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Hartman TJ, Christie J, Wilson A, Ziegler TR, Methe B, Flanders WD, Rolls BJ, Loye Eberhart B, Li JV, Huneault H, Cousineau B, Perez MR, O'Keefe SJD. Fibre-rich Foods to Treat Obesity and Prevent Colon Cancer trial study protocol: a randomised clinical trial of fibre-rich legumes targeting the gut microbiome, metabolome and gut transit time of overweight and obese patients with a history of noncancerous adenomatous polyps. BMJ Open 2024; 14:e081379. [PMID: 38316601 PMCID: PMC10860035 DOI: 10.1136/bmjopen-2023-081379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/15/2024] [Indexed: 02/07/2024] Open
Abstract
INTRODUCTION Recently published studies support the beneficial effects of consuming fibre-rich legumes, such as cooked dry beans, to improve metabolic health and reduce cancer risk. In participants with overweight/obesity and a history of colorectal polyps, the Fibre-rich Foods to Treat Obesity and Prevent Colon Cancer randomised clinical trial will test whether a high-fibre diet featuring legumes will simultaneously facilitate weight reduction and suppress colonic mucosal biomarkers of colorectal cancer (CRC). METHODS/DESIGN This study is designed to characterise changes in (1) body weight; (2) biomarkers of insulin resistance and systemic inflammation; (3) compositional and functional profiles of the faecal microbiome and metabolome; (4) mucosal biomarkers of CRC risk and (5) gut transit. Approximately 60 overweight or obese adults with a history of noncancerous adenomatous polyps within the previous 3 years will be recruited and randomised to one of two weight-loss diets. Following a 1-week run-in, participants in the intervention arm will receive preportioned high-fibre legume-rich entrées for two meals/day in months 1-3 and one meal/day in months 4-6. In the control arm, entrées will replace legumes with lean protein sources (eg, chicken). Both groups will receive in-person and written guidance to include nutritionally balanced sides with energy intake to lose 1-2 pounds per week. ETHICS AND DISSEMINATION The National Institutes of Health fund this ongoing 5-year study through a National Cancer Institute grant (5R01CA245063) awarded to Emory University with a subaward to the University of Pittsburgh. The study protocol was approved by the Emory Institutional Review Board (IRB approval number: 00000563). TRIAL REGISTRATION NUMBER NCT04780477.
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Affiliation(s)
- Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
- Nutrition and Health Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Jennifer Christie
- Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Annette Wilson
- Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Thomas R Ziegler
- Department of Medicine, Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Barbara Methe
- Pulmonary, Allergy and Critical Care Medicine, Center for the Microbiome and Medicine, University of Pittsburg, Pittsburgh, Pennsylvania, USA
| | - William Dana Flanders
- Department of Biostatistics and Bioinformatics, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Barbara J Rolls
- Department of Nutritional Sciences, The Pennsylvania State University, State College, Pennsylvania, USA
| | - Blaine Loye Eberhart
- Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jia V Li
- Section of Nutrition Research, Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Commonwealth Building, Hammersmith Hospital Campus, Imperial College London, South Kensington, London, UK
| | - Helaina Huneault
- Nutrition and Health Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Ben Cousineau
- Nutrition and Health Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Miriam R Perez
- Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Stephen J D O'Keefe
- Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Kwan ML, Valice E, Ergas IJ, Roh JM, Caan BJ, Cespedes Feliciano EM, Kolevska T, Hartman TJ, Quesenberry CP, Ambrosone CB, Kushi LH. Alcohol consumption and prognosis and survival in breast cancer survivors: The Pathways Study. Cancer 2023; 129:3938-3951. [PMID: 37555890 PMCID: PMC10840903 DOI: 10.1002/cncr.34972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/23/2023] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND The impact of alcohol consumption on breast cancer (BC) prognosis remains unclear. METHODS The authors examined short-term alcohol intake in relation to recurrence and mortality in 3659 women who were diagnosed with stage I-IV BC from 2003 to 2013 in the Pathways Study. Alcohol drinking in the past 6 months was assessed at cohort entry (mean, 2 months postdiagnosis) and 6 months later using a food-frequency questionnaire. Study end points were recurrence and death from BC, cardiovascular disease, and all causes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards models. RESULTS Over an average follow-up of 11.2 years, 524 recurrences and 834 deaths (369 BC-specific and 314 cardiovascular disease-specific) occurred. Compared with nondrinkers (36.9%), drinkers were more likely younger, more educated, and current or past smokers. Overall, alcohol consumption was not associated with recurrence or mortality. However, women with higher body mass index (BMI ≥ 30 kg/m2 ) had lower risk of overall mortality with increasing alcohol consumption for occasional drinking (HR, 0.71; 95% CI, 0.54-0.94) and regular drinking (HR, 0.77; 95% CI, 0.56-1.08) around the time of diagnosis, along with 6 months later, in a dose-response manner (p < .05). Women with lower BMI (<30 kg/m2 ) were not at higher risk of mortality but were at possibly higher, yet nonsignificant, risk of recurrence for occasional drinking (HR, 1.29; 95% CI, 0.97-1.71) and regular drinking (HR, 1.19; 95% CI, 0.88-1.62). CONCLUSIONS Alcohol drinking around the time of and up to 6 months after BC diagnosis was associated with lower risk of all-cause mortality in obese women. A possible higher risk of recurrence was observed in nonobese women.
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Affiliation(s)
- Marilyn L Kwan
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Emily Valice
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Isaac J Ergas
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Janise M Roh
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Bette J Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | | | - Tatjana Kolevska
- Department of Oncology, Kaiser Permanente Vallejo Medical Center, Vallejo, California, USA
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Charles P Quesenberry
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
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Bailey RL, Jun S, Cowan AE, Eicher-Miller HA, Gahche JJ, Dwyer JT, Hartman TJ, Mitchell DC, Seguin-Fowler RA, Carroll RJ, Tooze JA. Major Gaps in Understanding Dietary Supplement Use in Health and Disease. Annu Rev Nutr 2023; 43:179-197. [PMID: 37196365 PMCID: PMC11078263 DOI: 10.1146/annurev-nutr-011923-020327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 05/19/2023]
Abstract
Precise dietary assessment is critical for accurate exposure classification in nutritional research, typically aimed at understanding how diet relates to health. Dietary supplement (DS) use is widespread and represents a considerable source of nutrients. However, few studies have compared the best methods to measure DSs. Our literature review on the relative validity and reproducibility of DS instruments in the United States [e.g., product inventories, questionnaires, and 24-h dietary recalls (24HR)] identified five studies that examined validity (n = 5) and/or reproducibility (n = 4). No gold standard reference method exists for validating DS use; thus, each study's investigators chose the reference instrument used to measure validity. Self-administered questionnaires agreed well with 24HR and inventory methods when comparing the prevalence of commonly used DSs. The inventory method captured nutrient amounts more accurately than the other methods. Reproducibility (over 3 months to 2.4 years) of prevalence of use estimates on the questionnaires was acceptable for common DSs. Given the limited body of research on measurement error in DS assessment, only tentative conclusions on these DS instruments can be drawn at present. Further research is critical to advancing knowledge in DS assessment for research and monitoring purposes.
