authors.forename: Weimin
authors.initials: W
authors.lastname: Ye
authors.forename: Malin
authors.initials: M
authors.lastname: Sund
authors.forename: Björn
authors.initials: B
authors.lastname: Lindkvist
authors.forename: Dorthe
authors.initials: D
authors.lastname: Johansen
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Nina
authors.initials: N
authors.lastname: Roswall
authors.forename: Kuanrong
authors.initials: K
authors.lastname: Li
authors.forename: Verena A
authors.initials: VA
authors.lastname: Grote
authors.forename: Annika
authors.initials: A
authors.lastname: Steffen
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Antoine
authors.initials: A
authors.lastname: Racine
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.forename: Franck
authors.initials: F
authors.lastname: Carbonnel
authors.forename: Petra H M
authors.initials: PH
authors.lastname: Peeters
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
authors.forename: Veronika
authors.initials: V
authors.lastname: Fedirko
authors.forename: Mazda
authors.initials: M
authors.lastname: Jenab
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.forename: Bas
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authors.lastname: Bueno-de-Mesquita
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006418:Heme; D006801:Humans; D019266:Iron, Dietary; D008274:Magnesium; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010190:Pancreatic Neoplasms / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D019266:Iron, Dietary; D006418:Heme; D008274:Magnesium