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Hruby A, Lieberman HR, Smith TJ. Symptoms of depression, anxiety, and post-traumatic stress disorder and their relationship to health-related behaviors in over 12,000 US military personnel: Bi-directional associations. J Affect Disord 2021; 283:84-93. [PMID: 33524663 DOI: 10.1016/j.jad.2021.01.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 12/29/2020] [Accepted: 01/10/2021] [Indexed: 12/23/2022]
Abstract
Background Military personnel are at greater risk of psychological disorders and related symptoms than civilians. Limited participation in health-promoting behaviors may increase presence of these disorders. Alternatively, these symptoms may limit engagement in health-promoting behaviors. Methods Self-reported data from the 2015 Department of Defense Health Related Behaviors Survey were used to assess bi-directional relationships between health-related behaviors (obesity, physical activity [PA], alcohol, smoking, sleep) and self-reported psychological disorders (generalized anxiety disorder [GAD], depression, post-traumatic disorder [PTSD]) in U.S. military personnel. Outcomes Among 12 708 respondents (14.7% female; 28.2% 17-24 y; 13.7% obese), self-reported depression was reported by 9.2%, GAD by 13.9%, and PTSD by 8.2%. Obesity and short sleep were associated with self-reported depression, GAD, and PTSD; current smoking was associated with higher odds of GAD; higher levels of vigorous PA were associated with lower odds of GAD; higher levels of moderate PA associated with lower odds of PTSD; and higher alcohol intake associated with higher odds of depression and PTSD. Self-reported depression, GAD, and PTSD were associated with higher odds of short sleep, obesity, and low levels of PA. Interpretation Obesity, short sleep, and limited engagement in health-promoting behaviors are associated with higher likelihood of self-reported psychological disorders, and vice-versa. Encouraging and improving health-promoting behaviors may contribute to positive mental health in military personnel.
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Affiliation(s)
- Adela Hruby
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, United States; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States; Tufts University School of Medicine, Department of Public Health and Community Medicine, and Tufts University Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Boston, MA, United States
| | - Harris R Lieberman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, United States
| | - Tracey J Smith
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, United States.
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Abstract
Understanding the health effects of protein intake is bedeviled by a number of factors, including protein quality and source. In addition, different units, including grams, grams per kilogram body weight (g/kg BW), and percent energy, may contribute to confusion about protein's effects on health, especially BW-based units in increasingly obese populations. We aimed to review the literature and to conduct a modeling demonstration of various units of protein intake in relation to markers of cardiometabolic health. Data from the Framingham Heart Study Offspring (n = 1847; 60.3 y; 62.5% women) and Third Generation (n = 2548; 46.2 y; 55.3% women) cohorts and the NHANES 2003-04 (n = 1625; 46.2 y; 49.7% women) and 2005-06 (n = 1347; 43.7 y; 49.5% women) cycles were used to model cross-sectional associations between 7 protein units (grams, percent energy, g/kg ideal BW, g/kg actual BW, BW-adjusted g/kg actual BW, g/kg lean BW, and g/kg fat-free BW) and 9 cardiometabolic outcomes (fasting glucose, systolic and diastolic blood pressure, total and HDL cholesterol, triglycerides, BMI, waist circumference, and estimated glomerular filtration rate). The literature review indicated the use of myriad units of protein intake, with differential results on cardiometabolic outcomes. The modeling demonstration showed units expressed in BW were confounded by BW, irrespective of outcome. Units expressed in grams, percent energy, and ideal BW showed similar results, with or without adjustment for body size. After adjusting for BW, results of units expressed in BW aligned with results of grams, percent energy, and ideal BW. In conclusion, protein intake in cardiometabolic health appears to depend on protein's unit of expression. Authors should be specific about the use of WHO (g/kg ideal BW) compared with US (g/kg actual BW) units, and ideally use gram or percent energy in observational studies. In populations where overweight/obesity are prevalent, intake based on actual BW should be reevaluated.
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Affiliation(s)
- Adela Hruby
- Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA
- Tufts University School of Medicine, Department of Public Health and Community Medicine, Boston, MA, USA
| | - Paul F Jacques
- Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA
- Nutritional Epidemiology, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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Hruby A, Sahni S, Bolster D, Jacques PF. Protein Intake and Functional Integrity in Aging: The Framingham Heart Study Offspring. J Gerontol A Biol Sci Med Sci 2020; 75:123-130. [PMID: 30247514 PMCID: PMC6909900 DOI: 10.1093/gerona/gly201] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Higher protein intake is linked to maintenance of muscle mass and strength, but few studies have related protein to physical function and disability in aging. METHODS In participants of the Framingham Heart Study Offspring, we examined associations between protein intake (g/d), estimated from food frequency questionnaires, and maintenance of functional integrity, as a functional integrity score based on responses to 17 questions from Katz Activities of Daily Living, Nagi, and Rosow-Breslau questionnaires, repeated up to five times (1991/1995-2011/2014) over 23 years of follow-up. Cox proportional hazard models were used to estimate risk of incident loss of functional integrity (functional integrity score ≤ 15th percentile). RESULTS In 2,917 participants (age 54.5 [9.8] years), baseline protein intake was 77.2 (15.6) g/d. The functional integrity score (baseline, mean 98.9, range 82.4-100.0) was associated with objective performance (gait speed, grip strength) and lower odds of falls, fractures, and frailty. Across follow-up, there were 731 incident cases of loss of functional integrity. In fully adjusted models, participants in the highest category of protein intake (median 92.2 g/d) had 30% lower risk of loss of functional integrity (hazard ratio [95% confidence interval] 0.70 [0.52, 0.95], p trend = .03), versus those with the lowest intake (median 64.4 g/d). However, sex-stratified analyses indicated the association was driven by the association in women alone (hazard ratio [95% confidence interval] 0.49 [0.32, 0.74], p trend = .002) and was nonsignificant in men (hazard ratio [95% confidence interval] 1.14 [0.70, 1.86], p trend = .59). CONCLUSIONS Higher protein intake was beneficially associated with maintenance of physical function in middle-aged, high-functioning U.S. adults over the span of two decades. This association was particularly evident in women.
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Affiliation(s)
- Adela Hruby
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.,The Friedman School of Nutrition Science and Policy, Boston, Massachusetts
| | - Shivani Sahni
- Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts.,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Douglas Bolster
- Research and Innovation, Danone North America, Louisville, Colorado
| | - Paul F Jacques
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.,The Friedman School of Nutrition Science and Policy, Boston, Massachusetts
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Hruby A, Dennis C, Jacques PF. Dairy Intake in 2 American Adult Cohorts Associates with Novel and Known Targeted and Nontargeted Circulating Metabolites. J Nutr 2020; 150:1272-1283. [PMID: 32055836 PMCID: PMC7198289 DOI: 10.1093/jn/nxaa021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/03/2019] [Accepted: 01/24/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The role of dairy in health can be elucidated by investigating circulating metabolites associated with intake. OBJECTIVES We sought to identify metabolites associated with quantity and type of dairy intake in the Framingham Heart Study Offspring and Third Generation (Gen3) cohorts. METHODS Dairy intake (total dairy, milk, cheese, yogurt, and cream/butter) was analyzed in relation to targeted (Offspring, n = 2205, 55.1 ± 9.8 y, 52% female, 217 signals; Gen3, n = 866, 40.5 ± 8.8 y, 54.9% female, 79 signals) and nontargeted metabolites (Gen3, ∼7031 signals) in a 2-step analysis including orthogonal projections to latent structures with discriminant analysis (OPLS-DA) in discovery subsets to identify metabolites distinguishing between high and low intake; and linear regression in confirmation subsets to assess putative associations, subsequently tested in the total samples. Previously reported associations were also investigated. RESULTS OPLS-DA in the Offspring targeted discovery subset resulted in a variable importance in projection (VIP) >1 of 65, 60, 58, 66, and 60 metabolites for total dairy, milk, cream/butter, cheese, and yogurt, respectively, of which 5, 3, 1, 6, and 4 metabolites, respectively, remained after confirmation. In the Gen3 targeted discovery subset, OPLS-DA resulted in a VIP >1 of 17, 15, 13, 7, and 6 metabolites for total dairy, milk, cream/butter, cheese, and yogurt, respectively. In the Gen3 nontargeted discovery subset, OPLS-DA resulted in a VIP >2 of 203, 503, 78, 186, and 206 metabolites, respectively. Combining targeted and nontargeted results in Gen3, significant associations of 7 (6 unannotated), 2, 12 (11 unannotated), 0, and 61 (all unannotated) metabolites, respectively, remained. Candidate identities of unannotated signals included fatty acids and food flavorings. Results supported relations previously reported for C14:0 sphingomyelin, and marginal associations for deoxycholates. CONCLUSIONS Dairy in 2 American adult cohorts associated with numerous circulating metabolites. Reports about diet-metabolite relations and confirmation of previous findings might be limited by specificity of dietary intake and breadth of measured metabolites.
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Affiliation(s)
- Adela Hruby
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA,Address correspondence to AH (e-mail: )
| | - Courtney Dennis
- Metabolomics Platform, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Paul F Jacques
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA
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Hruby A, Lieberman HR, Smith TJ. Behavioral correlates of self-reported health status in US active duty military. Prev Med 2020; 131:105930. [PMID: 31765709 DOI: 10.1016/j.ypmed.2019.105930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 10/10/2019] [Accepted: 11/21/2019] [Indexed: 10/25/2022]
Abstract
Trends and relationships between health behaviors and conditions in US active duty military and Coast Guard personnel are understudied. Self-reported data from the 2011 and 2015 Department of Defense Health Related Behaviors Surveys were analyzed to estimate associations between seven behaviors (reasons for not exercising; moderate, vigorous, and strength training exercise; alcohol intake; sleep; and smoking) and five health conditions (high blood pressure [BP], blood sugar [BG], cholesterol [CH]; overweight/obesity [OW]; or obesity [OB]). In 33,531 respondents, 14.8%, 1.7%, 13.6%, 65.5%, and 12.1% had high BP, BG, CH, OW, or OB, respectively. Respondents in 2015, versus 2011, had higher odds of BP, BG, OW, and OB. Compared to exercising as much as desired, citing a disability or injury, or work commitments as reasons for not exercising associated with higher odds of each condition. Longer sleep associated with lower odds of each condition except BG. Current and former smoking associated with higher odds of BP; former smoking also associated with higher odds of high CH and OW. Three behaviors contributing to the best predictive models of each condition resulted in associations of reasons for not exercising with all conditions; strength training for OW and OB; alcohol intake for BP and BG; sleep for BP and CH; and moderate exercise for BG. Disability and injury and time constraints limiting exercise were consistent markers of self-reported health conditions. Military-specific initiatives to promote strategies for overcoming barriers to exercising, continued emphasis on adequate sleep, and reduction of alcohol intake and smoking are warranted.
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Affiliation(s)
- Adela Hruby
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760, USA; Henry Jackson Foundation for the Advancement of Military Medicine, 6720-A Rockledge Drive, Suite 100, Bethesda, MD 20817, USA; Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA
| | - Harris R Lieberman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
| | - Tracey J Smith
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760, USA.
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Gayer B, Sawicki C, Jacques P, Livingston K, Hruby A, Rogers G, McKeown N. Quality and Sources of Dietary Carbohydrate Intake and Self-perceived Quality of Life in Middle-aged and Older Adults of the Framingham Heart Offspring Study (P18-081-19). Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz039.p18-081-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objectives
The objective of the present study was to examine the cross-sectional association between carbohydrate quality and intake of carbohydrate-rich food groups with quality of life.
Methods
We examined the cross-sectional association between carbohydrate intake and self-reported quality of life among 2414 participants of the Framingham Offspring Study (FOS). Self-reported quality of life was assessed using three summary scores from the SF-36 questionnaire: Physical Component Summary (PCS), Mental Component Summary (MCS), and Physical Function Score (PFS). Cumulative dietary intake from the fifth (1991–1995) and sixth (1995–1998) FOS examinations was used to assess overall dietary carbohydrate quality using the Carbohydrate Quality Index (CQI) as well as intake of five carbohydrate-rich food groups: fruits, vegetables, whole grain (WG), refined grains, and sugar-sweetened beverages (SSB). Multivariable-adjusted mean PCS and MCS, and the odds ratio (OR) of reporting good physical function defined as PFS ≥ 80, were estimated across tertiles of carbohydrate exposures. P for trend was calculated to assess linearity of associations.
Results
Higher CQI was significantly associated with a 3% higher mean PCS score after adjustment for demographic and lifestyle factors, and independent of high cholesterol, hypertension, diabetes, and other aspects of diet (P trend = 0.0003). Furthermore, our results showed a higher odds of having good PFS in the highest CQI tertile [OR (95% CI) 1.9 (1.5–2.5); P trend < 0.0001]. No association was observed between CQI and MCS. After adjustment for other aspects of diet, fruit and vegetable intake were positively associated with PCS and with odds of having good PFS, while an inverse association was observed between SSB intake and PCS. A nominal significant positive relationship was observed between WG intake and PCS (P-trend = 0.06) after adjustment for other aspects of diet, fruit and vegetable intake. Refined grain intake was not associated with any quality of life measures.
Conclusions
Overall carbohydrate quality, as well as specific carbohydrate-rich food sources including fruits, vegetables, and WG, are associated with higher self-reported physical quality of life measures.
Funding Sources
This work is supported by the General Mills Bell Institute of Health and Nutrition and USDA ARS agreement No. 58-1950-4-003.
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Affiliation(s)
- Bridget Gayer
- Friedman School of Nutrition Science and Policy at Tufts University
| | - Caleigh Sawicki
- Friedman School of Nutrition Science and Policy at Tufts University; HNRCA At Tufts University
| | - Paul Jacques
- Friedman School of Nutrition Science and Policy at Tufts University; HNRCA At Tufts University
| | - Kara Livingston
- The Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University
| | - Adela Hruby
- Friedman School of Nutrition Science and Policy at Tufts University; HNRCA At Tufts University
| | - Gail Rogers
- The Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University
| | - Nicola McKeown
- Friedman School of Nutrition Science and Policy at Tufts University; HNRCA At Tufts University
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Hruby A, Jacques PF. Dietary Protein and Changes in Biomarkers of Inflammation and Oxidative Stress in the Framingham Heart Study Offspring Cohort. Curr Dev Nutr 2019; 3:nzz019. [PMID: 31037277 PMCID: PMC6483052 DOI: 10.1093/cdn/nzz019] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 02/04/2019] [Accepted: 03/25/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Chronic inflammation is thought to be a major characteristic of aging, which may increase need for substrates, specifically protein, to support anti-inflammatory processes. OBJECTIVES The aim of this study was to assess associations between dietary protein and changes in biomarkers of inflammation and oxidative stress over the long term in a community-dwelling population. METHODS In 2061 participants of the Framingham Heart Study Offspring cohort who attended exams 7 (1998-2001; mean ± SD age 60.0 ± 8.8 y, 56% female) and 8 (2005-2008), total, animal, and plant protein intakes were assessed by food-frequency questionnaire at each exam, energy adjusted, and averaged. We defined an inflammation and oxidative stress score as the sum of rank-normalized values of 9 circulating biomarkers (C-reactive protein, osteoprotegerin, P-selectin, tumor necrosis factor receptor II, soluble intercellular adhesion molecule-1, interleukin 6, monocyte chemoattractant protein 1, and lipoprotein phospholipase A2 mass and activity), and urinary isoprostanes, along with 2 subscores. Adjusted least-square means of changes in the scores and log individual biomarkers in quartile categories of intake were estimated with the use of linear regression models, across mean ± SD 6.6 ± 0.7 y of follow-up. RESULTS Protein intake was inversely associated with changes in the inflammation and oxidative stress score (mean ± SE in Q1 compared with Q4: 0.77 ± 0.17 compared with 0.31 ± 0.19; P-trend = 0.02), indicating overall inflammation/oxidative stress increased less in those with the highest intake than in those with the lowest. Favorable associations were observed for plant protein (Q1 compared with Q4: 0.89 ± 0.25 compared with 0.14 ± 0.25; P-trend = 0.001), but only trended toward significance for animal protein (Q1 compared with Q4: 0.70 ± 0.26 compared with 0.31 ± 0.26; P-trend = 0.05). Total protein and plant protein intakes were also inversely associated with changes in monocyte chemoattractant protein 1 (total: Q1 compared with Q4: 0.19 ± 0.01 compared with 0.15 ± 0.01 log-pg/mL; P-trend = 0.03; plant: Q1 compared with Q4: 0.21 ± 0.01 compared with 0.16 ± 0.01 log-pg/mL; P-trend = 0.003). CONCLUSIONS Dietary protein, particularly from plant sources, may be associated with beneficial changes in the inflammatory burden in aging populations.