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Affiliation(s)
- Regan L Bailey
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Texas, USA;
| | - Shinyoung Jun
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Alexandra E Cowan
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Texas, USA;
| | | | - Jaime J Gahche
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland, USA
| | - Johanna T Dwyer
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland, USA
- Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Diane C Mitchell
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Texas, USA;
| | - Rebecca A Seguin-Fowler
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Texas, USA;
| | - Raymond J Carroll
- Department of Statistics, Texas A&M University, College Station, Texas, USA
| | - Janet A Tooze
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Troeschel AN, Hartman TJ, McCullough LE, Ergas IJ, Collin LJ, Kwan ML, Ambrosone CB, Flanders WD, Bradshaw PT, Feliciano EMC, Roh JM, Wang Y, Valice E, Kushi LH. Associations of Post-Diagnosis Lifestyle with Prognosis in Women with Invasive Breast Cancer. Cancer Epidemiol Biomarkers Prev 2023; 32:963-975. [PMID: 37079336 PMCID: PMC10330263 DOI: 10.1158/1055-9965.epi-22-1274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/05/2022] [Revised: 03/03/2023] [Accepted: 04/14/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Lifestyle habits can impact breast cancer development, but its impact on breast cancer prognosis remains unclear. We investigated associations of post-diagnosis lifestyle with mortality and recurrence in 1,964 women with invasive breast cancer enrolled in the Kaiser Permanente Northern California Pathways Study shortly after diagnosis with lifestyle information at baseline (2005-2013) and the 2-year follow-up. METHODS We calculated a post-diagnosis lifestyle score (range, 0-18) based on 9 diet, physical activity, and body weight recommendations from the American Cancer Society/American Society of Clinical Oncology (ACS/ASCO) using follow-up data (body weight also included baseline data); higher scores indicate greater guideline concordance. Similarly, we calculated a pre-diagnosis lifestyle score using baseline data to investigate pre- to post-diagnosis changes. We estimated hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazard models, with follow-up through December 2018 (observing 290 deaths and 176 recurrences). RESULTS The 2-year post-diagnosis lifestyle score was inversely associated with all-cause mortality (ACM; HR per 2-point increase = 0.90; 95% CI, 0.82-0.98), and breast cancer-related mortality (HR, 0.79; 95% CI, 0.67-0.95), but not recurrence. Relative to women who maintained low concordance with recommendations at both time points, women who maintained high concordance had a lower risk of ACM (HR, 0.61, 95% CI, 0.37-1.03). Improved concordance with some specific recommendations (particularly PA) may be associated with a lower hazard of ACM (HRPA, 0.52; 95% CI, 0.35-0.78). CONCLUSIONS Results suggest that women with breast cancer may benefit from a post-diagnosis lifestyle aligned with ACS/ASCO guidelines. IMPACT This information may potentially guide lifestyle recommendations for breast cancer survivors to reduce mortality risk.
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Affiliation(s)
- Alyssa N. Troeschel
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Terryl J. Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
- Winship Cancer Institute, Emory University, Atlanta, GA
| | - Lauren E. McCullough
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
- Winship Cancer Institute, Emory University, Atlanta, GA
| | - Isaac J. Ergas
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Lindsay J. Collin
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT
| | - Marilyn L. Kwan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | | | - W. Dana Flanders
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
- Winship Cancer Institute, Emory University, Atlanta, GA
| | - Patrick T. Bradshaw
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | | | - Janise M. Roh
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Ying Wang
- Department of Population Science, American Cancer Society, Atlanta, GA
| | - Emily Valice
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Lawrence H. Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
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Hartman TJ, Masters M, Flanders WD, Wang Y, Li M, Mitchell DC, Guinter M, Patel AV, McCullough ML. Self-Reported Eating-Occasion Frequency and Timing are Reproducible and Relatively Valid in the American Cancer Society Cancer Prevention Study-3 Diet Assessment Substudy. J Nutr 2023; 152:2827-2836. [PMID: 36055776 DOI: 10.1093/jn/nxac206] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 06/20/2022] [Revised: 08/12/2022] [Accepted: 08/29/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Accurate assessment of eating-occasion behaviors, such as timing, frequency, and consumption intervals, is important for evaluating associations with obesity and other chronic diseases. OBJECTIVES The main objective of this study was to assess the relative validity of a 24-hour grid approach to assess eating-occasion timing and frequency in comparison to data derived from repeated 24-hour dietary recalls (DRs). A second objective was to assess the 1-year test-retest reproducibility of the 24-hour grid. METHODS Between 2015 and 2016, 626 participants in the Cancer Prevention Study-3 (CPS-3) Diet Assessment Substudy (mean age, 52 years; age range, 31-70 years; 64% female; 64% non-Hispanic white, 22% non-Hispanic black, 14% Hispanic) completed 2 grids and up to 6 unannounced, telephone, interviewer-administered DRs over 1 year. Spearman correlations (ρ; 95% CIs) were calculated to assess reproducibility between the repeated eating-occasion grid-derived variables (e.g., numbers of snacks and meals per day, timing of eating occasions) and to assess relative validity by comparing the meal grid and DR-derived summary data separately for weekdays and weekend days. RESULTS Reproducibility correlations for eating-occasion variables derived from the eating-occasion grids completed 1 year apart were ≥0.5 for the majority of variables analyzed for both weekdays and weekend days, including numbers of snacks and meals per day and timing of the first and last eating occasions of the day. Relative validity was highest among weekday variables and was ≥0.5 for the majority of variables, with correlations ranging from ρ values of 0.32 (number of meals per day) to 0.68 (hour of the first eating occasion). CONCLUSIONS These findings suggest the eating-occasion grid used in CPS-3 has good reproducibility over 1 year and yields estimates comparable to those from a more detailed method of assessment of eating timing and frequency.
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Affiliation(s)
- Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Matthew Masters
- Behavioral and Epidemiology Research Program, American Cancer Society, Kennesaw, GA, USA
| | - W Dana Flanders
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Ying Wang
- Behavioral and Epidemiology Research Program, American Cancer Society, Kennesaw, GA, USA
| | - Mengyi Li
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Diane C Mitchell
- Diet Assessment Center, Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
| | - Mark Guinter
- Behavioral and Epidemiology Research Program, American Cancer Society, Kennesaw, GA, USA
| | - Alpa V Patel
- Behavioral and Epidemiology Research Program, American Cancer Society, Kennesaw, GA, USA
| | - Marjorie L McCullough
- Behavioral and Epidemiology Research Program, American Cancer Society, Kennesaw, GA, USA
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Adgent MA, Gebretsadik T, Elaiho CR, Milne GL, Moore P, Hartman TJ, Cowell W, Alcala CS, Bush N, Davis R, LeWinn KZ, Tylavsky FA, Wright RJ, Carroll KN. The association between prenatal F 2-isoprostanes and child wheeze/asthma and modification by maternal race. Free Radic Biol Med 2022; 189:85-90. [PMID: 35863687 PMCID: PMC9414072 DOI: 10.1016/j.freeradbiomed.2022.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 05/06/2022] [Revised: 06/24/2022] [Accepted: 07/12/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Childhood wheeze, asthma, and allergic rhinitis are common and likely have prenatal origins. Oxidative stress is associated with respiratory disease, but the association of oxidative stress during the prenatal period with development of respiratory and atopic disease in childhood, particularly beyond the infancy period, is unknown. This study aims to investigate associations between prenatal oxidative stress, measured by maternal urinary F2-isoprostanes, and child respiratory outcomes, including effect modification by maternal race. METHODS We prospectively studied Black (n = 717) and White (n = 363) mother-child dyads. We measured F2-isoprostanes in 2nd-trimester urine (ng/mg-creatinine). At approximately age 4, we obtained parent report of provider-diagnosed asthma (ever), current wheeze, current asthma (diagnosis, symptoms and/or medication), and current allergic rhinitis (current defined as previous 12 months). We used multivariable logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) per interquartile range (IQR) increase in F2-isoprostane concentration, controlling for confounders. We examined modification by maternal race using interaction terms. RESULTS The prevalence of provider-diagnosed asthma and current wheeze, asthma and allergic rhinitis was 14%, 19%, 15%, and 24%, respectively. Median (IQR) F2-isoprostane levels were 2.1 (1.6, 2.9) ng/mg-creatinine. Associations between prenatal F2-isoprostanes and provider-diagnosed asthma, current wheeze, and current asthma were modified by maternal race. Results were strongest for current wheeze (aOR [95%CI]: 1.55 [1.16, 2.06] for White; 0.98 [0.78, 1.22] for Black; p-interaction = 0.01). We observed no association between F2-isoprostanes and allergic rhinitis. CONCLUSION Prenatal urinary F2-isoprostanes may be a marker associated with childhood wheeze/asthma in certain populations. Research is needed to understand underlying mechanisms and racial differences.
