Nutrient-wide association study of 57 foods/nutrients and epithelial ovarian cancer in the European Prospective Investigation into Cancer and Nutrition study and the Netherlands Cohort Study

Melissa A. Merritt*, Joanna Tzoulaki, Piet A. van den Brandt, Leo J. Schouten, Konstantinos K. Tsilidis, Elisabete Weiderpass, Chirag J. Patel, Anne Tjonneland, Louise Hansen, Kim Overvad, Mathilde His, Laureen Dartois, Marie-Christine Boutron-Ruault, Renee T. Fortner, Rudolf Kaaks, Krasimira Aleksandrova, Heiner Boeing, Antonia Trichopoulou, Pagona Lagiou, Christina BamiaDomenico Palli, Vittorio Krogh, Rosario Tumino, Fulvio Ricceri, Amalia Mattiello, H. Bas Bueno-de-Mesquita, N. Charlotte Onland-Moret, Petra H. Peeters, Guri Skeie, Mie Jareid, J. Ramon Quiros, Mireia Obon-Santacana, Maria-Jose Sanchez, Saioa Chamosa, Jose M. Huerta, Aurelio Barricarte, Joana A. Dias, Emily Sonestedt, Annika Idahl, Eva Lundin, Nicholas J. Wareham, Kay-Tee Khaw, Ruth C. Travis, Pietro Ferrari, Elio Riboli, Marc J. Gunter

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

21 Citations (Web of Science)


Background: Studies of the role of dietary factors in epithelial ovarian cancer (EOC) development have been limited, and no specific dietary factors have been consistently associated with EOC risk. Objective: We used a nutrient-wide association study approach to systematically test the association between dietary factors and invasive EOC risk while accounting for multiple hypothesis testing by using the false discovery rate and evaluated the findings in an independent cohort. Design: We assessed dietary intake amounts of 28 foods/food groups and 29 nutrients estimated by using dietary questionnaires in the EPIC (European Prospective Investigation into Cancer and Nutrition) study (n = 1095 cases). We selected 4 foods/nutrients that were statistically significantly associated with EOC risk when comparing the extreme quartiles of intake in the EPIC study (false discovery rate = 0.43) and evaluated these factors in the NLCS (Netherlands Cohort Study; n = 383 cases). Cox regression models were used to estimate HRs and 95% CIs. Results: None of the 4 dietary factors that were associated with EOC risk in the EPIC study (cholesterol, polyunsaturated and saturated fat, and bananas) were statistically significantly associated with EOC risk in the NLCS; however, in meta-analysis of the EPIC study and the NLCS, we observed a higher risk of EOC with a high than with a low intake of saturated fat (quartile 4 compared with quartile 1; overall BR: 1.21; 95% CI: 1.04, 1.41). Conclusion: In the meta-analysis of both studies, there was a higher risk of EOC with a high than with a low intake of saturated fat.
Original languageEnglish
Pages (from-to)161-167
JournalAmerican Journal of Clinical Nutrition
Issue number1
Publication statusPublished - Jan 2016


  • nutrition
  • ovarian cancer
  • saturated fat
  • serous
  • prospective cohort
  • diet

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