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Affiliation(s)
- Adela Hruby
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA
| | - Paul F Jacques
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA
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Nakayama AT, Lutz LJ, Hruby A, Karl JP, McClung JP, Gaffney-Stomberg E. A dietary pattern rich in calcium, potassium, and protein is associated with tibia bone mineral content and strength in young adults entering initial military training. Am J Clin Nutr 2019; 109:186-196. [PMID: 30615068 DOI: 10.1093/ajcn/nqy199] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/20/2018] [Indexed: 12/28/2022] Open
Abstract
Background Stress fracture risk is elevated during initial military training (IMT), particularly in lower-extremity bones such as the tibia. Although the etiology of stress fractures is multifactorial, lower bone strength increases risk. Objective The objective of this study was to assess, through the use of peripheral quantitative computed tomography, whether adherence to a dietary pattern rich in calcium, potassium, and protein before IMT is positively associated with bone indexes in young adults entering IMT. Design A cross-sectional analysis was performed with the use of baseline data from 3 randomized controlled trials in Army, Air Force, and Marine recruits (n = 401; 179 men, 222 women). Dietary intake was estimated from a food-frequency questionnaire. A dietary pattern characterized by calcium, potassium, and protein was derived via reduced rank regression and a pattern z score was computed for each volunteer, where higher scores indicated greater adherence to the pattern. At the 4% (metaphysis) and 14% (diaphysis) sites of the tibia, bone mineral content (BMC), volumetric bone mineral density, robustness, and strength indexes were evaluated. Associations between dietary pattern z score as the predictor variable and bone indexes as the response variables were evaluated by multiple linear regression. Results Pattern z score was positively associated with BMC (P = 0.004) and strength (P = 0.01) at the metaphysis and with BMC (P = 0.0002), strength (P = 0.0006), and robustness (P = 0.02) at the diaphysis when controlling for age, sex, race, energy, smoking, education, and exercise. Further adjustment for BMI attenuated the associations, except with diaphyseal BMC (P = 0.005) and strength (P = 0.01). When height and weight were used in place of body mass index, the association with BMC remained (P = 0.046). Conclusions A dietary pattern rich in calcium, potassium, and protein is positively associated with measures of tibia BMC and strength in recruits entering IMT. Whether adherence to this dietary pattern before IMT affects injury susceptibility during training remains to be determined. These trials were registered at clinicaltrials.gov as NCT01617109 and NCT02636348.
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Affiliation(s)
- Anna T Nakayama
- Oak Ridge Institute for Science and Education supporting the Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, MA.,Military Performance, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Laura J Lutz
- Military Performance, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Adela Hruby
- Oak Ridge Institute for Science and Education supporting the Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA.,Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - James P Karl
- Oak Ridge Institute for Science and Education supporting the Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - James P McClung
- Military Nutrition Divisions, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Erin Gaffney-Stomberg
- Military Performance, US Army Research Institute of Environmental Medicine, Natick, MA
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Hruby A, Lieberman HR, Smith TJ. Self-reported health behaviors, including sleep, correlate with doctor-informed medical conditions: data from the 2011 Health Related Behaviors Survey of U.S. Active Duty Military Personnel. BMC Public Health 2018; 18:853. [PMID: 29996814 PMCID: PMC6042384 DOI: 10.1186/s12889-018-5781-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 06/28/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Health behaviors and cardiometabolic disease risk factors may differ between military and civilian populations; therefore, in U.S. active duty military personnel, we assessed relationships between demographic characteristics, self-reported health behaviors, and doctor-informed medical conditions. METHODS Data were self-reported by 27,034 active duty military and Coast Guard personnel who responded to the 2011 Department of Defense Health Related Behaviors Survey. Multivariate linear and logistic regressions were used to estimate cross-sectional associations between (1) demographic characteristics (age, sex, service branch, marital status, children, race/ethnicity, pay grade) and self-reported behaviors (exercise, diet, smoking, alcohol, sleep); (2) demographic characteristics and doctor-informed medical conditions (hypertension, hypercholesterolemia, low high density lipoprotein (HDL) cholesterol, hyperglycemia) and overweight/obesity; and (3) behaviors and doctor-informed medical conditions. RESULTS Among respondents (age 29.9 ± 0.1 years, 14.7% female), females reported higher intake than men of fruit, vegetables, and dairy; those with higher education reported higher intakes of whole grains; those currently married and/or residing with children reported higher intake of starches. Older age and female sex were associated with higher odds (ORs 1.25 to 12.54 versus the youngest age group) of overweight/obesity. Older age and female sex were also associated with lower odds (ORs 0.29 to 0.65 versus male sex) of doctor-informed medical conditions, except for blood glucose, for which females had higher odds. Those currently married had higher odds of high cholesterol and overweight/obesity, and separated/divorced/widowed respondents had higher odds of high blood pressure and high cholesterol. Short sleep duration (< 5 versus 7-8 h/night) was associated with higher odds (ORs 1.36to 2.22) of any given doctor-informed medical condition. Strength training was associated with lower probability of high cholesterol, high triglycerides, and low HDL, and higher probability of overweight/obesity. Dietary factors were variably associated with doctor-informed medical conditions and overweight/obesity. CONCLUSIONS This study observed pronounced associations between health behaviors-especially sleep-and medical conditions, thus adding to evidence that sleep is a critical, potentially modifiable behavior within this population. When possible, adequate sleep should continue to be promoted as an important part of overall health and wellness throughout the military community.
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Affiliation(s)
- Adela Hruby
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760 USA
- Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111 USA
| | - Harris R. Lieberman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760 USA
| | - Tracey J. Smith
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760 USA
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Hruby A, Guasch-Ferré M, Bhupathiraju SN, Manson JE, Willett WC, McKeown NM, Hu FB. Magnesium Intake, Quality of Carbohydrates, and Risk of Type 2 Diabetes: Results From Three U.S. Cohorts. Diabetes Care 2017; 40:1695-1702. [PMID: 28978672 PMCID: PMC5711333 DOI: 10.2337/dc17-1143] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 09/05/2017] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Magnesium intake is inversely associated with risk of type 2 diabetes in many observational studies, but few have assessed this association in the context of the carbohydrate quality of the diet. We hypothesized that higher magnesium intake is associated with lower risk of type 2 diabetes, especially in the context of a poor carbohydrate-quality diet characterized by low cereal fiber or high glycemic index (GI) or glycemic load (GL). RESEARCH DESIGN AND METHODS In the Nurses' Health Study (NHS; 1984-2012, n = 69,176), NHS2 (1991-2013, n = 91,471), and the Health Professionals' Follow-Up Study (1986-2012, n = 42,096), dietary intake was assessed from food frequency questionnaires every 4 years. Type 2 diabetes was ascertained by biennial and supplementary questionnaires. We calculated multivariate hazard ratios (HRs) of magnesium intake and incident diabetes, adjusted for age, BMI, family history of diabetes, physical activity, smoking, hypertension, hypercholesterolemia, GL, energy intake, alcohol, cereal fiber, polyunsaturated fats, trans fatty acids, and processed meat, and we considered the joint associations of magnesium and carbohydrate quality on diabetes risk. RESULTS We documented 17,130 incident cases of type 2 diabetes over 28 years of follow-up. In pooled analyses across the three cohorts, those with the highest magnesium intake had 15% lower risk of type 2 diabetes compared with those with the lowest intake (pooled multivariate HR in quintile 5 vs. 1: 0.85 [95% CI 0.80-0.91], P < 0.0001). Higher magnesium intake was more strongly associated with lower risk of type 2 diabetes among participants with high GI or low cereal fiber than among those with low GI or high cereal fiber (both P interaction <0.001). CONCLUSIONS Higher magnesium intake is associated with lower risk of type 2 diabetes, especially in the context of lower carbohydrate-quality diets.
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Affiliation(s)
- Adela Hruby
- Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA .,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Marta Guasch-Ferré
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Shilpa N Bhupathiraju
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Nicola M McKeown
- Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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11
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Dashti HS, Follis JL, Smith CE, Tanaka T, Garaulet M, Gottlieb DJ, Hruby A, Jacques PF, Kiefte-de Jong JC, Lamon-Fava S, Scheer FAJL, Bartz TM, Kovanen L, Wojczynski MK, Frazier-Wood AC, Ahluwalia TS, Perälä MM, Jonsson A, Muka T, Kalafati IP, Mikkilä V, Ordovás JM. Erratum. Gene-Environment Interactions of Circadian-Related Genes for Cardiometabolic Traits. Diabetes Care 2015;38:1456-1466. Diabetes Care 2017; 40:1420. [PMID: 28842526 PMCID: PMC5606312 DOI: 10.2337/dc17-er10a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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12
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Toledo E, Wang DD, Ruiz-Canela M, Clish CB, Razquin C, Zheng Y, Guasch-Ferré M, Hruby A, Corella D, Gómez-Gracia E, Fiol M, Estruch R, Ros E, Lapetra J, Fito M, Aros F, Serra-Majem L, Liang L, Salas-Salvadó J, Hu FB, Martínez-González MA. Plasma lipidomic profiles and cardiovascular events in a randomized intervention trial with the Mediterranean diet. Am J Clin Nutr 2017; 106:973-983. [PMID: 28814398 PMCID: PMC5611779 DOI: 10.3945/ajcn.116.151159] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 07/19/2017] [Indexed: 12/21/2022] Open
Abstract
Background: Lipid metabolites may partially explain the inverse association between the Mediterranean diet (MedDiet) and cardiovascular disease (CVD).Objective: We evaluated the associations between 1) lipid species and the risk of CVD (myocardial infarction, stroke, or cardiovascular death); 2) a MedDiet intervention [supplemented with extra virgin olive oil (EVOO) or nuts] and 1-y changes in these molecules; and 3) 1-y changes in lipid species and subsequent CVD.Design: With the use of a case-cohort design, we profiled 202 lipid species at baseline and after 1 y of intervention in the PREDIMED (PREvención con DIeta MEDiterránea) trial in 983 participants [230 cases and a random subcohort of 790 participants (37 overlapping cases)].Results: Baseline concentrations of cholesterol esters (CEs) were inversely associated with CVD. A shorter chain length and higher saturation of some lipids were directly associated with CVD. After adjusting for multiple testing, direct associations remained significant for 20 lipids, and inverse associations remained significant for 6 lipids. When lipid species were weighted by the number of carbon atoms and double bonds, the strongest inverse association was found for CEs [HR: 0.39 (95% CI: 0.22, 0.68)] between extreme quintiles (P-trend = 0.002). Participants in the MedDiet + EVOO and MedDiet + nut groups experienced significant (P < 0.05) 1-y changes in 20 and 17 lipids, respectively, compared with the control group. Of these changes, only those in CE(20:3) in the MedDiet + nuts group remained significant after correcting for multiple testing. None of the 1-y changes was significantly associated with CVD risk after correcting for multiple comparisons.Conclusions: Although the MedDiet interventions induced some significant 1-y changes in the lipidome, they were not significantly associated with subsequent CVD risk. Lipid metabolites with a longer acyl chain and higher number of double bonds at baseline were significantly and inversely associated with the risk of CVD.
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Affiliation(s)
- Estefanía Toledo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain;,Navarra Institute for Health Research, Pamplona, Spain;,Biomedical Research Center in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain
| | | | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain;,Navarra Institute for Health Research, Pamplona, Spain;,Biomedical Research Center in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain
| | | | - Cristina Razquin
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain;,Navarra Institute for Health Research, Pamplona, Spain;,Biomedical Research Center in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain
| | | | | | - Adela Hruby
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA
| | - Dolores Corella
- Biomedical Research Center in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain;,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | | | - Miquel Fiol
- Biomedical Research Center in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain;,Institute of Health Sciences, University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain
| | - Ramón Estruch
- Biomedical Research Center in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain;,Departments of Internal Medicine and
| | - Emilio Ros
- Biomedical Research Center in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain;,Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - José Lapetra
- Biomedical Research Center in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain;,Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain
| | - Montserrat Fito
- Biomedical Research Center in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain;,Cardiovascular and Nutrition Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Fernando Aros
- Biomedical Research Center in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain;,Department of Cardiology, University Hospital of Alava, Vitoria, Spain
| | - Luis Serra-Majem
- Biomedical Research Center in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain;,Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Liming Liang
- Epidemiology, and,Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jordi Salas-Salvadó
- Biomedical Research Center in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain;,Human Nutrition Unit, Pere Virgili Institute for Health Research, Rovira i Virgili University, Reus, Spain; and
| | - Frank B Hu
- Departments of Nutrition,,Epidemiology, and,Department of Medicine, Channing Division for Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Miguel A Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; .,Navarra Institute for Health Research, Pamplona, Spain.,Biomedical Research Center in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain.,Departments of Nutrition
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13
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Ruiz-Canela M, Hruby A, Clish CB, Liang L, Martínez-González MA, Hu FB. Comprehensive Metabolomic Profiling and Incident Cardiovascular Disease: A Systematic Review. J Am Heart Assoc 2017; 6:JAHA.117.005705. [PMID: 28963102 PMCID: PMC5721826 DOI: 10.1161/jaha.117.005705] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Metabolomics is a promising tool of cardiovascular biomarker discovery. We systematically reviewed the literature on comprehensive metabolomic profiling in association with incident cardiovascular disease (CVD). Methods and Results We searched MEDLINE and EMBASE from inception to January 2016. Studies were eligible if they pertained to adult humans; followed an agnostic and/or comprehensive approach; used serum or plasma (not urine or other biospecimens); conducted metabolite profiling at baseline in the context of examining prospective disease; and included myocardial infarction, stroke, and/or CVD death in the CVD outcome definition. We identified 12 original articles (9 cohort and 3 nested case‐control studies); participant numbers ranged from 67 to 7256. Mass spectrometry was the predominant analytical method. The number and chemical diversity of metabolites were very heterogeneous, ranging from 31 to >10 000 features. Four studies used untargeted profiling. Different types of metabolites were associated with CVD risk: acylcarnitines, dicarboxylacylcarnitines, and several amino acids and lipid classes. Only tiny improvements in CVD prediction beyond traditional risk factors were observed using these metabolites (C index improvement ranged from 0.006 to 0.05). Conclusions There are a limited number of longitudinal studies assessing associations between comprehensive metabolomic profiles and CVD risk. Quantitatively synthesizing the literature is challenging because of the widely varying analytical tools and the diversity of methodological and statistical approaches. Although some results are promising, more research is needed, notably standardization of metabolomic techniques and statistical approaches. Replication and combinations of novel and holistic methodological approaches would move the field toward the realization of its promise.
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Affiliation(s)
- Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.,IDISNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Adela Hruby
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Clary B Clish
- The Broad Institute of MIT and Harvard, Cambridge, MA
| | - Liming Liang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Miguel A Martínez-González
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA .,Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.,IDISNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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14
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Hruby A, Ma J, Rogers G, Meigs JB, Jacques PF. Associations of Dairy Intake with Incident Prediabetes or Diabetes in Middle-Aged Adults Vary by Both Dairy Type and Glycemic Status. J Nutr 2017; 147:1764-1775. [PMID: 28768835 PMCID: PMC5572495 DOI: 10.3945/jn.117.253401] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 05/28/2017] [Accepted: 07/06/2017] [Indexed: 12/25/2022] Open
Abstract
Background: Inconsistent evidence describes the association between dietary intake of dairy and milk-based products and type 2 diabetes (T2D) risk.Objective: Our objective was to assess associations between consumption of milk-based products, incident prediabetes, and progression to T2D in the Framingham Heart Study Offspring Cohort.Methods: Total dairy and milk-based product consumption was assessed by ≤4 food-frequency questionnaires across a mean of 12 y of follow-up in 2809 participants [mean ± SD age: 54.0 ± 9.7 y; body mass index (in kg/m2): 27.1 ± 4.7; 54% female]. Prediabetes was defined as the first occurrence of fasting plasma glucose ≥5.6 to <7.0 mmol/L (≥100 to <126 mg/dL), and T2D was defined as the first occurrence of fasting plasma glucose ≥7.0 mmol/L (≥126 mg/dL) or diabetes treatment. Proportional hazards models were used to estimate the risk of incident outcomes relative to dairy product intake in subsets of the cohort who were at risk of developing the outcomes. Spline regressions were used to examine potential nonlinear relations.Results: Of 1867 participants free of prediabetes at baseline, 902 (48%) developed prediabetes. Total, low-fat, and high-fat dairy consumptions were associated with a 39%, 32%, and 25% lower risk of incident prediabetes, respectively, in the highest compared with the lowest intakes (≥14 compared with <4 servings/wk). Total, low-fat and skim milk, whole-milk, and yogurt intakes were associated nonlinearly with incident prediabetes; moderate intake was associated with the greatest relative risk reduction. Neither cheese nor cream and butter was associated with prediabetes. Of 925 participants with prediabetes at baseline, 196 (21%) developed T2D. Only high-fat dairy and cheese showed evidence of dose-response, inverse associations with incident T2D, with 70% and 63% lower risk, respectively, of incident T2D between the highest and lowest intake categories (≥14 compared with <1 serving/wk for high-fat dairy, ≥4 compared with <1 serving/wk for cheese).Conclusion: Associations of dairy with incident prediabetes or diabetes varied both by dairy product and type and by baseline glycemic status in this middle-aged US population. Baseline glycemic status may partially underlie prior equivocal evidence regarding the role of dairy intake in diabetes.