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Affiliation(s)
- Margaret A Adgent
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tebeb Gebretsadik
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cordelia R Elaiho
- Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ginger L Milne
- Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paul Moore
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Terryl J Hartman
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Whitney Cowell
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cecilia S Alcala
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nicole Bush
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA; Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Robert Davis
- Center for Biomedical Informatics, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Kaja Z LeWinn
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Rosalind J Wright
- Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kecia N Carroll
- Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
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Tylavsky FA, Han L, Sims Taylor LM, Mason WA, Carroll KN, Bush NR, LeWinn KZ, Melough MM, Hartman TJ, Zhao Q. Oxidative Balance Score during Pregnancy Is Associated with Oxidative Stress in the CANDLE Study. Nutrients 2022; 14:2327. [PMID: 35684127 PMCID: PMC9182929 DOI: 10.3390/nu14112327] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 02/04/2023] Open
Abstract
The objective of this study was to calculate an oxidative balance score (OBS) utilizing diet and lifestyle information collected from 1322 women during the second trimester of pregnancy in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood study. An energy-adjusted OBS was calculated using nutrient information from a Food Frequency Questionnaire (FFQ), lifestyle measures, and plasma folate and vitamin D levels. Using the least absolute shrinkage and selection operator method, 91 food items from the FFQ were selected and they accounted for 82% of the variance in the OBS, with cruciferous vegetables, citrus fruits, fruit juice, and coffee being among the highest anti-oxidant predictors, and red meats and alcohol among the highest pro-oxidant contributors. Urinary F2-isoprostane, an objective indicator of oxidative stress, was lower with increasing OBS quintiles in a stairstep manner (p for trend = 0.0003), suggesting the possible utility of the OBS as an indicator of oxidative stress. The OBS was moderately correlated with the Healthy Eating Index (correlation coefficient = 0.6076), suggesting it provides a distinct measure of a healthy diet. In conclusion, the OBS may serve as a valid reflective indicator of urinary F2-isoprostanes and an epidemiological tool to inform intervention studies, in order to minimize oxidative stress during pregnancy.
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Affiliation(s)
- Frances A. Tylavsky
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (F.A.T.); (L.H.); (L.M.S.T.); (W.A.M.)
| | - Luhang Han
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (F.A.T.); (L.H.); (L.M.S.T.); (W.A.M.)
| | - Lauren M. Sims Taylor
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (F.A.T.); (L.H.); (L.M.S.T.); (W.A.M.)
| | - W. Alex Mason
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (F.A.T.); (L.H.); (L.M.S.T.); (W.A.M.)
| | - Kecia N. Carroll
- Division of General Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Nicole R. Bush
- Department of Psychiatry and Behavioral Health, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94118, USA; (N.R.B.); (K.Z.L.)
- Department of Pediatrics, University of California San Francisco, San Francisco, CA 94118, USA
| | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Health, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94118, USA; (N.R.B.); (K.Z.L.)
| | - Melissa M. Melough
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, WA 98121, USA;
| | - Terryl J. Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 303221, USA;
| | - Qi Zhao
- Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (F.A.T.); (L.H.); (L.M.S.T.); (W.A.M.)
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Marks KJ, Northstone K, Papadopoulou E, Brantsæter AL, Haug LS, Howards PP, Smarr MM, Flanders WD, Hartman TJ. Maternal dietary patterns during pregnancy and exposure to persistent endocrine disrupting chemicals in two European birth cohorts. Environ Adv 2021; 6:10.1016/j.envadv.2021.100130. [PMID: 35979229 PMCID: PMC9380587 DOI: 10.1016/j.envadv.2021.100130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Food consumption, particularly of animal-based products, is considered the most important contributor to persistent endocrine disrupting chemical (EDC) exposure. This study aims to describe the association between maternal diet during pregnancy and exposure to persistent EDCs using dietary pattern analysis. This study is based on subsamples of the Avon Longitudinal Study of Parents and Children (ALSPAC) (N=422) and the Norwegian Mother, Father, and Child Cohort Study (MoBa) (N=276) which uses data from the Medical Birth Registry of Norway (MBRN). Women in both studies completed food frequency questionnaires (FFQs) during pregnancy, from which consumption data were categorized into 38 aggregated food groups. Maternal blood samples were collected during pregnancy and concentrations of perfluoroalkyl substances (PFAS), polychlorinated biphenyls (PCBs), and organochlorine pesticides (OCPs) in serum/plasma were measured. Dietary patterns were identified using reduced rank regression, with blood EDC concentrations as response variables. Within ALSPAC, all patterns (PFAS, PCB, and OCP) were characterized by high consumption of meat, poultry, white fish, and biscuits. In MoBa, high consumption of sausages and burgers (representing processed meats), pasta, and chocolate bars characterized PCB and OCP dietary patterns, while high consumption of cheese characterized the PFAS pattern. Across both cohorts, PFAS patterns were characterized by high consumption of cheese, PCB patterns by high consumption of rice, and OCP patterns by poultry. Dietary patterns explained between 8 and 20% of the variation in serum EDC concentrations, with explained variance being the highest for PCBs in both cohorts. In conclusion, dietary patterns high in animal-based products appear to be associated with persistent EDC concentrations among pregnant women. Diet explains more variation in PCB concentrations than for other persistent EDC classes.
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Affiliation(s)
- Kristin J. Marks
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, Georgia 30322, United States
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, Georgia 30341, United States
- Oak Ridge Institute for Science and Education, 100 ORAU Way, Oak Ridge, Tennessee 37830, United States
| | - Kate Northstone
- Department of Population Health Sciences, Bristol Medical School, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom
| | - Eleni Papadopoulou
- Department of Environmental Health, Norwegian Institute of Public Health, P.O. Box 222, NO-0213 Skoyen, Oslo, Norway
| | - Anne Lise Brantsæter
- Department of Environmental Health, Norwegian Institute of Public Health, P.O. Box 222, NO-0213 Skoyen, Oslo, Norway
| | - Line Småstuen Haug
- Department of Environmental Health, Norwegian Institute of Public Health, P.O. Box 222, NO-0213 Skoyen, Oslo, Norway
| | - Penelope P. Howards
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, Georgia 30322, United States
| | - Melissa M. Smarr
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, Georgia 30322, United States
| | - W. Dana Flanders
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, Georgia 30322, United States
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, Georgia 30341, United States
| | - Terryl J. Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, Georgia 30322, United States
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, Georgia 30341, United States
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Marks KJ, Howards PP, Smarr MM, Flanders WD, Northstone K, Daniel JH, Sjödin A, Calafat AM, Hartman TJ. Prenatal exposure to mixtures of persistent endocrine disrupting chemicals and postnatal body size in British girls. Early Hum Dev 2021; 161:105450. [PMID: 34418724 PMCID: PMC8464514 DOI: 10.1016/j.earlhumdev.2021.105450] [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: 02/09/2021] [Revised: 07/02/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Endocrine disrupting chemical (EDC) exposure is ubiquitous. EDC exposure during critical windows of development may interfere with the body's endocrine system, affecting growth. Previous human studies have examined one EDC at a time in relation to infant growth. By studying mixtures, the human experience can be better approximated. AIMS We investigated the association of prenatal exposure to persistent EDCs (per- and polyfluoroalkyl substances (PFAS), polychlorinated biphenyls (PCBs), and organochlorine pesticides (OCPs)) as mixtures with postnatal body size among female offspring. SUBJECTS We used a sub-sample of the Avon Longitudinal Study of Parents and Children (N = 425), based in the United Kingdom. STUDY DESIGN We quantified 52 EDCs in maternal serum collected during pregnancy. We used Bayesian kernel machine regression with a random intercept to examine the association of prenatal concentrations of EDC mixtures with longitudinal postnatal body size measures for each EDC class separately (PFAS, PCBs, and OCPs) and for all three classes combined. OUTCOME MEASURES Weight and height measures at 0, 2, 9, and 19 months were obtained by health professionals as part of routine child health surveillance. RESULTS The mixture representing all three classes combined (31 chemicals) (n = 301) was inversely associated with postnatal body size. Holding all EDCs in the 31-chemical mixture at the 75th percentile compared to the 50th percentile was associated with 0.15 lower weight-for-age z-score (95% credible interval -0.26, -0.03). Weak inverse associations were also seen for height-for-age and body mass index-for-age scores. CONCLUSIONS These results suggest that prenatal exposure to mixtures of persistent EDCs may affect postnatal body size.
