title: Main nutrient patterns are associated with prospective weight change in adults from 10 European countries.
abstract: OBJECTIVE
  Various food patterns have been associated with weight change in adults, but it is unknown which combinations of nutrients may account for such observations. We investigated associations between main nutrient patterns and prospective weight change in adults.
  
  
  METHODS
  This study includes 235,880 participants, 25-70 years old, recruited between 1992 and 2000 in 10 European countries. Intakes of 23 nutrients were estimated from country-specific validated dietary questionnaires using the harmonized EPIC Nutrient DataBase. Four nutrient patterns, explaining 67 % of the total variance of nutrient intakes, were previously identified from principal component analysis. Body weight was measured at recruitment and self-reported 5 years later. The relationship between nutrient patterns and annual weight change was examined separately for men and women using linear mixed models with random effect according to center controlling for confounders.
  
  
  RESULTS
  Mean weight gain was 460 g/year (SD 950) and 420 g/year (SD 940) for men and women, respectively. The annual differences in weight gain per one SD increase in the pattern scores were as follows: principal component (PC) 1, characterized by nutrients from plant food sources, was inversely associated with weight gain in men (-22 g/year; 95 % CI -33 to -10) and women (-18 g/year; 95 % CI -26 to -11). In contrast, PC4, characterized by protein, vitamin B2, phosphorus, and calcium, was associated with a weight gain of +41 g/year (95 % CI +2 to +80) and +88 g/year (95 % CI +36 to +140) in men and women, respectively. Associations with PC2, a pattern driven by many micro-nutrients, and with PC3, a pattern driven by vitamin D, were less consistent and/or non-significant.
  