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Affiliation(s)
- Adela Hruby
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA
| | - Jiantao Ma
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA;,National Heart, Lung, and Blood Institute, Framingham Heart Study, Framingham, MA; and
| | - Gail Rogers
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA
| | - James B Meigs
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Paul F Jacques
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA;
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15
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Yu E, Ruiz-Canela M, Hu FB, Clish CB, Corella D, Salas-Salvadó J, Hruby A, Fitó M, Liang L, Toledo E, Ros E, Estruch R, Gómez-Gracia E, Lapetra J, Arós F, Romaguera D, Serra-Majem L, Guasch-Ferré M, Wang DD, Martínez-González MA. Plasma Arginine/Asymmetric Dimethylarginine Ratio and Incidence of Cardiovascular Events: A Case-Cohort Study. J Clin Endocrinol Metab 2017; 102:1879-1888. [PMID: 28323949 PMCID: PMC6283443 DOI: 10.1210/jc.2016-3569] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 02/27/2017] [Indexed: 01/03/2023]
Abstract
CONTEXT Arginine, its methylated metabolites, and other metabolites related to the urea cycle have been independently associated with cardiovascular risk, but the potential causal meaning of these associations (positive for some metabolites and negative for others) remains elusive due to a lack of studies measuring metabolite changes over time. OBJECTIVE To examine the association between baseline and 1-year concentrations of urea cycle metabolites and cardiovascular disease (CVD) in a case-cohort setting. DESIGN A case-cohort study was nested within the Prevención con Dieta Mediterránea trial. We used liquid chromatography-tandem mass spectrometry to assess metabolite levels at baseline and after 1-year follow-up. The primary CVD outcome was a composite of myocardial infarction, stroke and cardiovascular death. We used weighted Cox regression models (Barlow weights) to estimate multivariable-adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs). SETTING Multicenter randomized trial in Spain. PARTICIPANTS Participants were 984 participants accruing 231 events over 4.7 years' median follow-up. MAIN OUTCOME MEASURE Incident CVD. RESULTS Baseline arginine/asymmetric dimethylarginine ratio [HR per standard deviation (SD) = 0.80; 95% CI, 0.67 to 0.96] and global arginine availability [arginine / (ornithine + citrulline)] (HR per SD = 0.83; 95% CI, 0.69 to 1.00) were significantly associated with lower risk of CVD. We observed no significant association for 1-year changes in these ratios or any effect modification by the Mediterranean diet (MD) intervention. CONCLUSIONS A higher baseline arginine/asymmetric dimethylarginine ratio was associated with lower CVD incidence in a high cardiovascular risk population. The intervention with the MD did not change 1-year levels of these metabolites.
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Affiliation(s)
- Edward Yu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, and Instituto de Investigacion Sanitaria de Navarra (IdiSNA), University of Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115
| | - Clary B Clish
- Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts 02142
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Human Nutrition Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV), University Hospital of Sant Joan de Reus, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Adela Hruby
- Jean Mayer United States Department of Agriculture (USDA) Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts 02111
| | - Montserrat Fitó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, 08028 Barcelona, Spain
| | - Liming Liang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, University of Navarra, and Instituto de Investigacion Sanitaria de Navarra (IdiSNA), University of Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, 08007 Barcelona, Spain
| | - Ramón Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, 08007 Barcelona, Spain
| | - Enrique Gómez-Gracia
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Preventive Medicine, University of Malaga, 29016 Malaga, Spain
| | - José Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Family Medicine, Research Unit, Primary Care Division of Sevilla, 41004 Sevilla, Spain
| | - Fernando Arós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Cardiology, University Hospital Araba, 01009 Vitoria, Spain
| | - Dora Romaguera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain
| | - Lluís Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, 35001 Las Palmas, Spain
| | - Marta Guasch-Ferré
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
| | - Dong D Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
| | - Miguel A Martínez-González
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
- Department of Preventive Medicine and Public Health, University of Navarra, and Instituto de Investigacion Sanitaria de Navarra (IdiSNA), University of Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Shumaker D, Killian K, Cole C, Hruby A, Grimm J. Existential Anxiety, Personality Type, and Therapy Preference in Young Adults. Journal of Humanistic Psychology 2017. [DOI: 10.1177/0022167817702783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The current study examines the relationship between existential anxiety (EA), personality traits, and therapy preference in a sample of young adults. EA is thought to be universal human experience, yet no published research has been conducted on whether certain personality traits predict higher levels of EA. Males and females ( N = 69) aged 18 to 25 years completed several self-report measures, including a measure of EA, five-factor personality traits, and therapy preference (insight- vs. action-oriented). Pearson correlation coefficients and linear regression analyses were conducted to determine the relationship among the constructs of interest. Results indicate a significant positive correlation between Neuroticism as measured by the NEO-Five Factor Inventory and EA. The Neuroticism N4 Self-Consciousness subscale showed the strongest association with EA. There was no relationship between therapy preference and EA. The results suggest that individuals with personality types characterized by elevated levels of shyness, guilt, and inferiority may be more likely to experience elevated EA. Experiencing higher levels of EA does not seem to affect therapy preference. These findings have important implications for clinicians treating young adults who present with internalizing symptoms.
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17
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Wang DD, Toledo E, Hruby A, Rosner BA, Willett WC, Sun Q, Razquin C, Zheng Y, Ruiz-Canela M, Guasch-Ferré M, Corella D, Gómez-Gracia E, Fiol M, Estruch R, Ros E, Lapetra J, Fito M, Aros F, Serra-Majem L, Lee CH, Clish CB, Liang L, Salas-Salvadó J, Martínez-González MA, Hu FB. Plasma Ceramides, Mediterranean Diet, and Incident Cardiovascular Disease in the PREDIMED Trial (Prevención con Dieta Mediterránea). Circulation 2017; 135:2028-2040. [PMID: 28280233 DOI: 10.1161/circulationaha.116.024261] [Citation(s) in RCA: 212] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 02/20/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although in vitro studies and investigations in animal models and small clinical populations have suggested that ceramides may represent an intermediate link between overnutrition and certain pathological mechanisms underlying cardiovascular disease (CVD), no prospective studies have investigated the association between plasma ceramides and risk of CVD. METHODS The study population consisted of 980 participants from the PREDIMED trial (Prevención con Dieta Mediterránea), including 230 incident cases of CVD and 787 randomly selected participants at baseline (including 37 overlapping cases) followed for ≤7.4 years. Participants were randomized to a Mediterranean diet supplemented with extra virgin olive oil, a Mediterranean diet supplemented with nuts, or a control diet. Plasma ceramide concentrations were measured on a liquid chromatography tandem mass spectrometry metabolomics platform. The primary outcome was a composite of nonfatal acute myocardial infarction, nonfatal stroke, or cardiovascular death. Hazard ratios were estimated with weighted Cox regression models using Barlow weights to account for the case-cohort design. RESULTS The multivariable hazard ratios (HR) and 95% confidence intervals (CIs) comparing the extreme quartiles of plasma concentrations of C16:0, C22:0, C24:0, and C24:1 ceramides were 2.39 (1.49-3.83, Ptrend<0.001), 1.91 (1.21-3.01, Ptrend=0.003), 1.97 (1.21-3.20, Ptrend=0.004), and 1.73 (1.09-2.74, Ptrend=0.011), respectively. The ceramide score, calculated as a weighted sum of concentrations of four ceramides, was associated with a 2.18-fold higher risk of CVD across extreme quartiles (HR, 2.18; 95% CI, 1.36-3.49; Ptrend<0.001). The association between baseline ceramide score and incident CVD varied significantly by treatment groups (Pinteraction=0.010). Participants with a higher ceramide score and assigned to either of the 2 active intervention arms of the trial showed similar CVD risk to those with a lower ceramide score, whereas participants with a higher ceramide score and assigned to the control arm presented significantly higher CVD risk. Changes in ceramide concentration were not significantly different between Mediterranean diet and control groups during the first year of follow-up. CONCLUSIONS Our study documented a novel positive association between baseline plasma ceramide concentrations and incident CVD. In addition, a Mediterranean dietary intervention may mitigate potential deleterious effects of elevated plasma ceramide concentrations on CVD. CLINICAL TRIAL REGISTRATION URL: http://www.isrctn.com. Unique identifier: ISRCTN35739639.
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Affiliation(s)
- Dong D Wang
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Estefanía Toledo
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Adela Hruby
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Bernard A Rosner
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Walter C Willett
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Qi Sun
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Cristina Razquin
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Yan Zheng
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Miguel Ruiz-Canela
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Marta Guasch-Ferré
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Dolores Corella
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Enrique Gómez-Gracia
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Miquel Fiol
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Ramón Estruch
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Emilio Ros
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - José Lapetra
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Montserrat Fito
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Fernando Aros
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Luis Serra-Majem
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Chih-Hao Lee
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Clary B Clish
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Liming Liang
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Jordi Salas-Salvadó
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Miguel A Martínez-González
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.)
| | - Frank B Hu
- From Department of Nutrition (D.D.W., W.C.W., Q.S., Y.Z., M.G.-F., C.-H.L., F.B.H.); Department of Epidemiology (D.D.W., W.C.W., L.L., F.B.H.), Department of Biostatistics (B.A.R., L.L.), Department of Genetics and Complex Diseases (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition (M.A.M.-G.), Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain (E.T., C.R., M.R.-C., M.A.M.-G.); CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain (E.T., C.R., M.R.-C., D.C., M.F., R.E., E.R., J.L., M.F., F.A., L.S.-M., J.S.-S., M.A.M.-G.); Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University and Tufts University Friedman School of Nutrition Science and Policy, Boston, MA (A.H.); Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (B.A.R., W.C.W., Q.S., F.B.H.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain (M.G.-F., J.S.-S.); Department of Preventive Medicine, University of Valencia, Spain (D.C.); Department of Preventive Medicine, University of Málaga, Spain (E.G.-G.); University Institute of Health Sciences (IUNICS), University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain (M.F.); Department of Internal Medicine (R.E.), Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, University of Barcelona, Spain (E.R.); Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain (J.L.); Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (M.F.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.); and Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA (C.B.C.).
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18
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Huang T, Zheng Y, Hruby A, Williamson DA, Bray GA, Shen Y, Sacks FM, Qi L. Dietary Protein Modifies the Effect of the MC4R Genotype on 2-Year Changes in Appetite and Food Craving: The POUNDS Lost Trial. J Nutr 2017; 147:439-444. [PMID: 28148682 DOI: 10.3945/jn.116.242958] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 10/18/2016] [Accepted: 01/09/2017] [Indexed: 02/01/2023] Open
Abstract
Background: The melanocortin-4 receptor (MC4R) plays a pivotal role in the regulation of appetite and eating behavior. Variants in the MC4R gene have been related to appetite and obesity.Objective: We aimed to examine whether weight-loss diets modified the effect of the "obesity-predisposing" MC4R genotype on appetite-related measures in a randomized controlled trial.Methods: A total of 811 overweight and obese subjects [25 ≤ body mass index (BMI; kg/m2) ≤ 40] aged 30-70 y were included in the 2-y POUNDS Lost (Preventing Overweight Using Novel Dietary Strategies) trial. We genotyped MC4R rs7227255 in 735 overweight adults and assessed appetite-related characteristics, including craving, fullness, hunger, and prospective consumption, as well as a composite appetite score. We examined the effects of the genotype-by-weight-loss diet intervention interaction on appetite variables by using general linear models in both the whole population and in white participants only.Results: We found that dietary protein intake (low compared with high: 15% of energy compared with 25% of energy, respectively) significantly modified MC4R genetic effects on changes in appetite score and craving (P-interaction = 0.03 and 0.02, respectively) at 2 y, after adjustment for age, sex, ethnicity, baseline BMI, weight change, and baseline perspective phenotype. The obesity-predisposing A allele was associated with a greater increase in overall appetite score (β = 0.10, P = 0.05) and craving (β = 0.13, P = 0.008) compared with the non-A allele among participants who consumed a high-protein diet. MC4R genotype did not modify the effects of fat or carbohydrate intakes on appetite measures. Similar interaction patterns were observed in whites.Conclusion: Our data suggest that individuals with the MC4R rs7227255 A allele rather than the non-A allele might experience greater increases in appetite and food craving when consuming a high-protein weight-loss diet. This trial was registered at clinicaltrials.gov as NCT00072995.
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Affiliation(s)
- Tao Huang
- Epidemiology Domain, Saw Swee Hock School of Public Health, and.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Yan Zheng
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Adela Hruby
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Donald A Williamson
- Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA
| | - George A Bray
- Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA
| | - Yiru Shen
- School of Medicine, Tufts University, Boston, MA
| | - Frank M Sacks
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Lu Qi
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; .,Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA; and.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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19
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Hruby A, Bulathsinhala L, McKinnon CJ, Hill OT, Montain SJ, Young AJ, Smith TJ. Body Mass Index at Accession and Incident Cardiometabolic Risk Factors in US Army Soldiers, 2001-2011. PLoS One 2017; 12:e0170144. [PMID: 28095509 PMCID: PMC5241140 DOI: 10.1371/journal.pone.0170144] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 12/29/2016] [Indexed: 12/17/2022] Open
Abstract
Individuals entering US Army service are generally young and healthy, but many are overweight, which may impact cardiometabolic risk despite physical activity and fitness requirements. This analysis examines the association between Soldiers' BMI at accession and incident cardiometabolic risk factors (CRF) using longitudinal data from 731,014 Soldiers (17.0% female; age: 21.6 [3.9] years; BMI: 24.7 [3.8] kg/m2) who were assessed at Army accession, 2001-2011. CRF were defined as incident diagnoses through 2011, by ICD-9 code, of metabolic syndrome, glucose/insulin disorder, hypertension, dyslipidemia, or overweight/obesity (in those not initially overweight/obese). Multivariable-adjusted proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) between BMI categories at accession and CRF. Initially underweight (BMI<18.5 kg/m2) were 2.4% of Soldiers, 53.5% were normal weight (18.5-<25), 34.2% were overweight (25-<30), and 10.0% were obese (≥30). Mean age range at CRF diagnosis was 24-29 years old, with generally low CRF incidence: 228 with metabolic syndrome, 3,880 with a glucose/insulin disorder, 26,373 with hypertension, and 13,404 with dyslipidemia. Of the Soldiers who were not overweight or obese at accession, 5,361 were eventually diagnosed as overweight or obese. Relative to Soldiers who were normal weight at accession, those who were overweight or obese, respectively, had significantly higher risk of developing each CRF after multivariable adjustment (HR [95% CI]: metabolic syndrome: 4.13 [2.87-5.94], 13.36 [9.00-19.83]; glucose/insulin disorder: 1.39 [1.30-1.50], 2.76 [2.52-3.04]; hypertension: 1.85 [1.80-1.90], 3.31 [3.20-3.42]; dyslipidemia: 1.81 [1.75-1.89], 3.19 [3.04-3.35]). Risk of hypertension, dyslipidemia, and overweight/obesity in initially underweight Soldiers was 40%, 31%, and 79% lower, respectively, versus normal-weight Soldiers. BMI in early adulthood has important implications for cardiometabolic health, even within young, physically active populations.