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Affiliation(s)
- Kristin J. Marks
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, Georgia 30322, United States,Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, Georgia 30341, United States,Oak Ridge Institute for Science and Education, 100 ORAU Way, Oak Ridge, Tennessee 37830, United States,Corresponding author: Kristin J. Marks, PhD, MPH, Mailstop S106-6, 4770 Buford Hwy NE, Atlanta, GA 30341, 770-488-3414,
| | - Penelope P. Howards
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, Georgia 30322, United States
| | - Melissa M. Smarr
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, Georgia 30322, United States
| | - W. Dana Flanders
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, Georgia 30322, United States,Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, Georgia 30341, United States
| | - Kate Northstone
- Department of Population Health Sciences, Bristol Medical School, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom
| | - Johnni H. Daniel
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, Georgia 30341, United States
| | - Andreas Sjödin
- Division Of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, Georgia 30341, United States
| | - Antonia M. Calafat
- Division Of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, Georgia 30341, United States
| | - Terryl J. Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, Georgia 30322, United States,Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, Georgia 30341, United States
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Hartman TJ, Wang Y, Hodge RA, Mitchell DC, Flanders WD, Li C, Sampson L, Troeschel AN, Patel AV, McCullough ML. Self-Reported Dietary Supplement Use Is Reproducible and Relatively Valid in the Cancer Prevention Study-3 Diet Assessment Substudy. J Acad Nutr Diet 2021; 122:1665-1676.e2. [PMID: 34399975 DOI: 10.1016/j.jand.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/01/2021] [Accepted: 07/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Dietary supplement use is common, particularly among cancer survivors and those at increased risk for cancer. OBJECTIVE The objectives of this study were to assess 1-year test-retest reproducibility of dietary supplement use reported via food frequency questionnaire (FFQ-1 vs FFQ-2) and relative validity in comparison to repeated 24-hour dietary recalls (FFQ-2 vs DRs). DESIGN This ancillary study was conducted within a large prospective cohort, the American Cancer Society's Cancer Prevention Study-3. PARTICIPANTS/SETTING Between 2015 and 2016, 684 participants in the United States (64% women; 62% non-Hispanic White, 23% non-Hispanic Black, and 15% Hispanic) completed two FFQs and up to six unannounced telephone interviewer-administered DRs over 1 year as part of the Cancer Prevention Study-3 Diet Assessment Substudy. PRIMARY OUTCOME MEASURES FFQs queried current multivitamin-mineral supplement (≥10 components) use, frequency and dose (range) for seven supplements taken individually or as part of a complex (individual/complex) including calcium, vitamins D, C, and E, folic acid, fish oil, and glucosamine. DRs allowed exact reporting of supplement frequency and dose. STATISTICAL ANALYSES Weighted κ statistics were used to evaluate reproducibility between FFQ-1 and FFQ-2 and Spearman correlation coefficients assessed agreement between supplemental nutrient amounts assessed by FFQ-2 and the average of DRs. RESULTS Just more than half of the participants reported taking multivitamin-mineral supplements on the baseline FFQ. Kappa statistics for the comparison of categorical responses between FFQ-1 and FFQ-2 were 0.67 for multivitamin-mineral supplements. Kappas for individual/complex supplements ranged from 0.47 for folic acid to 0.74 for vitamin D, with a mean of 0.64. Results were similar between men and women. Spearman correlation coefficients comparing FFQ-2 with the average of DRs (validity) for nutrient intakes from all sources ranged from 0.65 (fish oil for women) to 0.77 (vitamin D for men and calcium for women); results were similar among men and women. CONCLUSIONS These findings suggest the FFQ used in Cancer Prevention Study-3 has good reproducibility over 1 year and yields estimates comparable to a more detailed assessment for commonly consumed dietary supplements.
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Marks KJ, Howards PP, Smarr MM, Flanders WD, Northstone K, Daniel JH, Sjödin A, Calafat AM, Hartman TJ. Prenatal Exposure to Mixtures of Persistent Endocrine-disrupting Chemicals and Birth Size in a Population-based Cohort of British Girls. Epidemiology 2021; 32:573-582. [PMID: 33767116 PMCID: PMC8159871 DOI: 10.1097/ede.0000000000001351] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Indexed: 01/18/2023]
Abstract
BACKGROUND Previous studies of endocrine-disrupting chemicals have examined one of these chemicals at a time in association with an outcome; studying mixtures better approximates human experience. We investigated the association of prenatal exposure to mixtures of persistent endocrine disruptors (perfluoroalkyl and polyfluoroalkyl substances [PFAS], polychlorinated biphenyls [PCBs], and organochlorine pesticides) with birth size among female offspring in the Avon Longitudinal Study of Parents and Children (ALSPAC), based in the United Kingdom in 1991-1992. METHODS We quantified concentrations of 52 endocrine-disrupting chemicals in maternal serum collected during pregnancy at median 15-week gestation. Birth weight, crown-to-heel length, and head circumference were measured at birth; ponderal index and small for gestational age were calculated from these. We used repeated holdout Weighted Quantile Sum (WQS) regression and Bayesian kernel machine regression to examine mixtures in 313 mothers. RESULTS Using WQS regression, all mixtures (each chemical class separately and all three together) were inversely associated with birth weight. A one-unit increase in WQS index (a one-decile increase in chemical concentrations) for all three classes combined was associated with 55 g (β = -55 g, 95% confidence interval [CI] = -89, -22 g) lower birth weight. Associations were weaker but still inverse using Bayesian kernel machine regression. Under both methods, PFAS were the most important contributors to the association with birth weight. We also observed inverse associations for crown-to-heel length. CONCLUSIONS These results are consistent with the hypothesis that prenatal exposure to mixtures of persistent endocrine-disrupting chemicals affects birth size.