  
  CONCLUSIONS
  We identified two main nutrient patterns that are associated with moderate but significant long-term differences in weight gain in adults.
authors: International Agency for Research on Cancer (IARC-WHO), 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France. freislingh@fellows.iarc.fr.
authors: Heinz
authors: H
authors: Freisling
authors: International Agency for Research on Cancer (IARC-WHO), 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France.|Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.
authors: Pedro T
authors: PT
authors: Pisa
authors: International Agency for Research on Cancer (IARC-WHO), 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France.
authors: Pietro
authors: P
authors: Ferrari
authors: International Agency for Research on Cancer (IARC-WHO), 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France.
authors: Graham
authors: G
authors: Byrnes
authors: International Agency for Research on Cancer (IARC-WHO), 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France.
authors: Aurelie
authors: A
authors: Moskal
authors: Section of Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
authors: Christina C
authors: CC
authors: Dahm
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
authors: Anne-Claire
authors: AC
authors: Vergnaud
authors: Centre for Research in Epidemiology and Population Health (CESP), Nutrition, Hormones and Women's Health Team, INSERM, Villejuif, France.|Université Paris Sud, Villejuif, France.|Institut Gustave Roussy, Villejuif, France.
authors: Marie-Christine
authors: MC
authors: Boutron-Ruault
authors: Centre for Research in Epidemiology and Population Health (CESP), Nutrition, Hormones and Women's Health Team, INSERM, Villejuif, France.|Université Paris Sud, Villejuif, France.|Institut Gustave Roussy, Villejuif, France.
authors: Guy
authors: G
authors: Fagherazzi
authors: Centre for Research in Epidemiology and Population Health (CESP), Nutrition, Hormones and Women's Health Team, INSERM, Villejuif, France.|Université Paris Sud, Villejuif, France.|Institut Gustave Roussy, Villejuif, France.
authors: Claire
authors: C
authors: Cadeau
authors: Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors: Tilman
authors: T
authors: Kühn
authors: Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors: Jasmine
authors: J
authors: Neamat-Allah
authors: Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany.
authors: Brian
authors: B
authors: Buijsse
authors: Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany.
authors: Heiner
authors: H
authors: Boeing
authors: Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark.
authors: Jytte
authors: J
authors: Halkjær
authors: Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark.
authors: Anne
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authors: Tjonneland
authors: Section of Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
authors: Camilla P
authors: CP
authors: Hansen
authors: Public Health Directorate, Asturias, Spain.
authors: J Ramón
authors: JR
authors: Quirós
authors: Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain.
authors: Noémie
authors: N
authors: Travier
authors: Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, Hospitales Universitarios de Granada, Universidad de Granada, Granada, Spain.|CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors: Esther
authors: E
authors: Molina-Montes
authors: Public Helath Division of Gipuzkoa, Basque Health Department, BioDonostia Research Institute, San Sebastián, Spain.|Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
authors: Pilar
authors: P
authors: Amiano
authors: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
authors: José M
authors: JM
authors: Huerta
authors: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.|Navarre Public Health Institute, Pamplona, Spain.
authors: Aurelio
authors: A
authors: Barricarte
authors: Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK.
authors: Kay-Tee
authors: KT
authors: Khaw
authors: Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
authors: Nicholas
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authors: Wareham
authors: Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
authors: Tim J
authors: TJ
authors: Key
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.|Instituto de Investigación Sanitaria de Palma (IdISPa), CIBER Fisiopatología de la Obesidad y Nutrición (CIBER-OBN), Madrid, Spain.
authors: Dora
authors: D
authors: Romaguera
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
authors: Yunxia
authors: Y
authors: Lu
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
authors: Camille M
authors: CM
authors: Lassale
authors: Hellenic Health Foundation, Athens, Greece.|Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.
authors: Androniki
authors: A
authors: Naska
authors: Hellenic Health Foundation, Athens, Greece.|Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.
authors: Philippos
authors: P
authors: Orfanos
authors: Hellenic Health Foundation, Athens, Greece.|Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.
authors: Antonia
authors: A
authors: Trichopoulou
authors: Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute, ISPO, Florence, Italy.
authors: Giovanna
authors: G
authors: Masala
authors: Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Valeria
authors: V
authors: Pala
authors: Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors: Franco
authors: F
authors: Berrino
authors: Cancer Registry, Azienda Ospedaliera "Civile M.P. Arezzo", Ragusa, Italy.
authors: Rosario
authors: R
authors: Tumino
authors: Unit of Cancer Epidemiology - CERMS, Department of Medical Sciences, University of Turin and Città della Salute e della Scienza Hospital, Turin, Italy.
authors: Fulvio
authors: F
authors: Ricceri
authors: Department of Clinical and Experimental Medicine, Frederico II University, Naples, Italy.
authors: Maria Santucci
authors: MS
authors: de Magistris
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.|National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.|Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands.|Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors: H Bas
authors: HB
authors: Bueno-de-Mesquita
authors: National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
authors: Marga C
authors: MC
authors: Ocké
authors: Department of Clinical Sciences, Lund University, Malmö, Sweden.
authors: Emily
authors: E
authors: Sonestedt
authors: Diabetes and Cardiovascular Disease, Genetic Epidemiology, Department of Clinical Sciences, Lund University, Malmö, Sweden.
authors: Ulrika
authors: U
authors: Ericson
authors: International Agency for Research on Cancer (IARC-WHO), 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France.|Department of Biobank Research, Umea University, Umeå, Sweden.
authors: Mattias
authors: M
authors: Johansson
authors: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsö, Norway.
authors: Guri
authors: G
authors: Skeie
authors: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsö, Norway.|Cancer Registry of Norway, Oslo, Norway.|Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.|Department of Genetic Epidemiology, Folkhälsan Research Center, Helsinki, Finland.
authors: Elisabete
authors: E
authors: Weiderpass
authors: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsö, Norway.
authors: Tonje
authors: T
authors: Braaten
authors: Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Petra H M
authors: PH
authors: Peeters
authors: International Agency for Research on Cancer (IARC-WHO), 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France.
authors: Nadia
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authors: Slimani
mesh_terms: D000328:Adult; D000368:Aged; D001205:Ascorbic Acid / Q000008:administration & dosage; D002136:Calcium, Dietary / Q000008:administration & dosage; D004032:Diet; D004043:Dietary Fiber / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D005060:Europe; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D016226:Phosphorus, Dietary / Q000008:administration & dosage; D011446:Prospective Studies; D012256:Riboflavin / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D015430:Weight Gain; D019207:beta Carotene / Q000008:administration & dosage
chemical_list: D002136:Calcium, Dietary; D004043:Dietary Fiber; D004044:Dietary Proteins; D016226:Phosphorus, Dietary; D019207:beta Carotene; D005492:Folic Acid; D001205:Ascorbic Acid; D012256:Riboflavin
keywords: Dietary patterns; Energy balance; Nutrients; Obesity; Public health; Weight gain