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Affiliation(s)
- Adela Hruby
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States of America
- Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, United States of America
| | - Lakmini Bulathsinhala
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States of America
- U.S. Army Medical Department Center and School, Health Readiness Center of Excellence, Fort Sam, Houston, TX, United States of America
| | - Craig J. McKinnon
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States of America
| | - Owen T. Hill
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States of America
- U.S. Army Medical Department Center and School, Health Readiness Center of Excellence, Fort Sam, Houston, TX, United States of America
| | - Scott J. Montain
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States of America
| | - Andrew J. Young
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States of America
| | - Tracey J. Smith
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States of America
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20
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Costello RB, Elin RJ, Rosanoff A, Wallace TC, Guerrero-Romero F, Hruby A, Lutsey PL, Nielsen FH, Rodriguez-Moran M, Song Y, Van Horn LV. Perspective: The Case for an Evidence-Based Reference Interval for Serum Magnesium: The Time Has Come. Adv Nutr 2016; 7:977-993. [PMID: 28140318 PMCID: PMC5105038 DOI: 10.3945/an.116.012765] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The 2015 Dietary Guidelines Advisory Committee indicated that magnesium was a shortfall nutrient that was underconsumed relative to the Estimated Average Requirement (EAR) for many Americans. Approximately 50% of Americans consume less than the EAR for magnesium, and some age groups consume substantially less. A growing body of literature from animal, epidemiologic, and clinical studies has demonstrated a varied pathologic role for magnesium deficiency that includes electrolyte, neurologic, musculoskeletal, and inflammatory disorders; osteoporosis; hypertension; cardiovascular diseases; metabolic syndrome; and diabetes. Studies have also demonstrated that magnesium deficiency is associated with several chronic diseases and that a reduced risk of these diseases is observed with higher magnesium intake or supplementation. Subclinical magnesium deficiency can exist despite the presentation of a normal status as defined within the current serum magnesium reference interval of 0.75-0.95 mmol/L. This reference interval was derived from data from NHANES I (1974), which was based on the distribution of serum magnesium in a normal population rather than clinical outcomes. What is needed is an evidenced-based serum magnesium reference interval that reflects optimal health and the current food environment and population. We present herein data from an array of scientific studies to support the perspective that subclinical deficiencies in magnesium exist, that they contribute to several chronic diseases, and that adopting a revised serum magnesium reference interval would improve clinical care and public health.
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Affiliation(s)
| | - Ronald J Elin
- Department of Pathology and Laboratory Medicine, University of Louisville, KY
| | | | - Taylor C Wallace
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA
| | | | - Adela Hruby
- Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Pamela L Lutsey
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | | | | | - Yiqing Song
- Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN; and
| | - Linda V Van Horn
- Division of Nutrition, Department of Preventive Medicine, Northwestern University, Chicago, IL
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21
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Ma J, Jacques PF, Meigs JB, Fox CS, Rogers GT, Smith CE, Hruby A, Saltzman E, McKeown NM. Sugar-Sweetened Beverage but Not Diet Soda Consumption Is Positively Associated with Progression of Insulin Resistance and Prediabetes. J Nutr 2016; 146:2544-2550. [PMID: 27934644 DOI: 10.3945/jn.116.234047] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 05/06/2016] [Accepted: 10/11/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Previous studies have shown an inconsistent relation between habitual beverage consumption and insulin resistance and prediabetes. OBJECTIVE The objective of the present study was to test the hypothesis that the consumption of sugar-sweetened beverages (SSBs), rather than diet soda, is associated with long-term progression of insulin resistance and the development of prediabetes. METHODS We analyzed the prospective association between cumulative mean consumption of SSBs or diet soda and incident prediabetes (n = 1685) identified across a median of 14 y of follow-up in participants [mean ± SD age: 51.9 ± 9.2 y; 59.6% women; mean ± SD body mass index (BMI; kg/m2): 26.3 ± 4.4] of the Framingham Offspring cohort. The prospective association between beverage consumption and change in homeostasis model assessment of insulin resistance (HOMA-IR; n = 2076) over ∼7 y was also analyzed. The cumulative mean consumption of SSBs and diet soda was estimated by using food-frequency questionnaires. Multivariable Cox proportional hazards models and linear regression models were implemented to estimate the HRs of incident prediabetes and change in HOMA-IR, respectively. RESULTS After adjustment for multiple potential confounders, including baseline BMI, we observed that SSB intake was positively associated with incident prediabetes (P-trend < 0.001); the highest SSB consumers (>3 servings/wk; median: 6 servings/wk) had a 46% higher risk of developing prediabetes than did the SSB nonconsumers (HR: 1.46; 95% CI: 1.16, 1.83). Higher SSB intake was also associated with a greater increase in HOMA-IR (P-trend = 0.006). No prospective associations were observed between diet soda intake and risk of prediabetes (P-trend = 0.24) or changes in HOMA-IR (P-trend = 0.25). These associations were similar after additional adjustment for change in BMI. CONCLUSION Regular SSB intake, but not diet soda intake, is associated with a greater increase in insulin resistance and a higher risk of developing prediabetes in a group of middle-aged adults.
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Affiliation(s)
| | | | - James B Meigs
- Division of General Internal Medicine, Department of Medicine, Harvard Medical School and Massachusetts General Hospital, Boston, MA; and
| | - Caroline S Fox
- Framingham Heart Study, Population Science Branch, National Heart, Lung, and Blood Institute, Framingham, MA
| | | | | | | | - Edward Saltzman
- Energy Metabolism Laboratory, USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
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22
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Zheng Y, Hu FB, Ruiz-Canela M, Clish CB, Dennis C, Salas-Salvado J, Hruby A, Liang L, Toledo E, Corella D, Ros E, Fitó M, Gómez-Gracia E, Arós F, Fiol M, Lapetra J, Serra-Majem L, Estruch R, Martínez-González MA. Metabolites of Glutamate Metabolism Are Associated With Incident Cardiovascular Events in the PREDIMED PREvención con DIeta MEDiterránea (PREDIMED) Trial. J Am Heart Assoc 2016; 5:e003755. [PMID: 27633391 PMCID: PMC5079035 DOI: 10.1161/jaha.116.003755] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 08/12/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Glutamate metabolism may play a role in the pathophysiology of cardiometabolic disorders. However, there is limited evidence of an association between glutamate-related metabolites and, moreover, changes in these metabolites, and risk of cardiovascular disease (CVD). METHODS AND RESULTS Plasma levels of glutamate and glutamine were measured at baseline and 1-year follow-up in a case-cohort study including 980 participants (mean age 68 years; 46% male) from the PREvención con DIeta MEDiterránea (PREDIMED) randomized trial, which assessed a Mediterranean diet intervention in the primary prevention of CVD. During median 4.8 years of follow-up, there were 229 incident CVD events (nonfatal stroke, nonfatal myocardial infarction, or CVD death). In fully adjusted models, per 1-SD, baseline glutamate was associated with 43% (95% CI: 16% to 76%) and 81% (39% to 137%) increased risk of composite CVD and stroke alone, respectively, and baseline glutamine-to-glutamate ratio with 25% (6% to 40%) and 44% (25% to 58%) decreased risk of composite CVD and stroke alone, respectively. Associations appeared linear for stroke (both Plinear trend≤0.005). Among participants with high baseline glutamate, the interventions lowered CVD risk by 37% compared to the control diet; the intervention effects were not significant when baseline glutamate was low (Pinteraction=0.02). No significant effect of the intervention on year-1 changes in metabolites was observed, and no effect of changes themselves on CVD risk was apparent. CONCLUSIONS Baseline glutamate was associated with increased CVD risk, particularly stroke, and glutamine-to-glutamate ratio was associated with decreased risk. Participants with high glutamate levels may obtain greater benefits from the Mediterranean diet than those with low levels. CLINICAL TRIAL REGISTRATION URL: www.controlled-trials.com. Unique identifier: ISRCTN 35739639.
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Affiliation(s)
- Yan Zheng
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Frank B Hu
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain IDISNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Clary B Clish
- Broad Institute of MIT and Harvard University, Cambridge, MA
| | - Courtney Dennis
- Broad Institute of MIT and Harvard University, Cambridge, MA
| | - Jordi Salas-Salvado
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain Human Nutrition Department, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Adela Hruby
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Liming Liang
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Estefania Toledo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain IDISNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain Department of Preventive Medicine, University of Valencia, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain Lipid Clinic, Departments of Endocrinology and Nutrition, Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Spain
| | - Montserrat Fitó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain
| | - Enrique Gómez-Gracia
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain Department of Preventive Medicine, University of Malaga, Spain
| | - Fernando Arós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain Department of Cardiology, University Hospital of Alava, Vitoria, Spain
| | - Miquel Fiol
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain Palma Institute of Health Research (IdISPa), Hospital Son Espases, Palma de Mallorca, Spain
| | - José Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain Research Unit, Department of Family Medicine, Distrito Sanitario Atencion Primaria Sevilla, Sevilla, Spain
| | - Lluis Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Ramón Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain Department of Internal Medicine, Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Spain
| | - Miguel A Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain IDISNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
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Zheng Y, Xu M, Li Y, Hruby A, Rimm EB, Hu FB, Wirth J, Albert CM, Rexrode KM, Manson JE, Qi L. Gallstones and Risk of Coronary Heart Disease: Prospective Analysis of 270 000 Men and Women From 3 US Cohorts and Meta-Analysis. Arterioscler Thromb Vasc Biol 2016; 36:1997-2003. [PMID: 27540264 PMCID: PMC5001914 DOI: 10.1161/atvbaha.116.307507] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 06/23/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Gallstone disease has been related to cardiovascular risk factors; however, whether presence of gallstones predicts coronary heart disease (CHD) is not well established. APPROACH AND RESULTS We followed up 269 142 participants who were free of cancer and cardiovascular disease at baseline from 3 US cohorts: the Nurses' Health Study (112 520 women; 1980-2010), Nurses' Health Study II (112 919 women; 1989-2011), and the Health Professionals Follow-up Study (43 703 men; 1986-2010) and documented 21 265 incident CHD cases. After adjustment for potential confounders, the hazard ratio for the participants with a history of gallstone disease compared with those without was 1.15 (95% confidence interval, 1.10-1.21) in Nurses' Health Study, 1.33 (95% confidence interval, 1.17-1.51) in Nurses' Health Study II, and 1.11 (95% confidence interval, 1.04-1.20) in Health Professionals Follow-up Study. The associations seemed to be stronger in individuals who were not obese, not diabetic, or were normotensive, compared with their counterparts. We identified 4 published prospective studies by searching PUBMED and EMBASE up to October 2015, coupled with our 3 cohorts, involving 842 553 participants and 51 123 incident CHD cases. The results from meta-analysis revealed that a history of gallstone disease was associated with a 23% (15%-33%) increased CHD risk. CONCLUSION Our findings support that a history of gallstone disease is associated with increased CHD risk, independently of traditional risk factors.
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Affiliation(s)
- Yan Zheng
- From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.)
| | - Min Xu
- From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.)
| | - Yanping Li
- From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.)
| | - Adela Hruby
- From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.)
| | - Eric B Rimm
- From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.)
| | - Frank B Hu
- From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.)
| | - Janine Wirth
- From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.)
| | - Christine M Albert
- From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.)
| | - Kathryn M Rexrode
- From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.)
| | - JoAnn E Manson
- From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.)
| | - Lu Qi
- From the Department of Nutrition (Y.Z., M.X., Y.L., A.H., E.B.R., F.B.H., L.Q.) and Department of Epidemiology (E.B.R., F.B.H., J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (M.X.); Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (J.W.); Division of Preventive Medicine, Department of Medicine (C.M.A., K.M.R., J.E.M.) and Channing Division of Network Medicine, Department of Medicine (E.B.R., F.B.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q.).
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24
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Abstract
OBJECTIVES To review the contribution of the Nurses' Health Studies (NHS and NHS II) in addressing hypotheses regarding risk factors for and consequences of obesity. METHODS Narrative review of the publications of the NHS and NHS II between 1976 and 2016. RESULTS Long-term NHS research has shown that weight gain and being overweight or obese are important risk factors for type 2 diabetes, cardiovascular diseases, certain types of cancers, and premature death. The cohorts have elucidated the role of dietary and lifestyle factors in obesity, especially sugar-sweetened beverages, poor diet quality, physical inactivity, prolonged screen time, short sleep duration or shift work, and built environment characteristics. Genome-wide association and gene-lifestyle interaction studies have shown that genetic factors predispose individuals to obesity but that such susceptibility can be attenuated by healthy lifestyle choices. This research has contributed to evolving clinical and public health guidelines on the importance of limiting weight gain through healthy dietary and lifestyle behaviors. CONCLUSIONS The NHS cohorts have contributed to our understanding of the risk factors for and consequences of obesity and made a lasting impact on clinical and public health guidelines on obesity prevention.
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Affiliation(s)
- Adela Hruby
- Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - JoAnn E Manson
- Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Lu Qi
- Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Vasanti S Malik
- Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Eric B Rimm
- Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Qi Sun
- Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Walter C Willett
- Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Frank B Hu
- Adela Hruby is with the Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Vasanti S. Malik, Eric B. Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston. JoAnn E. Manson is with the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
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25
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Zheng Y, Li Y, Qi Q, Hruby A, Manson JE, Willett WC, Wolpin BM, Hu FB, Qi L. Cumulative consumption of branched-chain amino acids and incidence of type 2 diabetes. Int J Epidemiol 2016; 45:1482-1492. [PMID: 27413102 DOI: 10.1093/ije/dyw143] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Plasma branched-chain amino acids (BCAAs, including leucine, isoleucine and valine) were recently related to risk of type 2 diabetes (T2D). Dietary intake is the only source of BCAAs; however, little is known about whether habitual dietary intake of BCAAs affects risk of T2D. METHODS We assessed associations between cumulative consumption of BCAAs and risk of T2D among participants from three prospective cohorts: the Nurses' Health Study (NHS; followed from 1980 to 2012); NHS II (followed from 1991 to 2011); and the Health Professionals Follow-up Study (HPFS; followed from 1986 to 2010). RESULTS We documented 16 097 incident T2D events during up to 32 years of follow-up. After adjustment for demographics and traditional risk factors, higher total BCAA intake was associated with an increased risk of T2D in men and women. In the meta-analysis of all cohorts, comparing participants in the highest quintile with those in the lowest quintile of intake, hazard ratios (95%confidence intervals) were for leucine 1.13 (1.07-1.19), for isoleucine 1.13 (1.07-1.19) and for valine 1.11 (1.05-1.17) (all P for trend < 0.001). In a healthy subsample, higher dietary BCAAs were significantly associated with higher plasma levels of these amino acids (P for trend = 0.01). CONCLUSIONS Our data suggest that high consumption of BCAAs is associated with an increased risk of T2D.
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Affiliation(s)
- Yan Zheng
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yanping Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Qibin Qi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Adela Hruby
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - JoAnn E Manson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Brian M Wolpin
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lu Qi
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA .,Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
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26
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Guasch-Ferré M, Zheng Y, Ruiz-Canela M, Hruby A, Martínez-González MA, Clish CB, Corella D, Estruch R, Ros E, Fitó M, Dennis C, Morales-Gil IM, Arós F, Fiol M, Lapetra J, Serra-Majem L, Hu FB, Salas-Salvadó J. Plasma acylcarnitines and risk of cardiovascular disease: effect of Mediterranean diet interventions. Am J Clin Nutr 2016; 103:1408-16. [PMID: 27099249 PMCID: PMC4881000 DOI: 10.3945/ajcn.116.130492] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 03/28/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Previous studies have suggested that metabolite profiles of elevated acylcarnitines were associated with increased risk of cardiovascular disease (CVD) in populations with established coronary disease. However, to our knowledge, this association has not been evaluated in the context of primary cardiovascular prevention. OBJECTIVES We evaluated the association between 28 plasma acylcarnitine species and risk of incident CVD and the potential modifying effect of Mediterranean diet (MedDiet) interventions. DESIGN We measured plasma acylcarnitines with the use of high-throughput liquid chromatography-tandem mass spectrometry at baseline and after 1 y of follow-up, both individually and classified into short-, medium-, or long-chain scores, in a case-cohort study within the Prevención con Dieta Mediterránea (PREDIMED) study, which is a randomized Mediterranean dietary intervention for primary cardiovascular prevention. A randomly selected subcohort (n = 751) and all available incident CVD cases (n = 229) after 4.8 y of follow-up were included in the current study. RESULTS After adjustment for age, sex, body mass index, and other CVD risk factors, participants in the highest quartile of baseline short- and medium-chain acylcarnitines had a higher risk of CVD than did participants in the lowest quartile [HRs: 1.80 (95% CI: 1.11, 2.91; P-trend 0.01) and 1.55 (95% CI: 1.01, 2.48; P-trend = 0.04), respectively]. Increased short-chain acylcarnitines after 1 y were associated with higher risks of total CVD and stroke. Participants with higher baseline concentrations of short-, medium-, and long-chain acylcarnitines who were randomly assigned to the control group had a higher risk of CVD than did subjects with lower concentrations of acylcarnitines who were assigned to the MedDiet group. CONCLUSIONS Our data support the conclusion that metabolite profiles characterized by elevated concentrations of acylcarnitines are independently associated with risks of total CVD and stroke alone in participants at high risk of CVD. MedDiet interventions may mitigate the adverse associations shown between higher concentrations of acylcarnitines and CVD. This trial was registered at www.controlled-trials.com as ISRCTN35739639.