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Affiliation(s)
- Kristin J Marks
- From the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Penelope P Howards
- From the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Melissa M Smarr
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - W Dana Flanders
- From the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kate Northstone
- Department of Population Health Sciences, Bristol Medical School, Oakfield House, Oakfield Grove, Bristol, United Kingdom
| | - Johnni H Daniel
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Andreas Sjödin
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Terryl J Hartman
- From the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
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Hartman TJ, Fung JL, Hsiao PY, Fan W, Mitchell DC, Goldman MB. Dietary Energy Density and Fertility: Results from the Lifestyle and Fertility Study. Curr Dev Nutr 2021; 5:nzab075. [PMID: 34084994 PMCID: PMC8163416 DOI: 10.1093/cdn/nzab075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/20/2021] [Accepted: 04/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Diet is a modifiable lifestyle factor linked with fertility in a growing number of studies. OBJECTIVE The objective of this study was to evaluate the association between dietary energy density (ED), a summary measure of diet quality that estimates the amount of energy per unit food (kcal/g) consumed, and conception and pregnancy outcomes. METHODS A prospective cohort study of couples planning their first pregnancy was conducted in the Northeast region of the USA. Dietary data were collected prior to conception via 3 unannounced interviewer-administered 24-h dietary recalls. Multivariable-adjusted logistic regression (ORs and Cox proportional hazards models [RR] and 95% CIs) were estimated for continuous and categorical (tertile [T]) variables of dietary ED. RESULTS The majority of women (n = 80; 61%) achieved clinical pregnancy. Median time to conception of a clincal pregnancy(TTC) for those who conceived was 4.64 mo with an IQR of 4.37 mo. ED modeled as a continuous variable was not associated with clinical pregnancy, live birth, or TTC after controlling for race, physical activity, and male partner's ED. When ED was categorized to consider nonlinear associations, 60%, 73%, and 50% of the participants in the tertiles (from lowest ED to highest) achieved clinical pregnancy. In multivariable logistic analyses with the middle group as the referent (ED = 1.37-1.60), membership in the highest ED group (ED >1.60) was associated with lower odds of clinical pregnancy (OR = 0.30; 95% CI: 0.11, 0.81, P = 0.02). In Cox proportional hazards analyses, membership in the highest ED group was associated with significantly longer TTC compared with the middle category (HR = 0.41; 95% CI: 0.21,0.82, P = 0.01). CONCLUSIONS These results suggest that high dietary ED is associated with reduced fertility.This study evaluated associations between dietary energy density and the probability of conceiving clinical pregnancy, having a live birth, and the time to conception among couples planning pregnancy.
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Affiliation(s)
- Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA, USA
- Emory Prevention Research Center , Atlanta, GA, USA
| | - June L Fung
- Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Pao Ying Hsiao
- Department of Food and Nutrition, Indiana University of Pennsylvania, Indiana, PA, USA
| | - Wenyi Fan
- Department of Biostatistics, Emory University, Atlanta, GA, USA
| | - Diane C Mitchell
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Marlene B Goldman
- Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
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13
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Marks KJ, Howards PP, Smarr MM, Flanders WD, Northstone K, Daniel JH, Calafat AM, Sjödin A, Marcus M, Hartman TJ. Prenatal exposure to mixtures of persistent endocrine disrupting chemicals and early menarche in a population-based cohort of British girls. Environ Pollut 2021; 276:116705. [PMID: 33592441 PMCID: PMC8111784 DOI: 10.1016/j.envpol.2021.116705] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 01/29/2021] [Accepted: 02/05/2021] [Indexed: 05/11/2023]
Abstract
Exposure to endocrine disrupting chemicals (EDCs) is ubiquitous. EDC exposure, especially during critical periods of development like the prenatal window, may interfere with the body's endocrine system, which can affect growth and developmental outcomes such as puberty. Most studies have examined one EDC at a time in relation to disease; however, humans are exposed to many EDCs. By studying mixtures, the human experience can be more closely replicated. We investigated the association of prenatal exposure to persistent EDCs (poly- and perfluoroalkyl substances (PFAS), polychlorinated biphenyls (PCBs), and organochlorine pesticides (OCPs)) as mixtures with early menarche among female offspring in a nested case-control study within the Avon Longitudinal Study of Parents and Children (ALSPAC) recruited in the United Kingdom in 1991-1992. Concentrations of 52 EDCs were quantified in maternal serum samples collected during pregnancy. Daughter's age at menarche was ascertained through mailed questionnaires sent annually. We used repeated holdout weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) to examine the association between prenatal exposure to multiple EDCs and early menarche (<11.5 (n = 218) vs. ≥11.5 years (n = 230)) for each chemical class separately (PFAS, PCBs, and OCPs) and for all three classes combined. Models adjusted for maternal age at menarche, maternal education, parity, pre-pregnancy body mass index, maternal age, prenatal smoking, and gestational week at sample collection. Mixture models showed null associations between prenatal exposure to EDC mixtures and early menarche. Using WQS regression, the odds ratio for early menarche for a one-decile increase in chemical concentrations for all three classes combined was 0.89 (95% CI: 0.76, 1.05); using BKMR, the odds ratio when all exposures were at the 60th percentile compared to the median was 0.98 (95% CI: 0.91, 1.05). Results suggest the overall effect of prenatal exposure to persistent EDC mixtures is not associated with early menarche.
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Affiliation(s)
- Kristin J Marks
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States; National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States; Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States.
| | - Penelope P Howards
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Melissa M Smarr
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - W Dana Flanders
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States; National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kate Northstone
- Department of Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
| | - Johnni H Daniel
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Andreas Sjödin
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Michele Marcus
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States; National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
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14
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McCullough ML, Wang Y, Hartman TJ, Hodge RA, Flanders WD, Stevens VL, Sampson L, Mitchell DC, Patel AV. The Cancer Prevention Study-3 FFQ Is a Reliable and Valid Measure of Nutrient Intakes among Racial/Ethnic Subgroups, Compared with 24-Hour Recalls and Biomarkers. J Nutr 2021; 151:636-648. [PMID: 33484132 DOI: 10.1093/jn/nxaa358] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 07/27/2020] [Revised: 08/26/2020] [Accepted: 10/15/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Valid assessment of dietary intake in diverse populations is important for studies of chronic disease risk in the United States. OBJECTIVES We evaluated the reproducibility and validity of a food frequency questionnaire (FFQ) modified for the American Cancer Society's Cancer Prevention Study-3 (CPS-3) prospective cohort, among a racially/ethnically diverse subgroup. METHODS The Diet Assessment Substudy included 677 CPS-3 participants (64% women; 61% non-Hispanic white, 24% non-Hispanic black, 15% Hispanic), aged 31-70 y, who completed 2 FFQs 1 y apart (FFQ1, FFQ2), 4-6 telephone-administered 24-h dietary recalls (24HRs), and 2 fasting blood samples and 24-h urine collections ∼6 mo apart in the interim. Spearman rank correlation coefficients (ρ) were used to evaluate FFQ reproducibility and validity compared with 24HRs for 67 nutrient exposures. For 18 of these nutrients, we used the method of triads to calculate validity coefficients (VCs, ρ) from pairwise correlations of FFQ2, 24HRs, and biomarkers. Analyses were stratified by sex, race/ethnicity, education, and BMI. RESULTS Mean (range) FFQ reproducibility correlations were ρ = 0.65 (0.50-0.91) for men and ρ = 0.63 (0.37-0.89) for women; mean (range) energy-adjusted, deattenuated correlations of FFQ2 with 24HRs were ρ = 0.60 (0.33-0.84) for men and ρ = 0.55 (0.21-0.79) for women. FFQ2 VCs (ρ) among men ranged from 0.42 for β-cryptoxanthin to 0.91 for omega-3 (n-3) fatty acids and, among women, from 0.41 for sodium to 0.79 for total vitamin D. Mean FFQ reproducibility and validity were highest among whites (ρ = 0.68, ρ = 0.58, respectively) and slightly lower among blacks (ρ = 0.57, ρ = 0.49, respectively) and Hispanics (ρ = 0.59, 0.55, respectively). FFQ reproducibility and validity were slightly lower among those with less than a 4-y college degree, and those with a BMI ≥30 kg/m2. CONCLUSIONS Reproducibility and validity of the CPS-3 FFQ were comparable with similar studies for most nutrients, among all subgroups. These findings support future dietary analyses in the contemporary CPS-3 cohort and other similar cohorts.