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Affiliation(s)
- Marta Guasch-Ferré
- Departments of Nutrition and Human Nutrition Department, Pere Virgili Research Institute, University Hospital of Sant Joan de Reus, Rovira i Virgili University, Reus, Spain; The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Health Institute Carlos III, Madrid, Spain
| | | | - Miguel Ruiz-Canela
- The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Health Institute Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra-Medical Research Institute of Navarra, Pamplona, Spain
| | | | - Miguel A Martínez-González
- The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Health Institute Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra-Medical Research Institute of Navarra, Pamplona, Spain
| | - Clary B Clish
- Broad Institute of MIT and Harvard University, Cambridge, MA
| | - Dolores Corella
- The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Health Institute Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Ramon Estruch
- The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Health Institute Carlos III, Madrid, Spain; Department of Internal Medicine and
| | - Emilio Ros
- The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Health Institute Carlos III, Madrid, Spain; Lipid Clinic, Department of Endocrinology and Nutrition, Biomedical Research Institute Agustí Pi Sunyer, Clinic Hospital, University of Barcelona, Barcelona, Spain
| | - Montserrat Fitó
- The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Health Institute Carlos III, Madrid, Spain; Cardiovascular and Nutrition Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | - Courtney Dennis
- Broad Institute of MIT and Harvard University, Cambridge, MA
| | - Isabel M Morales-Gil
- Department of Infirmary, Faculty of Health Science, University of Malaga, Malaga, Spain
| | - Fernando Arós
- Department of Cardiology, University Hospital of Alava, Vitoria, Spain
| | - Miquel Fiol
- Institute of Health Sciences of University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain
| | - José Lapetra
- The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Health Institute Carlos III, Madrid, Spain; Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain
| | - Lluís Serra-Majem
- The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Health Institute Carlos III, Madrid, Spain; Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain; and
| | - Frank B Hu
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jordi Salas-Salvadó
- Human Nutrition Department, Pere Virgili Research Institute, University Hospital of Sant Joan de Reus, Rovira i Virgili University, Reus, Spain; The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Health Institute Carlos III, Madrid, Spain;
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Hruby A, Bulathsinhala L, McKinnon CJ, Hill OT, Montain SJ, Young AJ, Smith TJ. BMI and Lower Extremity Injury in U.S. Army Soldiers, 2001-2011. Am J Prev Med 2016; 50:e163-e171. [PMID: 26699247 DOI: 10.1016/j.amepre.2015.10.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 10/06/2015] [Accepted: 10/19/2015] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Little data exist regarding the long-term impact of excess weight on lower extremity musculoskeletal injury/disorder (MID) in U.S. Army Soldiers. This prospective analysis examines the association between BMI of Soldiers at accession and risk of MID. METHODS A total of 736,608 Soldiers were followed from accession into the Army, 2001-2011. Data were analyzed January through March 2015. MID was categorized as any first incident lower extremity musculoskeletal injury/disorder, and secondarily, as first incident injury/disorder at a specific site (i.e., hips, upper legs/thighs, knees, lower legs/ankles, feet/toes). Multivariable-adjusted proportional hazards models estimated associations between BMI category at accession and MID risk. RESULTS During 15,678,743 person-months of follow-up, 411,413 cases of any first MID were documented (70,578 hip, 77,050 upper leg, 162,041 knee, 338,080 lower leg, and 100,935 foot injuries in secondary analyses). The overall MID rate was 2.62 per 100 person-months. Relative to Soldiers with normal BMI (18.5 to <25 kg/m(2)) at accession, those who were underweight (<18.5); overweight (25 to <30); or obese (≥30) had 7%, 11%, and 33% higher risk of MID, respectively, after adjustment. Risks were highest in Soldiers who were obese at accession, and lowest in those with a BMI of 21-23 kg/m(2). CONCLUSIONS Soldier BMI at accession has important implications for MID. A BMI of 21-23 kg/m(2) in newly accessing Soldiers was associated with the lowest risk of incident MID, suggesting that accession be limited to people within this range to reduce overall incidence of MID among service personnel.
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Affiliation(s)
- Adela Hruby
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Lakmini Bulathsinhala
- Environmental Medicine Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts; Center for the Intrepid, Fort Sam, Houston, Texas
| | - Craig J McKinnon
- Environmental Medicine Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Owen T Hill
- Environmental Medicine Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts; Center for the Intrepid, Fort Sam, Houston, Texas
| | - Scott J Montain
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Andrew J Young
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Tracey J Smith
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts.
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Huang T, Tobias DK, Hruby A, Rifai N, Tworoger SS, Hu FB. An Increase in Dietary Quality Is Associated with Favorable Plasma Biomarkers of the Brain-Adipose Axis in Apparently Healthy US Women. J Nutr 2016; 146:1101-8. [PMID: 27075907 PMCID: PMC4841930 DOI: 10.3945/jn.115.229666] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 03/07/2016] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The associations between long-term dietary quality and biomarkers of the brain-adipose axis have not been examined. OBJECTIVE We evaluated both cross-sectional and longitudinal associations between dietary quality and several biomarkers involved in the brain-adipose axis. METHODS In the Nurses' Health Study II, 831 women [baseline mean age: 45 y; body mass index (BMI; in kg/m(2)): 24.6] were randomly selected from women who provided 2 fasting blood samples in 1996-1999 and 2010-2011 to measure plasma concentrations of leptin, soluble leptin receptor (sOB-R), adiponectin, insulin, retinol binding protein-4 (RBP-4), interleukin-6 (IL-6), and C-reactive protein (CRP). Dietary quality was assessed by the Alternative Healthy Eating Index (AHEI-2010) with the use of semiquantitative food-frequency questionnaires administered in 1995 and 2011. We used linear mixed models to evaluate the cross-sectional associations between dietary quality and biomarker concentrations. We also examined change in dietary quality in relation to change in biomarker concentrations. RESULTS In cross-sectional analyses that compared the highest with the lowest quintile of AHEI-2010, we observed significantly lower leptin (P-trend < 0.0001), insulin (P-trend < 0.0001), and CRP (P-trend = 0.02) and significantly higher sOB-R (P-trend < 0.0001) and adiponectin (P-trend = 0.0003). These associations, except for CRP, remained significant after adjustment for BMI. In longitudinal analyses, women in the highest quintile of AHEI-2010 score change (most improvement) had a 13% increase in leptin, compared with a 42% increase (P-trend < 0.0001) in the lowest quintile (least improvement). The corresponding multivariable-adjusted percentage changes for other biomarkers were 4% compared with -1% for sOB-R (P-trend = 0.04), 14% compared with 6% for adiponectin (P-trend = 0.02), and -11% compared with 16% for CRP (P-trend = 0.02). Adjustment for interim weight change attenuated these associations. No associations were observed for RBP-4 or IL-6. CONCLUSION Improvement in dietary quality was associated with favorable profiles of several biomarkers of the brain-adipose axis in women.
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Affiliation(s)
- Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine,
| | - Deirdre K Tobias
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Adela Hruby
- Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Nader Rifai
- Division of Laboratory Medicine, Boston Children’s Hospital, Boston, MA; and
| | - Shelley S Tworoger
- Channing Division of Network Medicine, Department of Medicine,,Departments of Epidemiology and
| | - Frank B Hu
- Channing Division of Network Medicine, Department of Medicine,,Departments of Epidemiology and,Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
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Guasch-Ferré M, Hruby A, Toledo E, Clish CB, Martínez-González MA, Salas-Salvadó J, Hu FB. Metabolomics in Prediabetes and Diabetes: A Systematic Review and Meta-analysis. Diabetes Care 2016; 39:833-46. [PMID: 27208380 PMCID: PMC4839172 DOI: 10.2337/dc15-2251] [Citation(s) in RCA: 565] [Impact Index Per Article: 70.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 02/06/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To conduct a systematic review of cross-sectional and prospective human studies evaluating metabolite markers identified using high-throughput metabolomics techniques on prediabetes and type 2 diabetes. RESEARCH DESIGN AND METHODS We searched MEDLINE and EMBASE databases through August 2015. We conducted a qualitative review of cross-sectional and prospective studies. Additionally, meta-analyses of metabolite markers, with data estimates from at least three prospective studies, and type 2 diabetes risk were conducted, and multivariable-adjusted relative risks of type 2 diabetes were calculated per study-specific SD difference in a given metabolite. RESULTS We identified 27 cross-sectional and 19 prospective publications reporting associations of metabolites and prediabetes and/or type 2 diabetes. Carbohydrate (glucose and fructose), lipid (phospholipids, sphingomyelins, and triglycerides), and amino acid (branched-chain amino acids, aromatic amino acids, glycine, and glutamine) metabolites were higher in individuals with type 2 diabetes compared with control subjects. Prospective studies provided evidence that blood concentrations of several metabolites, including hexoses, branched-chain amino acids, aromatic amino acids, phospholipids, and triglycerides, were associated with the incidence of prediabetes and type 2 diabetes. We meta-analyzed results from eight prospective studies that reported risk estimates for metabolites and type 2 diabetes, including 8,000 individuals of whom 1,940 had type 2 diabetes. We found 36% higher risk of type 2 diabetes per study-specific SD difference for isoleucine (pooled relative risk 1.36 [1.24-1.48]; I(2) = 9.5%), 36% for leucine (1.36 [1.17-1.58]; I(2) = 37.4%), 35% for valine (1.35 [1.19-1.53]; I(2) = 45.8%), 36% for tyrosine (1.36 [1.19-1.55]; I(2) = 51.6%), and 26% for phenylalanine (1.26 [1.10-1.44]; I(2) = 56%). Glycine and glutamine were inversely associated with type 2 diabetes risk (0.89 [0.81-0.96] and 0.85 [0.82-0.89], respectively; both I(2) = 0.0%). CONCLUSIONS In studies using high-throughput metabolomics, several blood amino acids appear to be consistently associated with the risk of developing type 2 diabetes.
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Affiliation(s)
- Marta Guasch-Ferré
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA Human Nutrition Unit, Faculty of Medicine and Health Sciences, Pere Virgili Institute for Health Research, Rovira i Virgili University, Reus, Spain CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Adela Hruby
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Estefanía Toledo
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain Department of Preventive Medicine and Public Health, University of Navarra, Health Research Institute of Navarra, Pamplona, Spain
| | | | - Miguel A Martínez-González
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain Department of Preventive Medicine and Public Health, University of Navarra, Health Research Institute of Navarra, Pamplona, Spain
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Pere Virgili Institute for Health Research, Rovira i Virgili University, Reus, Spain CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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Martínez-González MÁ, Ruiz-Canela M, Hruby A, Liang L, Trichopoulou A, Hu FB. Intervention Trials with the Mediterranean Diet in Cardiovascular Prevention: Understanding Potential Mechanisms through Metabolomic Profiling. J Nutr 2016; 146:913S-919S. [PMID: 26962184 PMCID: PMC4807639 DOI: 10.3945/jn.115.219147] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/06/2015] [Accepted: 09/09/2015] [Indexed: 12/15/2022] Open
Abstract
Large observational epidemiologic studies and randomized trials support the benefits of a Mediterranean dietary pattern on cardiovascular disease (CVD). Mechanisms postulated to mediate these benefits include the reduction of low-grade inflammation, increased adiponectin concentrations, decreased blood coagulation, enhanced endothelial function, lower oxidative stress, lower concentrations of oxidized LDL, and improved apolipoprotein profiles. However, the metabolic pathways through which the Mediterranean diet influences CVD risk remain largely unknown. Investigating specific mechanisms in the context of a large intervention trial with the use of high-throughput metabolomic profiling will provide more solid public health messages and may help to identify key molecular targets for more effective prevention and management of CVD. Although metabolomics is not without its limitations, the techniques allow for an assessment of thousands of metabolites, providing wide-ranging profiling of small molecules related to biological status. Specific candidate plasma metabolites that may be associated with CVD include branched-chain and aromatic amino acids; the glutamine-to-glutamate ratio; some short- to medium-chain acylcarnitines; gut flora metabolites (choline, betaine, and trimethylamine N-oxide); urea cycle metabolites (citrulline and ornithine); and specific lipid subclasses. In addition to targeted metabolites, the role of a large number of untargeted metabolites should also be assessed. Large intervention trials with the use of food patterns for the prevention of CVD provide an unparalleled opportunity to examine the effects of these interventions on plasma concentrations of specific metabolites and determine whether such changes mediate the benefits of the dietary interventions on CVD risk.
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Affiliation(s)
- Miguel Á Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra-Navarra Institute for Health Research, Pamplona, Spain;,Biomedical Research Networking Center Consortium-Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain;,To whom correspondence should be addressed E-mail:
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra-Navarra Institute for Health Research, Pamplona, Spain;,Biomedical Research Networking Center Consortium-Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | | | - Liming Liang
- Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; and
| | | | - Frank B Hu
- Departments of Nutrition and,Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; and
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Zhang X, Del Gobbo LC, Hruby A, Rosanoff A, He K, Dai Q, Costello RB, Zhang W, Song Y. The Circulating Concentration and 24-h Urine Excretion of Magnesium Dose- and Time-Dependently Respond to Oral Magnesium Supplementation in a Meta-Analysis of Randomized Controlled Trials. J Nutr 2016; 146:595-602. [PMID: 26865651 DOI: 10.3945/jn.115.223453] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 01/08/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Accurate determination of Mg status is important for improving nutritional assessment and clinical risk stratification. OBJECTIVE We aimed to quantify the overall responsiveness of Mg biomarkers to oral Mg supplementation among adults without severe diseases and their dose- and time responses using available data from randomized controlled trials (RCTs). METHODS We identified 48 Mg supplementation trials (n = 2131) through searches of MEDLINE and the Cochrane Library up to November 2014. Random-effects meta-analysis was used to estimate weighted mean differences of biomarker concentrations between intervention and placebo groups. Restricted cubic splines were used to determine the dose- and time responses of Mg biomarkers to supplementation. RESULTS Among the 35 biomarkers assessed, serum, plasma, and urine Mg were most commonly measured. Elemental Mg supplementation doses ranged from 197 to 994 mg/d. Trials ranged from 3 wk to 5 y (median: 12 wk). Mg supplementation significantly elevated circulating Mg by 0.04 mmol/L (95% CI: 0.02, 0.06) and 24-h urine Mg excretion by 1.52 mmol/24 h (95% CI: 1.20, 1.83) as compared to placebo. Circulating Mg concentrations and 24-h urine Mg excretion responded to Mg supplementation in a dose- and time-dependent manner, gradually reaching a steady state at doses of 300 mg/d and 400 mg/d, or after ~20 wk and 40 wk, respectively (all P-nonlinearity ≤ 0.001). The higher the circulating Mg concentration at baseline, the lower the responsiveness of circulating Mg to supplementation, and the higher the urinary excretion (all P-linearity < 0.05). In addition, RBC Mg, fecal Mg, and urine calcium were significantly more elevated by Mg supplementation than by placebo (all P-values < 0.05), but there is insufficient evidence to determine their responses to increasing Mg doses. CONCLUSIONS This meta-analysis of RCTs demonstrated significant dose- and time responses of circulating Mg concentration and 24-h urine Mg excretion to oral Mg supplementation.
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Affiliation(s)
- Xi Zhang
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN
| | - Liana C Del Gobbo
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University, Stanford, CA
| | - Adela Hruby
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| | | | - Ka He
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN
| | - Qi Dai
- Division of Epidemiology, Vanderbilt Ingram Cancer Center, and Department of Veterans Affairs, Tennessee Valley Healthcare System, Geriatric, Research, Education and Clinical Center, Nashville, TN; and
| | | | - Wen Zhang
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yiqing Song
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN;
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Ruiz-Canela M, Toledo E, Clish CB, Hruby A, Liang L, Salas-Salvadó J, Razquin C, Corella D, Estruch R, Ros E, Fitó M, Gómez-Gracia E, Arós F, Fiol M, Lapetra J, Serra-Majem L, Martínez-González MA, Hu FB. Plasma Branched-Chain Amino Acids and Incident Cardiovascular Disease in the PREDIMED Trial. Clin Chem 2016; 62:582-92. [PMID: 26888892 DOI: 10.1373/clinchem.2015.251710] [Citation(s) in RCA: 192] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 01/08/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND The role of branched-chain amino acids (BCAAs) in cardiovascular disease (CVD) remains poorly understood. We hypothesized that baseline BCAA concentrations predict future risk of CVD and that a Mediterranean diet (MedDiet) intervention may counteract this effect. METHODS We developed a case-cohort study within the Prevención con Dieta Mediterránea (PREDIMED), with 226 incident CVD cases and 744 noncases. We used LC-MS/MS to measure plasma BCAAs (leucine, isoleucine, and valine), both at baseline and after 1 year of follow-up. The primary outcome was a composite of incident stroke, myocardial infarction, or cardiovascular death. RESULTS After adjustment for potential confounders, baseline leucine and isoleucine concentrations were associated with higher CVD risk: the hazard ratios (HRs) for the highest vs lowest quartile were 1.70 (95% CI, 1.05-2.76) and 2.09 (1.27-3.44), respectively. Stronger associations were found for stroke. For both CVD and stroke, we found higher HRs across successive quartiles of BCAAs in the control group than in the MedDiet groups. With stroke as the outcome, a significant interaction (P = 0.009) between baseline BCAA score and intervention with MedDiet was observed. No significant effect of the intervention on 1-year changes in BCAAs or any association between 1-year changes in BCAAs and CVD were observed. CONCLUSIONS Higher concentrations of baseline BCAAs were associated with increased risk of CVD, especially stroke, in a high cardiovascular risk population. A Mediterranean-style diet had a negligible effect on 1-year changes in BCAAs, but it may counteract the harmful effects of BCAAs on stroke.
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Affiliation(s)
- Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain
| | - Estefania Toledo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain
| | - Clary B Clish
- Broad Institute of MIT and Harvard University, Cambridge, MA
| | | | - Liming Liang
- Biostatistics, and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain; Human Nutrition Department, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Cristina Razquin
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Ramón Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain; Department of Internal Medicine and
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain; Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Montserrat Fitó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain; Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain
| | - Enrique Gómez-Gracia
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Malaga, Malaga, Spain
| | - Fernando Arós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain; Department of Cardiology, University Hospital of Alava, Vitoria, Spain
| | - Miquel Fiol
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain; Institute of Health Sciences IUNICS, University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain
| | - José Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain; Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain
| | - Lluis Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences and Research Institute of Biomedical & Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Miguel A Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain
| | - Frank B Hu
- Departments of Nutrition, Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Cambridge, MA.
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Affiliation(s)
- Adela Hruby
- Department of Nutrition; Harvard T.H. Chan School of Public Health; Boston MA
| | - Frank B. Hu
- Department of Nutrition; Harvard T.H. Chan School of Public Health; Boston MA
- Department of Epidemiology; T.H. Chan School of Public Health; Boston MA
- Channing Division of Network Medicine, Department of Medicine; Brigham and Women's Hospital and Harvard Medical School; Boston MA
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35
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Li Y, Hruby A, Bernstein AM, Ley SH, Wang DD, Chiuve SE, Sampson L, Rexrode KM, Rimm EB, Willett WC, Hu FB. Saturated Fats Compared With Unsaturated Fats and Sources of Carbohydrates in Relation to Risk of Coronary Heart Disease: A Prospective Cohort Study. J Am Coll Cardiol 2015; 66:1538-1548. [PMID: 26429077 PMCID: PMC4593072 DOI: 10.1016/j.jacc.2015.07.055] [Citation(s) in RCA: 303] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/10/2015] [Accepted: 07/07/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND The associations between dietary saturated fats and the risk of coronary heart disease (CHD) remain controversial, but few studies have compared saturated with unsaturated fats and sources of carbohydrates in relation to CHD risk. OBJECTIVES This study sought to investigate associations of saturated fats compared with unsaturated fats and different sources of carbohydrates in relation to CHD risk. METHODS We followed 84,628 women (Nurses' Health Study, 1980 to 2010), and 42,908 men (Health Professionals Follow-up Study, 1986 to 2010) who were free of diabetes, cardiovascular disease, and cancer at baseline. Diet was assessed by a semiquantitative food frequency questionnaire every 4 years. RESULTS During 24 to 30 years of follow-up, we documented 7,667 incident cases of CHD. Higher intakes of polyunsaturated fatty acids (PUFAs) and carbohydrates from whole grains were significantly associated with a lower risk of CHD comparing the highest with lowest quintile for PUFAs (hazard ratio [HR]: 0.80, 95% confidence interval [CI]: 0.73 to 0.88; p trend <0.0001) and for carbohydrates from whole grains (HR: 0.90, 95% CI: 0.83 to 0.98; p trend = 0.003). In contrast, carbohydrates from refined starches/added sugars were positively associated with a risk of CHD (HR: 1.10, 95% CI: 1.00 to 1.21; p trend = 0.04). Replacing 5% of energy intake from saturated fats with equivalent energy intake from PUFAs, monounsaturated fatty acids, or carbohydrates from whole grains was associated with a 25%, 15%, and 9% lower risk of CHD, respectively (PUFAs, HR: 0.75, 95% CI: 0.67 to 0.84; p < 0.0001; monounsaturated fatty acids, HR: 0.85, 95% CI: 0.74 to 0.97; p = 0.02; carbohydrates from whole grains, HR: 0.91, 95% CI: 0.85 to 0.98; p = 0.01). Replacing saturated fats with carbohydrates from refined starches/added sugars was not significantly associated with CHD risk (p > 0.10). CONCLUSIONS Our findings indicate that unsaturated fats, especially PUFAs, and/or high-quality carbohydrates can be used to replace saturated fats to reduce CHD risk.
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Affiliation(s)
- Yanping Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Adela Hruby
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Sylvia H. Ley
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Dong D. Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Stephanie E. Chiuve
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Laura Sampson
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kathryn M. Rexrode
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Eric B. Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Walter C. Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Frank B. Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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Guasch-Ferré M, Hruby A, Salas-Salvadó J, Martínez-González MA, Sun Q, Willett WC, Hu FB. Olive oil consumption and risk of type 2 diabetes in US women. Am J Clin Nutr 2015; 102:479-86. [PMID: 26156740 PMCID: PMC4515873 DOI: 10.3945/ajcn.115.112029] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 05/28/2015] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Olive oil has been shown to improve various cardiometabolic risk factors. However, to our knowledge, the association between olive oil intake and type 2 diabetes (T2D) has never been evaluated in the US population. OBJECTIVE We aimed to examine the association between olive oil intake and incident T2D. DESIGN We followed 59,930 women aged 37-65 y from the Nurses' Health Study (NHS) and 85,157 women aged 26-45 y from the NHS II who were free of diabetes, cardiovascular disease, and cancer at baseline. Diet was assessed by validated food-frequency questionnaires, and data were updated every 4 y. Incident cases of T2D were identified through self-report and confirmed by supplementary questionnaires. RESULTS After 22 y of follow-up, we documented 5738 and 3914 incident cases of T2D in the NHS and NHS II, respectively. With the use of Cox regression models with repeated measurements of diet and multivariate adjustment for major lifestyle and dietary factors, the pooled HR (95% CI) of T2D in those who consumed >1 tablespoon (>8 g) of total olive oil per day compared with those who never consumed olive oil was 0.90 (0.82, 0.99). The corresponding HRs (95% CIs) were 0.95 (0.87, 1.04) for salad dressing olive oil and 0.85 (0.74, 0.98) for olive oil added to food or bread. We estimated that substituting olive oil (8 g/d) for stick margarine, butter, or mayonnaise was associated with 5%, 8%, and 15% lower risk of T2D, respectively, in the pooled analysis of both cohorts. CONCLUSIONS Our results suggest that higher olive oil intake is associated with modestly lower risk of T2D in women and that hypothetically substituting other types of fats and salad dressings (stick margarine, butter, and mayonnaise) with olive oil is inversely associated with T2D.
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Affiliation(s)
- Marta Guasch-Ferré
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain; Departments of Nutrition and
| | | | - Jordi Salas-Salvadó
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain
| | | | - Qi Sun
- Departments of Nutrition and Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Walter C Willett
- Departments of Nutrition and Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Frank B Hu
- Departments of Nutrition and Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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Dashti HS, Follis JL, Smith CE, Tanaka T, Garaulet M, Gottlieb DJ, Hruby A, Jacques PF, Kiefte-de Jong JC, Lamon-Fava S, Scheer FAJL, Bartz TM, Kovanen L, Wojczynski MK, Frazier-Wood AC, Ahluwalia TS, Perälä MM, Jonsson A, Muka T, Kalafati IP, Mikkilä V, Ordovás JM, Partonen T, Ebeling T, Hopkins PN, Paternoster L, Lahti J, Hernandez DG, Toft U, Saxena R, Vitezova A, Kanoni S, Raitakari OT, Psaty BM, Perola M, Männistö S, Straka RJ, Hansen T, Räikkönen K, Ferrucci L, Grarup N, Johnson WC, Rallidis L, Kähönen M, Siscovick DS, Havulinna AS, Astrup A, Jørgensen T, Chen TA, Hofman A, Deloukas P, Viikari JS, Mozaffarian D, Pedersen O, Rotter JI, Uitterlinden AG, Seppälä I, Tiemeier H, Salomaa V, Gharib SA, Borecki IB, Arnett DK, Sørensen TI, Eriksson JG, Bandinelli S, Linneberg A, Rich SS, Franco OH, Dedoussis G, Lehtimäki T. Gene-Environment Interactions of Circadian-Related Genes for Cardiometabolic Traits. Diabetes Care 2015; 38:1456-66. [PMID: 26084345 PMCID: PMC4512139 DOI: 10.2337/dc14-2709] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 04/11/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Common circadian-related gene variants associate with increased risk for metabolic alterations including type 2 diabetes. However, little is known about whether diet and sleep could modify associations between circadian-related variants (CLOCK-rs1801260, CRY2-rs11605924, MTNR1B-rs1387153, MTNR1B-rs10830963, NR1D1-rs2314339) and cardiometabolic traits (fasting glucose [FG], HOMA-insulin resistance, BMI, waist circumference, and HDL-cholesterol) to facilitate personalized recommendations. RESEARCH DESIGN AND METHODS We conducted inverse-variance weighted, fixed-effect meta-analyses of results of adjusted associations and interactions between dietary intake/sleep duration and selected variants on cardiometabolic traits from 15 cohort studies including up to 28,190 participants of European descent from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. RESULTS We observed significant associations between relative macronutrient intakes and glycemic traits and short sleep duration (<7 h) and higher FG and replicated known MTNR1B associations with glycemic traits. No interactions were evident after accounting for multiple comparisons. However, we observed nominally significant interactions (all P < 0.01) between carbohydrate intake and MTNR1B-rs1387153 for FG with a 0.003 mmol/L higher FG with each additional 1% carbohydrate intake in the presence of the T allele, between sleep duration and CRY2-rs11605924 for HDL-cholesterol with a 0.010 mmol/L higher HDL-cholesterol with each additional hour of sleep in the presence of the A allele, and between long sleep duration (≥9 h) and MTNR1B-rs1387153 for BMI with a 0.60 kg/m(2) higher BMI with long sleep duration in the presence of the T allele relative to normal sleep duration (≥7 to <9 h). CONCLUSIONS Our results suggest that lower carbohydrate intake and normal sleep duration may ameliorate cardiometabolic abnormalities conferred by common circadian-related genetic variants. Until further mechanistic examination of the nominally significant interactions is conducted, recommendations applicable to the general population regarding diet—specifically higher carbohydrate and lower fat composition—and normal sleep duration should continue to be emphasized among individuals with the investigated circadian-related gene variants.
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Affiliation(s)
- Hassan S Dashti
- Nutrition and Genomics Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Jack L Follis
- Department of Mathematics, Computer Science and Cooperative Engineering, University of St. Thomas, Houston, TX
| | - Caren E Smith
- Nutrition and Genomics Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD
| | - Marta Garaulet
- Department of Physiology, University of Murcia, Murcia, Spain
| | - Daniel J Gottlieb
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA Division of Sleep Medicine, Harvard Medical School, Boston, MA Sleep Disorders Center, VA Boston Healthcare System, Boston, MA
| | - Adela Hruby
- Department of Nutrition, Harvard School of Public Health, Boston, MA
| | - Paul F Jacques
- Nutritional Epidemiology Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands Global Public Health, Leiden University College, The Hague, the Netherlands
| | - Stefania Lamon-Fava
- Cardiovascular Nutrition Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Frank A J L Scheer
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA Department of Biostatistics, University of Washington, Seattle, WA
| | - Leena Kovanen
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Mary K Wojczynski
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Alexis C Frazier-Wood
- U.S. Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Tarunveer S Ahluwalia
- The Novo Nordisk Foundation Centre for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Danish Pediatric Asthma Centre, Gentofte Hospital, The Capital Region, Copenhagen, Denmark
| | - Mia-Maria Perälä
- Department of Chronic Disease Prevention, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Anna Jonsson
- The Novo Nordisk Foundation Centre for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Taulant Muka
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Ioanna P Kalafati
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Vera Mikkilä
- Department of Food and Environmental Sciences, Division of Nutrition, University of Helsinki, Helsinki, Finland Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - José M Ordovás
- Nutrition and Genomics Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA Department of Epidemiology, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain
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Abstract
The epidemic of overweight and obesity presents a major challenge to chronic disease prevention and health across the life course around the world. Fueled by economic growth, industrialization, mechanized transport, urbanization, an increasingly sedentary lifestyle, and a nutritional transition to processed foods and high-calorie diets over the last 30 years, many countries have witnessed the prevalence of obesity in its citizens double and even quadruple. A rising prevalence of childhood obesity, in particular, forebodes a staggering burden of disease in individuals and healthcare systems in the decades to come. A complex, multifactorial disease, with genetic, behavioral, socioeconomic, and environmental origins, obesity raises the risk of debilitating morbidity and mortality. Relying primarily on epidemiologic evidence published within the last decade, this non-exhaustive review discusses the extent of the obesity epidemic, its risk factors-known and novel-, sequelae, and economic impact across the globe.
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Affiliation(s)
- Adela Hruby
- Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA,
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Hruby A, Hill OT, Bulathsinhala L, McKinnon CJ, Montain SJ, Young AJ, Smith TJ. Trends in overweight and obesity in soldiers entering the US Army, 1989-2012. Obesity (Silver Spring) 2015; 23:662-70. [PMID: 25611465 DOI: 10.1002/oby.20978] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 11/04/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The US Army recruits new soldiers from an increasingly obese civilian population. The change in weight status at entry into the Army between 1989 and 2012 and the demographic characteristics associated with overweight/obesity at entry were examined. METHODS 1,741,070 unique individuals with complete sex, age, and anthropometric information contributed data to linear and logistic regressions examining time trends and associations between demographic characteristics and overweight/obesity. RESULTS The prevalence of overweight (body mass index 25-<30 kg/m(2)) generally increased, from 25.8% (1989) to 37.2% (2012), peaking at 37.9% (2011). The prevalence of obesity (body mass index ≥30 kg/m(2)) also increased from 5.6% (1989) to 8.0% (2012), peaking at 12.3% (2009); 2005-2009 annual prevalence exceeded 10%. The most consistent demographic characteristics predicting overweight/obesity were male sex, older age, Hispanic or Asian/Pacific Island race/ethnicity, and being married. There were no distinct geographic trends. CONCLUSIONS The US Army is not immune to the US obesity epidemic. Demographic characteristics associated with being overweight or obese should be considered when developing military-sponsored weight management programs for new soldiers.
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Affiliation(s)
- Adela Hruby
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA; Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
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Dashti HS, Follis JL, Smith CE, Tanaka T, Cade BE, Gottlieb DJ, Hruby A, Jacques PF, Lamon-Fava S, Richardson K, Saxena R, Scheer FAJL, Kovanen L, Bartz TM, Perälä MM, Jonsson A, Frazier-Wood AC, Kalafati IP, Mikkilä V, Partonen T, Lemaitre RN, Lahti J, Hernandez DG, Toft U, Johnson WC, Kanoni S, Raitakari OT, Perola M, Psaty BM, Ferrucci L, Grarup N, Highland HM, Rallidis L, Kähönen M, Havulinna AS, Siscovick DS, Räikkönen K, Jørgensen T, Rotter JI, Deloukas P, Viikari JSA, Mozaffarian D, Linneberg A, Seppälä I, Hansen T, Salomaa V, Gharib SA, Eriksson JG, Bandinelli S, Pedersen O, Rich SS, Dedoussis G, Lehtimäki T, Ordovás JM. Habitual sleep duration is associated with BMI and macronutrient intake and may be modified by CLOCK genetic variants. Am J Clin Nutr 2015; 101:135-43. [PMID: 25527757 PMCID: PMC4266883 DOI: 10.3945/ajcn.114.095026] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Short sleep duration has been associated with greater risks of obesity, hypertension, diabetes, and cardiovascular disease. Also, common genetic variants in the human Circadian Locomotor Output Cycles Kaput (CLOCK) show associations with ghrelin and total energy intake. OBJECTIVES We examined associations between habitual sleep duration, body mass index (BMI), and macronutrient intake and assessed whether CLOCK variants modify these associations. DESIGN We conducted inverse-variance weighted, fixed-effect meta-analyses of results of adjusted associations of sleep duration and BMI and macronutrient intake as percentages of total energy as well as interactions with CLOCK variants from 9 cohort studies including up to 14,906 participants of European descent from the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium. RESULTS We observed a significant association between sleep duration and lower BMI (β ± SE = 0.16 ± 0.04, P < 0.0001) in the overall sample; however, associations between sleep duration and relative macronutrient intake were evident in age- and sex-stratified analyses only. We observed a significant association between sleep duration and lower saturated fatty acid intake in younger (aged 20-64 y) adults (men: 0.11 ± 0.06%, P = 0.03; women: 0.10 ± 0.05%, P = 0.04) and with lower carbohydrate (-0.31 ± 0.12%, P < 0.01), higher total fat (0.18 ± 0.09%, P = 0.05), and higher PUFA (0.05 ± 0.02%, P = 0.02) intakes in older (aged 65-80 y) women. In addition, the following 2 nominally significant interactions were observed: between sleep duration and rs12649507 on PUFA intake and between sleep duration and rs6858749 on protein intake. CONCLUSIONS Our results indicate that longer habitual sleep duration is associated with lower BMI and age- and sex-specific favorable dietary behaviors. Differences in the relative intake of specific macronutrients associated with short sleep duration could, at least in part, explain previously reported associations between short sleep duration and chronic metabolic abnormalities. In addition, the influence of obesity-associated CLOCK variants on the association between sleep duration and macronutrient intake suggests that longer habitual sleep duration could ameliorate the genetic predisposition to obesity via a favorable dietary profile.