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Affiliation(s)
| | - Ying Wang
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health Emory University, Atlanta, GA, USA.,Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Rebecca A Hodge
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - W Dana Flanders
- Department of Epidemiology, Rollins School of Public Health Emory University, Atlanta, GA, USA.,Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Victoria L Stevens
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Laura Sampson
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Diane C Mitchell
- Dietary Assessment Center, Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
| | - Alpa V Patel
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
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15
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Dennis KK, Judd SE, Alvarez JA, Kahe K, Jones DP, Hartman TJ. Plant food intake is associated with lower cadmium body burden in middle-aged adults. Eur J Nutr 2021; 60:3365-3374. [PMID: 33615415 DOI: 10.1007/s00394-021-02513-3] [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] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 02/05/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Dietary intake is a primary source of cadmium (Cd) exposure in the non-smoking population. Plant foods containing metal-binding plant compounds such as polyphenols, phytates, and phytochelatins may reduce Cd bioavailability and result in lower Cd body burden. In this study, we investigated the association between plant food intake and urinary creatinine-adjusted Cd (uCd), a well-established marker of Cd body burden. METHODS Participants were from a cross-sectional sample of 1901 adults in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Dietary intake was assessed with a food frequency questionnaire. We created a 12-point plant food score (PFS) based on reported intake across seven categories (fruits, vegetables, legumes, nuts/seeds, whole grains, tea, and wine). Higher scores indicated higher consumption and diversity of plant food intake. Multivariable linear regression models were used to estimate the association between PFS and uCd. Due to the influence of age and smoking on Cd status, stratified analyses were conducted. RESULTS Mean PFS was 5.4 (SD 2.2) and mean uCd was 0.53 µg/g creatinine (SD 0.39). In adjusted models, PFS was not associated with uCd (p > 0.05). In stratified analyses, PFS was inversely associated with uCd (p = 0.047) with a 1-point higher PFS associated with 0.018 µg/g lower uCd among middle-aged (45-59) adults. No significant association was observed between PFS and uCd in older (≥ 60) adults. The association of PFS and uCd did not differ by smoking status. CONCLUSION Our findings suggest higher plant food intake is associated with lower Cd body burden in middle-aged but not older adults.
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Affiliation(s)
- Kristine K Dennis
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA
| | - Suzanne E Judd
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jessica A Alvarez
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA.,Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Ka Kahe
- Epidemiology and Obstetrics and Gynecology, Columbia University Irving Medical Center, New York City, NY, USA
| | - Dean P Jones
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA.,Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Terryl J Hartman
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA. .,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Micklesfield LK, Hanson SK, Lobelo F, Cunningham SA, Hartman TJ, Norris SA, Stein AD. Adolescent physical activity, sedentary behavior and sleep in relation to body composition at age 18 years in urban South Africa, Birth-to-Twenty+ Cohort. BMC Pediatr 2021; 21:30. [PMID: 33430834 PMCID: PMC7798220 DOI: 10.1186/s12887-020-02451-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 04/12/2020] [Accepted: 12/01/2020] [Indexed: 01/18/2023] Open
Abstract
Background Adolescence is marked by a decline in physical activity, rapid physical growth and changes in body composition, which have been linked to body composition. Prospective data on these associations are rare, particularly in Africa. Aim The aim of this study was to examine the association of longitudinal patterns across adolescent in physical activity, sedentary behavior and sleep, with anthropometry and body composition at age 18 years in urban South Africa. Methods We analyzed data from the Birth-to-Twenty Plus Cohort (Bt20+), a longitudinal study of children born in 1990 in Soweto-Johannesburg, South Africa. We used general linear models to investigate the association of adolescent (ages 12 to 18 years) longitudinal trends in physical activity, sedentary behavior and schoolnight sleep and overall physical activity patterns, with body mass index (BMI), waist circumference, fat mass index (FMI), lean mass index (LMI) and percent body fat at age 18 years. Results The final study sample included 1337 participants with anthropometric measurements (52% female) and 958 participants with body composition measurements (53% female). Males who were consistently more active and consistently walked to school over adolescence had lower waist circumference (B = − 2.0, 95% CI: − 3.9 to − 0.2), FMI (B = − 0.8, 95%: CI: − 1.2 to − 0.1) and percent body fat (B = -2.9, 95% CI: − 4.9 to − 0.9) at age 18 years than those who decreased activity and did not walk to school. Consistently-sedentary females had higher waist circumference than those whose sedentary behavior increased over adolescence (B = 5.4, 95% CI: 0.2 to 10.6). Males who reported sleeping 9 h or more per night on schoolnights had significantly lower BMI (B = -1.0, 95% CI: − 1.4 to- 0.5), and percent body fat (B = -1.5, 95%CI − 2.8 to − 0.1) than those who reported sleeping 8 h or less per night. Conclusion Patterns of adolescent physical activity, sedentary behavior and sleep are related to young-adult body composition in urban South Africa. These modifiable behaviors may be paths for public health interventions to curb overweight and obesity in many low- or middle-income countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-020-02451-9.
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Affiliation(s)
- Lisa K Micklesfield
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sara K Hanson
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA
| | - Felipe Lobelo
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Solveig A Cunningham
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Shane A Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. .,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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17
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Bellissimo MP, Bettermann EL, Tran PH, Crain BH, Ferranti EP, Binongo JN, Hartman TJ, Jones DP, Ziegler TR, Alvarez JA. Physical Fitness but Not Diet Quality Distinguishes Lean and Normal Weight Obese Adults. J Acad Nutr Diet 2020; 120:1963-1973.e2. [PMID: 33011149 PMCID: PMC7686254 DOI: 10.1016/j.jand.2020.07.020] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 06/27/2020] [Accepted: 07/19/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Individuals with normal weight obesity (NWO) have increased cardiometabolic disease and mortality risk, but factors contributing to NWO development are unknown. OBJECTIVE The objective of this study was to determine whether diet quality scores and physical fitness levels differed between adults classified as lean, NWO, and overweight-obese. Secondary objectives of the study were to compare clinical biomarkers and food groups and macronutrient intakes between the three groups, and to test for associations between body composition components with diet quality scores and physical fitness levels. DESIGN This is a secondary data analysis from a cross-sectional study that included metropolitan university and health care system employees. Body composition was measured by dual energy x-ray absorptiometry. Individuals with a body mass index <25 kg/m2 and body fat >23% for men and >30% for women were classified as having NWO. Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension score, and Mediterranean Diet Score were calculated from Block food frequency questionnaires. Physical fitness was assessed by measuring maximal oxygen uptake (VO2 maximum) during treadmill testing. PARTICIPANTS/SETTING This study included 693 adults (65% women, mean age 48.9 ± 11.5 years) enrolled between 2007 and 2013 in Atlanta, GA. MAIN OUTCOME MEASURES The main outcome measures were Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension, and Mediterranean Diet Score diet quality scores and maximal oxygen uptake. STATISTICAL ANALYSES Multiple linear regression analyses with post hoc comparisons were used to investigate group differences in fitness, diet quality, and biomarkers. Regression analyses were also used to examine relationships between diet quality scores and fitness with body composition. RESULTS VO2 maximum was significantly lower in the NWO compared with the lean group (36.2 ± 0.8 mL/min/kg vs 40.2 ± 1.0 mL/min/kg; P < 0.05). Individuals with NWO reported similar diet quality to lean individuals and more favorable Alternate Healthy Eating Index and Dietary Approaches to Stop Hypertension scores than individuals with overweight-obesity (P < 0.05). Diet quality scores and physical fitness levels were inversely associated with percent body fat and visceral adipose tissue (P < 0.05), regardless of weight status. Individuals with NWO exhibited higher fasting blood insulin concentrations, insulin resistance, low-density lipoprotein cholesterol, and triglyceride levels, and significantly lower high-density lipoprotein cholesterol levels than lean individuals (P < 0.05). CONCLUSIONS Physical fitness was significantly decreased in individuals with NWO compared with lean individuals. Higher diet quality was associated with decreased total and visceral fat but did not distinguish individuals with NWO from lean individuals.