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Affiliation(s)
- Hassan S Dashti
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Jack L Follis
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Caren E Smith
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Toshiko Tanaka
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Brian E Cade
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Daniel J Gottlieb
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Adela Hruby
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Paul F Jacques
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Stefania Lamon-Fava
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Kris Richardson
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Richa Saxena
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Frank A J L Scheer
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Leena Kovanen
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Traci M Bartz
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Mia-Maria Perälä
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Anna Jonsson
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Alexis C Frazier-Wood
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Ioanna-Panagiota Kalafati
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Vera Mikkilä
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Timo Partonen
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Rozenn N Lemaitre
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Jari Lahti
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Dena G Hernandez
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Ulla Toft
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - W Craig Johnson
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Stavroula Kanoni
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Olli T Raitakari
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Markus Perola
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Bruce M Psaty
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Luigi Ferrucci
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Niels Grarup
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Heather M Highland
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Loukianos Rallidis
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Mika Kähönen
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Aki S Havulinna
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - David S Siscovick
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Katri Räikkönen
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Torben Jørgensen
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Jerome I Rotter
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Panos Deloukas
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Jorma S A Viikari
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Dariush Mozaffarian
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Allan Linneberg
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Ilkka Seppälä
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Torben Hansen
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Veikko Salomaa
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Sina A Gharib
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Johan G Eriksson
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Stefania Bandinelli
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Oluf Pedersen
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Stephen S Rich
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - George Dedoussis
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - Terho Lehtimäki
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
| | - José M Ordovás
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Nutritional Epidemiology Laboratory (PFJ), and Cardiovascular Nutrition Laboratory (SL-F), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA; the Department of Mathematics, Computer Science, and Cooperative Engineering, University of St. Thomas, Houston, TX (JLF); the Translational Gerontology Branch (TT and LF) and Laboratory of Neurogenetics (DGH), National Institute on Aging, Baltimore, MD; the Divisions of Sleep and Circadian Disorders (BEC, DJG, RS, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Brigham and Women's Hospital, Boston, MA; the Divisions of Sleep Medicine (BEC, DJG, and FAJLS) and Cardiovascular Medicine and Channing Division of Network Medicine (DM), Harvard Medical School, Boston, MA; the Sleep Disorders Center, VA Boston Healthcare System, Boston, MA (DJG); the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH and DM); the Center for Human Genetic Research and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA (RS); the Departments of Mental Health and Substance Abuse Services (LK and TP) and Chronic Disease Prevention (M-MP, MP, ASH, VS, and JGE) and National Institute for Health and Welfare (THL), Helsinki, Finland; the Cardiovascular Health Research Unit (TMB, RNL, and BMP), Departments of Medicine (TMB, RNL, BMP, and SAG), Biostatistics (TMB and WCJ), and Epidemiology and Health Services (BMP), Computational Medicine Core (SAG), Center for Lung Biology (SAG), and University of Washington Medicine Sleep Center (SAG), University of Washington, Seattle, WA; The Novo Nordisk Foundation Center for Basic Metabolic Research (AJ, NG, TH, and OP) and Department of Clinical Medicine (AL), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the USDA
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Dashti HS, Shea MK, Smith CE, Tanaka T, Hruby A, Richardson K, Wang TJ, Nalls MA, Guo X, Liu Y, Yao J, Li D, Johnson WC, Benjamin EJ, Kritchevsky SB, Siscovick DS, Ordovás JM, Booth SL. Meta-analysis of genome-wide association studies for circulating phylloquinone concentrations. Am J Clin Nutr 2014; 100:1462-9. [PMID: 25411281 PMCID: PMC4232014 DOI: 10.3945/ajcn.114.093146] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Poor vitamin K status is linked to greater risk of several chronic diseases. Age, sex, and diet are determinants of circulating vitamin K; however, there is still large unexplained interindividual variability in vitamin K status. Although a strong genetic component has been hypothesized, this has yet to be examined by a genome-wide association (GWA) study. OBJECTIVE The objective was to identify common genetic variants associated with concentrations of circulating phylloquinone, the primary circulating form of vitamin K. DESIGN We conducted a 2-stage GWA meta-analysis of circulating phylloquinone in 2 populations of European descent from the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium Nutrition Working Group. Circulating phylloquinone was measured by using reversed-phase high-performance liquid chromatography. Results from adjusted cohort-specific discovery GWA analyses were meta-analyzed with inverse variance weights (n = 2138). Associations with circulating phylloquinone at P < 1 × 10(-6) were then evaluated in a second-stage analysis consisting of one independent cohort (n = 265). RESULTS No significant association was observed for circulating phylloquinone at the genome-wide significance level of 5 × 10(-8). However, from the discovery GWA, there were 11 single-nucleotide polymorphism (SNP) associations with circulating phylloquinone at P < 1 × 10(-6), including a functional variant previously associated with warfarin dose and altered phylloquinone metabolism. These SNPs are on 5 independent loci on 11q23.3, 8q24.3, 5q22.3, 2p12, and 19p13.12, and they fall within or near the candidate genes APOA1/C3/A4/A5 cluster (involved in lipoprotein metabolism), COL22A1, CDO1, CTNAA2, and CYP4F2 (a phylloquinone oxidase), respectively. Second-stage analysis in an independent cohort further suggests the association of the 5q22.3 locus with circulating phylloquinone (P < 0.05). CONCLUSIONS Multiple candidate genes related to lipoprotein and vitamin K metabolism were identified as potential determinants of circulating phylloquinone. Further investigation with a larger sample is warranted to verify our initial findings and identify other loci contributing to circulating phylloquinone. Trials related to this study were registered at clinicaltrials.gov as NCT00005121 (Framingham Offspring Study) and NCT00005487 (Multi-Ethnic Study of Atherosclerosis).
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Affiliation(s)
- Hassan S Dashti
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - M Kyla Shea
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - Caren E Smith
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - Toshiko Tanaka
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - Adela Hruby
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - Kris Richardson
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - Thomas J Wang
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - Mike A Nalls
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - Xiuqing Guo
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - Yongmei Liu
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - Jie Yao
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - Dalin Li
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - W Craig Johnson
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - Emelia J Benjamin
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - Stephen B Kritchevsky
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - David S Siscovick
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - José M Ordovás
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
| | - Sarah L Booth
- From the Nutrition and Genomics Laboratory (HSD, CES, KR, and JMO), Vitamin K Laboratory (MKS and SLB), Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; the Translational Gerontology Branch (TT), Laboratory of Neurogenetics (MAN), National Institute on Aging, Baltimore, MD; the Department of Nutrition, Harvard School of Public Health, Boston, MA (AH); the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (TJW); the Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA (XG and JY); the Department of Public Health Sciences (YL), Sticht Center on Aging (SBK), Wake Forest Medical Center, Winston-Salem, NC; Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA (DL); the Department of Biostatistics, University of Washington, Seattle, WA (WCJ); Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (EJB); the Department of Medicine, Boston University School of Medicine, Boston, MA (EJB); New York Academy of Medicine, New York, NY (DSS); the Department of Epidemiology, Centro Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain (JMO); and Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-FOOD), Madrid, Spain (JMO). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture
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Bhupathiraju SN, Tobias DK, Malik VS, Pan A, Hruby A, Manson JE, Willett WC, Hu FB. Glycemic index, glycemic load, and risk of type 2 diabetes: results from 3 large US cohorts and an updated meta-analysis. Am J Clin Nutr 2014; 100:218-32. [PMID: 24787496 PMCID: PMC4144100 DOI: 10.3945/ajcn.113.079533] [Citation(s) in RCA: 232] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 04/04/2014] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Epidemiologic evidence for the relation between carbohydrate quality and risk of type 2 diabetes (T2D) has been mixed. OBJECTIVE We prospectively examined the association of dietary glycemic index (GI) and glycemic load (GL) with T2D risk. DESIGN We prospectively followed 74,248 women from the Nurses' Health Study (1984-2008), 90,411 women from the Nurses' Health Study II (1991-2009), and 40,498 men from the Health Professionals Follow-Up Study (1986-2008) who were free of diabetes, cardiovascular disease, and cancer at baseline. Diet was assessed by using a validated questionnaire and updated every 4 y. We also conducted an updated meta-analysis, including results from our 3 cohorts and other studies. RESULTS During 3,800,618 person-years of follow-up, we documented 15,027 cases of incident T2D. In pooled multivariable analyses, those in the highest quintile of energy-adjusted GI had a 33% higher risk (95% CI: 26%, 41%) of T2D than those in the lowest quintile. Participants in the highest quintile of energy-adjusted GL had a 10% higher risk (95% CI: 2%, 18%) of T2D. Participants who consumed a combination diet that was high in GI or GL and low in cereal fiber had an ~50% higher risk of T2D. In the updated meta-analysis, the summary RRs (95% CIs) comparing the highest with the lowest categories of GI and GL were 1.19 (1.14, 1.24) and 1.13 (1.08, 1.17), respectively. CONCLUSION The updated analyses from our 3 cohorts and meta-analyses provide further evidence that higher dietary GI and GL are associated with increased risk of T2D.
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Affiliation(s)
- Shilpa N Bhupathiraju
- From the Departments of Nutrition (SNB, DKT, VSM, AH, WCW, and FBH) and Epidemiology (JEM, WCW, and FBH), Harvard School of Public Health, Boston, MA; the Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (AP); the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEM); and the Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW and FBH)
| | - Deirdre K Tobias
- From the Departments of Nutrition (SNB, DKT, VSM, AH, WCW, and FBH) and Epidemiology (JEM, WCW, and FBH), Harvard School of Public Health, Boston, MA; the Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (AP); the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEM); and the Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW and FBH)
| | - Vasanti S Malik
- From the Departments of Nutrition (SNB, DKT, VSM, AH, WCW, and FBH) and Epidemiology (JEM, WCW, and FBH), Harvard School of Public Health, Boston, MA; the Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (AP); the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEM); and the Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW and FBH)
| | - An Pan
- From the Departments of Nutrition (SNB, DKT, VSM, AH, WCW, and FBH) and Epidemiology (JEM, WCW, and FBH), Harvard School of Public Health, Boston, MA; the Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (AP); the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEM); and the Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW and FBH)
| | - Adela Hruby
- From the Departments of Nutrition (SNB, DKT, VSM, AH, WCW, and FBH) and Epidemiology (JEM, WCW, and FBH), Harvard School of Public Health, Boston, MA; the Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (AP); the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEM); and the Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW and FBH)
| | - JoAnn E Manson
- From the Departments of Nutrition (SNB, DKT, VSM, AH, WCW, and FBH) and Epidemiology (JEM, WCW, and FBH), Harvard School of Public Health, Boston, MA; the Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (AP); the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEM); and the Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW and FBH)
| | - Walter C Willett
- From the Departments of Nutrition (SNB, DKT, VSM, AH, WCW, and FBH) and Epidemiology (JEM, WCW, and FBH), Harvard School of Public Health, Boston, MA; the Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (AP); the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEM); and the Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW and FBH)
| | - Frank B Hu
- From the Departments of Nutrition (SNB, DKT, VSM, AH, WCW, and FBH) and Epidemiology (JEM, WCW, and FBH), Harvard School of Public Health, Boston, MA; the Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (AP); the Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (JEM); and the Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (WCW and FBH)
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Hruby A, Meigs JB, O'Donnell CJ, Jacques PF, McKeown NM. Higher magnesium intake reduces risk of impaired glucose and insulin metabolism and progression from prediabetes to diabetes in middle-aged americans. Diabetes Care 2014; 37:419-27. [PMID: 24089547 PMCID: PMC3898748 DOI: 10.2337/dc13-1397] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To assess 7-year associations between magnesium intake and incident prediabetes and/or insulin resistance (IR), and progression from these states to type 2 diabetes. RESEARCH DESIGN AND METHODS In 2,582 community-dwelling participants 26-81 years old at baseline, magnesium intake and risk of incident "metabolic impairment," defined as impaired fasting glucose (FG) (≥5.6 to <7.0 mmol/L), impaired glucose tolerance (2-h postload glucose ≥7.8 to <11.1 mmol/L), IR, or hyperinsulinemia (≥90th percentile of homeostasis model assessment of IR or fasting insulin, respectively), was estimated among those with normal baseline status, and risk of incident diabetes was estimated among those with baseline metabolic impairment. In participants without incident diabetes, we examined magnesium intake in relation to 7-year changes in fasting and postload glucose and insulin, IR, and insulin sensitivity. RESULTS After adjusting for age, sex, and energy intake, compared with those with the lowest magnesium intake, those with the highest intake had 37% lower risk of incident metabolic impairment (P trend = 0.02), and in those with baseline metabolic impairment, higher intake was associated with 32% lower risk of incident diabetes (P trend = 0.05). In the combined population, the risk in those with the highest intake was 53% (P trend = 0.0004) of those with the lowest intake. Adjusting for risk factors and dietary fiber attenuated associations in the baseline normal population but did not substantially affect associations in the metabolically impaired. Higher magnesium intake tended to associate with lower follow-up FG and IR, but not fasting insulin, postload values, or insulin sensitivity. CONCLUSIONS Magnesium intake may be particularly beneficial in offsetting risk of developing diabetes among those at high risk. Magnesium's long-term associations with non-steady-state (dynamic) measures deserve further research.
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Hruby A, McKeown NM, Song Y, Djoussé L. Dietary magnesium and genetic interactions in diabetes and related risk factors: a brief overview of current knowledge. Nutrients 2013; 5:4990-5011. [PMID: 24322525 PMCID: PMC3875916 DOI: 10.3390/nu5124990] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 11/18/2013] [Accepted: 11/27/2013] [Indexed: 12/15/2022] Open
Abstract
Nutritional genomics has exploded in the last decade, yielding insights—both nutrigenomic and nutrigenetic—into the physiology of dietary interactions and our genes. Among these are insights into the regulation of magnesium transport and homeostasis and mechanisms underlying magnesium’s role in insulin and glucose handling. Recent observational evidence has attempted to examine some promising research avenues on interaction between genetics and dietary magnesium in relation to diabetes and diabetes risk factors. This brief review summarizes the recent evidence on dietary magnesium’s role in diabetes and related traits in the presence of underlying genetic risk, and discusses future potential research directions.
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Affiliation(s)
- Adela Hruby
- Department of Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Building 2, Boston, MA 02115, USA; E-Mail:
| | - Nicola M. McKeown
- Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, 9th Floor, Boston, MA 02111, USA; E-Mail:
| | - Yiqing Song
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, 714 N. Senate Avenue, Indianapolis, IN 46202, USA; E-Mail:
| | - Luc Djoussé
- Division of Aging, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, 1620 Tremont Street, 3rd Floor, Boston, MA 02120, USA
- Boston Veterans Affairs Healthcare System, Boston, MA 02130, USA
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-617-525-7591; Fax: +1-617-525-7739
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Hruby A, O'Donnell CJ, Jacques PF, Meigs JB, Hoffmann U, McKeown NM. Magnesium intake is inversely associated with coronary artery calcification: the Framingham Heart Study. JACC Cardiovasc Imaging 2013; 7:59-69. [PMID: 24290571 DOI: 10.1016/j.jcmg.2013.10.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/25/2013] [Accepted: 10/25/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim of this study was to examine whether magnesium intake is associated with coronary artery calcification (CAC) and abdominal aortic calcification (AAC). BACKGROUND Animal and cell studies suggest that magnesium may prevent calcification within atherosclerotic plaques underlying cardiovascular disease. Little is known about the association of magnesium intake and atherosclerotic calcification in humans. METHODS We examined cross-sectional associations of self-reported total (dietary and supplemental) magnesium intake estimated by food frequency questionnaire with CAC and AAC in participants of the Framingham Heart Study who were free of cardiovascular disease and underwent Multi-Detector Computed Tomography (MDCT) of the heart and abdomen (n = 2,695; age: 53 ± 11 years), using multivariate-adjusted Tobit regression. CAC and AAC were quantified using modified Agatston scores (AS). Models were adjusted for age, sex, body mass index, smoking status, systolic blood pressure, fasting insulin, total-to-high-density lipoprotein cholesterol ratio, use of hormone replacement therapy (women only), menopausal status (women only), treatment for hyperlipidemia, hypertension, cardiovascular disease prevention, or diabetes, as well as self-reported intake of calcium, vitamins D and K, saturated fat, fiber, alcohol, and energy. Secondary analyses included logistic regressions of CAC and AAC outcomes as cut-points (AS >0 and AS ≥90th percentile for age and sex), as well as sex-stratified analyses. RESULTS In fully adjusted models, a 50-mg/day increment in self-reported total magnesium intake was associated with 22% lower CAC (p < 0.001) and 12% lower AAC (p = 0.07). Consistent with these observations, the odds of having any CAC were 58% lower (p trend: <0.001) and any AAC were 34% lower (p trend: 0.01), in those with the highest compared to those with the lowest magnesium intake. Stronger inverse associations were observed in women than in men. CONCLUSIONS In community-dwelling participants free of cardiovascular disease, self-reported magnesium intake was inversely associated with arterial calcification, which may play a contributing role in magnesium's protective associations in stroke and fatal coronary heart disease.
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Affiliation(s)
- Adela Hruby
- Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts
| | - Christopher J O'Donnell
- National Heart, Lung, and Blood Institute (NHLBI) Division of Intramural Research, and NHLBI's Framingham Heart Study, Framingham, Massachusetts; Cardiovascular Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Paul F Jacques
- Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts
| | - James B Meigs
- Harvard Medical School, Boston, Massachusetts; General Medicine Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Udo Hoffmann
- Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital Cardiac MR PET CT Program and the Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Nicola M McKeown
- Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts.
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Hruby A, O'Donnell CJ, Jacques PF, Meigs JB, Wood RJ, McKeown NM. Associations of magnesium intake with coronary artery calcification in the Framingham Heart Study. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.622.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Adela Hruby
- Nutritional EpidemiologyJean Mayer USDA Human Nutrition Research Center on Aging at Tufts UniversityBostonMA
| | - Christopher J. O'Donnell
- Cardiovascular DivisionDepartment of MedicineMassachusetts General Hospital and Harvard Medical SchoolBostonMA
- National HeartLung and Blood Institute's Framingham Heart StudyFraminghamMA
| | - Paul F. Jacques
- Nutritional EpidemiologyJean Mayer USDA Human Nutrition Research Center on Aging at Tufts UniversityBostonMA
| | - James B. Meigs
- General Medicine DivisionDepartment of MedicineMassachusetts General Hospital and Harvard Medical SchoolBostonMA
| | | | - Nicola M. McKeown
- Nutritional EpidemiologyJean Mayer USDA Human Nutrition Research Center on Aging at Tufts UniversityBostonMA
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Hruby A, Ngwa JS, Renström F, Wojczynski MK, Ganna A, Hallmans G, Houston DK, Jacques PF, Kanoni S, Lehtimäki T, Lemaitre RN, Manichaikul A, North KE, Ntalla I, Sonestedt E, Tanaka T, van Rooij FJA, Bandinelli S, Djoussé L, Grigoriou E, Johansson I, Lohman KK, Pankow JS, Raitakari OT, Riserus U, Yannakoulia M, Zillikens MC, Hassanali N, Liu Y, Mozaffarian D, Papoutsakis C, Syvänen AC, Uitterlinden AG, Viikari J, Groves CJ, Hofman A, Lind L, McCarthy MI, Mikkilä V, Mukamal K, Franco OH, Borecki IB, Cupples LA, Dedoussis GV, Ferrucci L, Hu FB, Ingelsson E, Kähönen M, Kao WHL, Kritchevsky SB, Orho-Melander M, Prokopenko I, Rotter JI, Siscovick DS, Witteman JCM, Franks PW, Meigs JB, McKeown NM, Nettleton JA. Higher magnesium intake is associated with lower fasting glucose and insulin, with no evidence of interaction with select genetic loci, in a meta-analysis of 15 CHARGE Consortium Studies. J Nutr 2013; 143:345-53. [PMID: 23343670 PMCID: PMC3713023 DOI: 10.3945/jn.112.172049] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Favorable associations between magnesium intake and glycemic traits, such as fasting glucose and insulin, are observed in observational and clinical studies, but whether genetic variation affects these associations is largely unknown. We hypothesized that single nucleotide polymorphisms (SNPs) associated with either glycemic traits or magnesium metabolism affect the association between magnesium intake and fasting glucose and insulin. Fifteen studies from the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium provided data from up to 52,684 participants of European descent without known diabetes. In fixed-effects meta-analyses, we quantified 1) cross-sectional associations of dietary magnesium intake with fasting glucose (mmol/L) and insulin (ln-pmol/L) and 2) interactions between magnesium intake and SNPs related to fasting glucose (16 SNPs), insulin (2 SNPs), or magnesium (8 SNPs) on fasting glucose and insulin. After adjustment for age, sex, energy intake, BMI, and behavioral risk factors, magnesium (per 50-mg/d increment) was inversely associated with fasting glucose [β = -0.009 mmol/L (95% CI: -0.013, -0.005), P < 0.0001] and insulin [-0.020 ln-pmol/L (95% CI: -0.024, -0.017), P < 0.0001]. No magnesium-related SNP or interaction between any SNP and magnesium reached significance after correction for multiple testing. However, rs2274924 in magnesium transporter-encoding TRPM6 showed a nominal association (uncorrected P = 0.03) with glucose, and rs11558471 in SLC30A8 and rs3740393 near CNNM2 showed a nominal interaction (uncorrected, both P = 0.02) with magnesium on glucose. Consistent with other studies, a higher magnesium intake was associated with lower fasting glucose and insulin. Nominal evidence of TRPM6 influence and magnesium interaction with select loci suggests that further investigation is warranted.
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Affiliation(s)
- Adela Hruby
- Tufts University Friedman School of Nutrition Science and Policy, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Julius S. Ngwa
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Frida Renström
- Department of Nutrition, Harvard School of Public Health, Boston, MA,Department of Clinical Sciences, Lund University, Malmö, Sweden,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Mary K. Wojczynski
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Andrea Ganna
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Göran Hallmans
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
| | - Denise K. Houston
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Paul F. Jacques
- Tufts University Friedman School of Nutrition Science and Policy, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Stavroula Kanoni
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK,Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Terho Lehtimäki
- Fimlab Laboratories and University of Tampere, School of Medicine, and Tampere University Hospital, Tampere, Finland
| | - Rozenn N. Lemaitre
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA
| | - Ani Manichaikul
- Center for Public Health Genomics, and Division of Biostatistics and Epidemiology, Department of Public Health Sciences, University of Virginia, Charlottesville, VA
| | - Kari E. North
- Department of Epidemiology and Carolina Center for Genome Sciences, University of North Carolina, Chapel Hill, NC
| | - Ioanna Ntalla
- Clinical Research Branch, National Institute on Aging, Baltimore, MD
| | - Emily Sonestedt
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Toshiko Tanaka
- Clinical Research Branch, National Institute on Aging, Baltimore, MD
| | - Frank J. A. van Rooij
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands
| | | | - Luc Djoussé
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Massachusetts Veterans Epidemiology and Research Information Center and Geriatric Research, Education, and Clinical Center, Boston Veterans Affairs Healthcare System, Boston, MA
| | - Efi Grigoriou
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | | | - Kurt K. Lohman
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - James S. Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Olli T. Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, and Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Ulf Riserus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - M. Carola Zillikens
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands,Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Neelam Hassanali
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Yongmei Liu
- Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC
| | - Dariush Mozaffarian
- Department of Epidemiology and Nutrition, Harvard School of Public Health, Boston, MA; Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | - Ann-Christine Syvänen
- Department of Medical Sciences, Molecular Medicine and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - André G. Uitterlinden
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands,Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jorma Viikari
- Department of Medicine, University of Turku, and Turku University Hospital, Turku, Finland
| | - Christopher J. Groves
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands
| | - Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Mark I. McCarthy
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK,Oxford NIHR Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - Vera Mikkilä
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Kenneth Mukamal
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA
| | - Oscar H. Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands
| | - Ingrid B. Borecki
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - L. Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, MA,Framingham Heart Study, Framingham, MA
| | - George V. Dedoussis
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Luigi Ferrucci
- Clinical Research Branch, National Institute on Aging, Baltimore, MD
| | - Frank B. Hu
- Department of Nutrition, Harvard School of Public Health, Boston, MA
| | - Erik Ingelsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, and University of Tampere, Tampere, Finland
| | - W. H. Linda Kao
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | | | | | - Inga Prokopenko
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK,Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Jerome I. Rotter
- Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - David S. Siscovick
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA,Department of Epidemiology, University of Washington, Seattle, WA
| | - Jacqueline C. M. Witteman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands
| | - Paul W. Franks
- Department of Nutrition, Harvard School of Public Health, Boston, MA,Department of Clinical Sciences, Lund University, Malmö, Sweden,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - James B. Meigs
- Harvard Medical School and General Medicine Division, Clinical Epidemiology and Diabetes Research Units, Massachusetts General Hospital, Boston, MA; and
| | - Nicola M. McKeown
- Tufts University Friedman School of Nutrition Science and Policy, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA,To whom correspondence should be addressed. E-mail:
| | - Jennifer A. Nettleton
- Division of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health at The University of Texas Health Science Center–Houston, Houston, TX
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Nettleton JA, Hivert MF, Lemaitre RN, McKeown NM, Mozaffarian D, Tanaka T, Wojczynski MK, Hruby A, Djoussé L, Ngwa JS, Follis JL, Dimitriou M, Ganna A, Houston DK, Kanoni S, Mikkilä V, Manichaikul A, Ntalla I, Renström F, Sonestedt E, van Rooij FJA, Bandinelli S, de Koning L, Ericson U, Hassanali N, Kiefte-de Jong JC, Lohman KK, Raitakari O, Papoutsakis C, Sjogren P, Stirrups K, Ax E, Deloukas P, Groves CJ, Jacques PF, Johansson I, Liu Y, McCarthy MI, North K, Viikari J, Zillikens MC, Dupuis J, Hofman A, Kolovou G, Mukamal K, Prokopenko I, Rolandsson O, Seppälä I, Cupples LA, Hu FB, Kähönen M, Uitterlinden AG, Borecki IB, Ferrucci L, Jacobs DR, Kritchevsky SB, Orho-Melander M, Pankow JS, Lehtimäki T, Witteman JCM, Ingelsson E, Siscovick DS, Dedoussis G, Meigs JB, Franks PW. Meta-analysis investigating associations between healthy diet and fasting glucose and insulin levels and modification by loci associated with glucose homeostasis in data from 15 cohorts. Am J Epidemiol 2013; 177:103-15. [PMID: 23255780 DOI: 10.1093/aje/kws297] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Whether loci that influence fasting glucose (FG) and fasting insulin (FI) levels, as identified by genome-wide association studies, modify associations of diet with FG or FI is unknown. We utilized data from 15 U.S. and European cohort studies comprising 51,289 persons without diabetes to test whether genotype and diet interact to influence FG or FI concentration. We constructed a diet score using study-specific quartile rankings for intakes of whole grains, fish, fruits, vegetables, and nuts/seeds (favorable) and red/processed meats, sweets, sugared beverages, and fried potatoes (unfavorable). We used linear regression within studies, followed by inverse-variance-weighted meta-analysis, to quantify 1) associations of diet score with FG and FI levels and 2) interactions of diet score with 16 FG-associated loci and 2 FI-associated loci. Diet score (per unit increase) was inversely associated with FG (β = -0.004 mmol/L, 95% confidence interval: -0.005, -0.003) and FI (β = -0.008 ln-pmol/L, 95% confidence interval: -0.009, -0.007) levels after adjustment for demographic factors, lifestyle, and body mass index. Genotype variation at the studied loci did not modify these associations. Healthier diets were associated with lower FG and FI concentrations regardless of genotype at previously replicated FG- and FI-associated loci. Studies focusing on genomic regions that do not yield highly statistically significant associations from main-effect genome-wide association studies may be more fruitful in identifying diet-gene interactions.
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Affiliation(s)
- Jennifer A Nettleton
- Division of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, 1200 Herman Pressler Drive, Suite E-641, Houston, TX 77030, USA.
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Hruby A, Chomitz VR, Arsenault LN, Must A, Economos CD, McGowan RJ, Sacheck JM. Predicting maintenance or achievement of healthy weight in children: the impact of changes in physical fitness. Obesity (Silver Spring) 2012; 20:1710-7. [PMID: 22307068 PMCID: PMC4465563 DOI: 10.1038/oby.2012.13] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Physical fitness is often inversely associated with adiposity in children cross-sectionally, but the effect of becoming fit or maintaining fitness over time on changes in weight status has not been well studied in children. We investigated the impact of changes in fitness over 1-4 years of follow-up on the maintenance or achievement of healthy weight among 2,793 schoolchildren who were first measured as 1st to 7th graders. Students were classified as "fit" or "underfit" according to age- and gender-specific norms in five fitness domains: endurance, agility, flexibility, upper body strength, and abdominal strength. Weight status was dichotomized by BMI percentile: "healthy weight" (<85th percentile) or "overweight/obese" (≥85th percentile). At baseline, of the 38.3% overweight/obese children, 81.9% (N = 875) were underfit. Underfit overweight students were more likely to achieve healthy weight if they achieved fitness (boys: odds ratio (OR) = 2.68, 95% confidence interval (CI) = 1.24-5.77; girls: OR = 4.67, 95%CI = 2.09-10.45). Initially fit overweight children (N = 194) were more likely to achieve healthy weight if they maintained fitness (boys: OR = 11.99, 95%CI = 2.18-65.89; girls: OR = 2.46, 95%CI = 1.04-5.83). Similarly, initially fit healthy-weight children (N = 717) were more likely to maintain healthy weight if they maintained fitness (boys: OR 3.70, 95%CI = 1.40-9.78; girls: OR = 4.14, 95%CI = 1.95-8.78). Overweight schoolchildren who achieve or maintain physical fitness are more likely to achieve healthy weight, and healthy-weight children who maintain fitness are more likely to maintain healthy weight. School-based policies/practices that support physical fitness may contribute to obesity reduction and maintenance of healthy weight among schoolchildren.
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Affiliation(s)
- Adela Hruby
- Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Boston, Massachusetts, USA
| | - Virginia R. Chomitz
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
- Institute for Community Health, Cambridge, Massachusetts, USA
| | | | - Aviva Must
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Christina D. Economos
- Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Boston, Massachusetts, USA
| | | | - Jennifer M. Sacheck
- Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Boston, Massachusetts, USA
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Hruby A, Ngwa JS, Meigs JB, Nettleton JA, McKeown NM. Meta‐analysis of interaction between dietary magnesium intake and genetic risk variants on diabetes phenotypes in the CHARGE Consortium. FASEB J 2012. [DOI: 10.1096/fasebj.26.1_supplement.243.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Adela Hruby
- Friedman School of Nutrition Science and PolicyTufts UniversityBostonMA
- Nutritional EpidemiologyJean Mayer USDA Human Nutrition Research Center on Aging at Tufts UniversityBostonMA
| | - Julius S. Ngwa
- Department of BiostatisticsBoston University School of Public HealthBostonMA
| | - James B. Meigs
- General Medicine DivisionDepartment of MedicineMassachusetts General Hospital and Harvard Medical SchoolBostonMA
| | - Jennifer A. Nettleton
- Division of Epidemiology, Human Genetics and Environmental SciencesSchool of Public Health at The University of Texas Health Science Center - HoustonHoustonTX
| | - Nicola M. McKeown
- Friedman School of Nutrition Science and PolicyTufts UniversityBostonMA
- Nutritional EpidemiologyJean Mayer USDA Human Nutrition Research Center on Aging at Tufts UniversityBostonMA
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