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Affiliation(s)
- Moriah P. Bellissimo
- Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University; Atlanta, GA, USA
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
- Emory Center for Clinical and Molecular Nutrition, Emory University; Atlanta, GA, USA
| | - Erika L. Bettermann
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
| | - Phong H. Tran
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
| | - Benjamin H. Crain
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
| | - Erin P. Ferranti
- Nell Hodgson School of Nursing, Emory University; Atlanta, GA, USA
| | - Jose N. Binongo
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University; Atlanta, GA, USA
| | - Terryl J. Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University; Atlanta, GA, USA
| | - Dean P. Jones
- Emory Center for Clinical and Molecular Nutrition, Emory University; Atlanta, GA, USA
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
- Clinical Biomarkers Laboratory, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
| | - Thomas R. Ziegler
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
- Emory Center for Clinical and Molecular Nutrition, Emory University; Atlanta, GA, USA
- Section of Endocrinology, Atlanta Veterans Affairs Medical Center; Decatur, GA, USA
| | - Jessica A. Alvarez
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
- Emory Center for Clinical and Molecular Nutrition, Emory University; Atlanta, GA, USA
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18
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Wang Y, Hodge RA, Stevens VL, Hartman TJ, McCullough ML. Identification and Reproducibility of Plasma Metabolomic Biomarkers of Habitual Food Intake in a US Diet Validation Study. Metabolites 2020; 10:metabo10100382. [PMID: 32993181 PMCID: PMC7600452 DOI: 10.3390/metabo10100382] [Citation(s) in RCA: 16] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/14/2020] [Accepted: 09/22/2020] [Indexed: 12/12/2022] Open
Abstract
Previous metabolomic studies have identified putative blood biomarkers of dietary intake. These biomarkers need to be replicated in other populations and tested for reproducibility over time for the potential use in future epidemiological studies. We conducted a metabolomics analysis among 671 racially/ethnically diverse men and women included in a diet validation study to examine the correlation between >100 food groups/items (101 by a food frequency questionnaire (FFQ), 105 by 24-h diet recalls (24HRs)) with 1141 metabolites measured in fasting plasma sample replicates, six months apart. Diet–metabolite associations were examined by Pearson’s partial correlation analysis. Biomarker reproducibility was assessed using intraclass correlation coefficients (ICCs). A total of 677 diet–metabolite associations were identified after Bonferroni adjustment for multiple comparisons and restricting absolute correlation coefficients to greater than 0.2 (601 associations using the FFQ and 395 using 24HRs). The median ICCs of the 238 putative biomarkers was 0.56 (interquartile range 0.46–0.68). In this study, with repeated FFQs, 24HRs and plasma metabolic profiles, we identified several potentially novel food biomarkers and replicated others found in our previous study. Our findings contribute to the growing literature on food-based biomarkers and provide important information on biomarker reproducibility which could facilitate their utilization in future nutritional epidemiological studies.
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Affiliation(s)
- Ying Wang
- Department of Population Science, American Cancer Society, Atlanta, GA 30303, USA; (R.A.H.); (V.L.S.); (M.L.M.)
- Correspondence: ; Tel.: +1-404-329-4341
| | - Rebecca A. Hodge
- Department of Population Science, American Cancer Society, Atlanta, GA 30303, USA; (R.A.H.); (V.L.S.); (M.L.M.)
| | - Victoria L. Stevens
- Department of Population Science, American Cancer Society, Atlanta, GA 30303, USA; (R.A.H.); (V.L.S.); (M.L.M.)
| | - Terryl J. Hartman
- Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA;
| | - Marjorie L. McCullough
- Department of Population Science, American Cancer Society, Atlanta, GA 30303, USA; (R.A.H.); (V.L.S.); (M.L.M.)
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19
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Gapstur SM, Gaudet MM, Wang Y, Hodge RA, Um CY, Hartman TJ, McCullough ML. Coffee Consumption and Invasive Breast Cancer Incidence among Postmenopausal Women in the Cancer Prevention Study-II Nutrition Cohort. Cancer Epidemiol Biomarkers Prev 2020; 29:2383-2386. [PMID: 32817071 DOI: 10.1158/1055-9965.epi-20-1051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/05/2020] [Accepted: 08/10/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND There is limited evidence of a potential inverse association between coffee, particularly caffeinated coffee, consumption and postmenopausal breast cancer risk, and few studies have examined this association by tumor hormone receptor status. To provide further evidence, we examined total, caffeinated, and decaffeinated coffee consumption in relation to postmenopausal invasive breast cancer incidence overall, and by tumor estrogen receptor (ER) and/or progesterone receptor (PR) subtype. METHODS Among 57,075 postmenopausal women in the Cancer Prevention Study-II Nutrition Cohort who were cancer free and reported coffee intake in 1999, we identified 2,980 women diagnosed with invasive breast cancer during follow-up through June 2015. Multivariable-adjusted Cox proportional hazards regression was used to compute hazard ratios (HR) and 95% confidence intervals (CI). RESULTS Neither total, caffeinated, nor decaffeinated coffee consumption was associated with invasive breast cancer risk; HRs (95% CIs) comparing consumption of ≥2 cups per day with <1 cup per month were 0.99 (0.89-1.11), 0.96 (0.87-1.06), and 1.06 (0.95-1.19), respectively. Similarly, coffee consumption was not associated with risk of hormone receptor-positive (ER+ or PR+) or hormone receptor-negative (ER- and PR-) breast tumors. CONCLUSIONS These findings do not support an association between coffee consumption and invasive breast cancer risk among postmenopausal women. IMPACT This large prospective study contributes to the limited evidence on coffee consumption and breast cancer risk, finding no association overall or by tumor receptor subtype.
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Affiliation(s)
- Susan M Gapstur
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Mia M Gaudet
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Ying Wang
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Rebecca A Hodge
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Caroline Y Um
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, Georgia
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20
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Byrd DA, Judd S, Flanders WD, Hartman TJ, Fedirko V, Bostick RM. Associations of Novel Dietary and Lifestyle Inflammation Scores with Incident, Sporadic Colorectal Adenoma. Cancer Epidemiol Biomarkers Prev 2020; 29:2300-2308. [PMID: 32856603 DOI: 10.1158/1055-9965.epi-20-0568] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/02/2020] [Accepted: 08/05/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Colorectal carcinogenesis is mechanistically linked to inflammation and is highly associated with diet and lifestyle factors that may affect chronic inflammation. We previously developed dietary (DIS) and lifestyle (LIS) inflammation scores, comprising inflammation biomarker-weighted components, to characterize the collective contributions of 19 food groups and four lifestyle exposures to systemic inflammation. Both scores were more strongly directly associated with circulating inflammation biomarkers in three validation populations, including a subset of the study population described below, than were the previously reported dietary inflammatory index and empirical dietary inflammatory pattern. METHODS We calculated the DIS and LIS in three pooled case-control studies of incident, sporadic colorectal adenoma (N = 765 cases and 1,986 controls) with extensive dietary and lifestyle data, and investigated their associations with adenoma using multivariable unconditional logistic regression. RESULTS For those in the highest (more proinflammatory) relative to the lowest (more anti-inflammatory) quintiles of the DIS and LIS, the multivariable-adjusted ORs were 1.31 [95% confidence interval (CI), 0.98-1.75; P trend = 0.09] and 1.98 (95% CI, 1.48-2.66; P trend < 0.001), respectively. These associations were strongest for adenomas with high-risk characteristics and among men. Those in the highest relative to the lowest joint DIS/LIS quintile had a 2.65-fold higher odds (95% CI, 1.77-3.95) of colorectal adenoma. CONCLUSIONS These results support that diets and lifestyles with higher balances of pro- to anti-inflammatory exposures may be associated with higher risk for incident, sporadic colorectal adenoma. IMPACT Our findings support further investigation of the DIS and LIS in relation to colorectal neoplasms.
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Affiliation(s)
- Doratha A Byrd
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Suzanne Judd
- Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama
| | - W Dana Flanders
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia.,Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Terryl J Hartman
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia.,Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Veronika Fedirko
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia.,Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Roberd M Bostick
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia. .,Winship Cancer Institute, Emory University, Atlanta, Georgia
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21
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Troeschel AN, Hartman TJ, Jacobs EJ, Stevens VL, Gansler T, Flanders WD, McCullough LE, Wang Y. Postdiagnosis Body Mass Index, Weight Change, and Mortality From Prostate Cancer, Cardiovascular Disease, and All Causes Among Survivors of Nonmetastatic Prostate Cancer. J Clin Oncol 2020; 38:2018-2027. [PMID: 32250715 PMCID: PMC8265380 DOI: 10.1200/jco.19.02185] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2020] [Indexed: 01/05/2023] Open
Abstract
PURPOSE To investigate the association of postdiagnosis body mass index (BMI) and weight change with prostate cancer-specific mortality (PCSM), cardiovascular disease-related mortality (CVDM), and all-cause mortality among survivors of nonmetastatic prostate cancer. METHODS Men in the Cancer Prevention Study II Nutrition Cohort diagnosed with nonmetastatic prostate cancer between 1992 and 2013 were followed for mortality through December 2016. Current weight was self-reported on follow-up questionnaires approximately every 2 years. Postdiagnosis BMI was obtained from the first survey completed 1 to < 6 years after diagnosis. Weight change was the difference in weight between the first and second postdiagnosis surveys. Deaths occurring within 4 years of the follow-up were excluded to reduce bias from reverse causation. Analyses of BMI and weight change included 8,330 and 6,942 participants, respectively. RESULTS Postdiagnosis BMI analyses included 3,855 deaths from all causes (PCSM, n = 500; CVDM, n = 1,155). Using Cox proportional hazards models, hazard ratios (HRs) associated with postdiagnosis obesity (BMI ≥ 30 kg/m2) compared with healthy weight (BMI 18.5 to < 25.0 kg/m2) were 1.28 for PCSM (95% CI, 0.96 to 1.67), 1.24 for CVDM (95% CI, 1.03 to 1.49), and 1.23 for all-cause mortality (95% CI, 1.11 to 1.35). Weight gain analyses included 2,973 deaths (PCSM, n = 375; CVDM, n = 881). Postdiagnosis weight gain (> 5% of body weight), compared with stable weight (± < 3%), was associated with a higher risk of PCSM (HR, 1.65; 95% CI, 1.21 to 2.25) and all-cause mortality (HR, 1.27; 95% CI, 1.12 to 1.45) but not CVDM. CONCLUSION Results suggest that among survivors of nonmetastatic prostate cancer with largely localized disease, postdiagnosis obesity is associated with higher CVDM and all-cause mortality, and possibly higher PCSM, and that postdiagnosis weight gain may be associated with a higher mortality as a result of all causes and prostate cancer.
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Affiliation(s)
- Alyssa N. Troeschel
- Department of Epidemiology, Rollins School of Public Health and the Laney Graduate School, Emory University, Atlanta, GA
| | - Terryl J. Hartman
- Department of Epidemiology, Rollins School of Public Health and the Laney Graduate School, Emory University, Atlanta, GA
| | - Eric J. Jacobs
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Victoria L. Stevens
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Ted Gansler
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - W. Dana Flanders
- Department of Epidemiology, Rollins School of Public Health and the Laney Graduate School, Emory University, Atlanta, GA
| | - Lauren E. McCullough
- Department of Epidemiology, Rollins School of Public Health and the Laney Graduate School, Emory University, Atlanta, GA
| | - Ying Wang
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
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22
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Troeschel AN, Hartman TJ, Flanders WD, Wang Y, Hodge RA, McCullough LE, Mitchell DC, Sampson L, Patel AV, McCullough ML. The American Cancer Society Cancer Prevention Study-3 FFQ Has Reasonable Validity and Reproducibility for Food Groups and a Diet Quality Score. J Nutr 2020; 150:1566-1578. [PMID: 32232407 DOI: 10.1093/jn/nxaa082] [Citation(s) in RCA: 14] [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: 12/03/2019] [Revised: 01/24/2020] [Accepted: 03/09/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND FFQs are commonly used to assess dietary intake and it is important to evaluate their performance in the target population. OBJECTIVE We evaluated the reproducibility and relative validity of the Cancer Prevention Study-3 (CPS-3) FFQ in estimating usual intake of 63 food groups and diet quality in accordance with the American Cancer Society dietary guidelines for cancer prevention. METHODS A subset of participants from the CPS-3 (433 women, 244 men), 31-70 y of age, were included in a cross-sectional diet assessment substudy (2015-2016). Reproducibility was assessed by comparing estimates from repeat FFQs, approximately 1 y apart, using Spearman correlation coefficient (rs) and Pearson correlation coefficient (rp) correlations for food groups and diet quality, respectively. Validity was assessed similarly by comparing FFQ estimates with estimates from ≤6 interviewer-administered 24-h dietary recall (24HR). Analyses were stratified by sex and race/ethnicity. RESULTS Reproducibility correlations for repeated FFQs were > 0.50 for 83-97% of food groups analyzed across strata of sex and race. Although participants tended to overreport plant foods (e.g., fruits and legumes) and underreport refined grains and sugar-sweetened beverages, the median energy-adjusted, deattenuated Spearman correlations comparing the second FFQ to the 24HR were 0.50 and 0.52 among men and women (range: 0.05-0.82), respectively, suggesting that ranking was preserved for most food groups. Validity was highest for coffee, alcohol, and total dairy, and lowest for pasta and regular-fat yogurt. Median validity across food groups varied by race/ethnicity and was highest among whites (rs = 0.54) followed by Hispanics (rs = 0.49) and African Americans (rs = 0.45). The diet quality score had good validity in all subgroups examined, but was higher among men (rp = 0.69) than women (rp = 0.61), and lower among whites (rp = 0.62) than Hispanics (rp = 0.64) or African Americans (rp = 0.73). CONCLUSIONS This study indicates good reproducibility and validity of the CPS-3 FFQ for most major food groups and the diet quality score in all sex and race/ethnicity groups examined.
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Affiliation(s)
- Alyssa N Troeschel
- Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University, Atlanta, GA
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University, Atlanta, GA.,Winship Cancer Institute, Emory University, Atlanta, GA
| | - W Dana Flanders
- Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University, Atlanta, GA.,Winship Cancer Institute, Emory University, Atlanta, GA
| | - Ying Wang
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Rebecca A Hodge
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Lauren E McCullough
- Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University, Atlanta, GA.,Winship Cancer Institute, Emory University, Atlanta, GA
| | - Diane C Mitchell
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Laura Sampson
- Nutrition Department, Harvard School of Public Health, Boston, MA
| | - Alpa V Patel
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
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23
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Byrd DA, Judd SE, Flanders WD, Hartman TJ, Fedirko V, Agurs-Collins T, Bostick RM. Associations of Novel Dietary and Lifestyle Inflammation Scores With Incident Colorectal Cancer in the NIH-AARP Diet and Health Study. JNCI Cancer Spectr 2020; 4:pkaa009. [PMID: 32455332 PMCID: PMC7236782 DOI: 10.1093/jncics/pkaa009] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/27/2020] [Accepted: 02/28/2020] [Indexed: 12/13/2022] Open
Abstract
Background Chronically higher inflammation, likely contributed to by dietary and lifestyle exposures, may increase risk for colorectal cancer (CRC). To address this, we investigated associations of novel dietary (DIS) and lifestyle (LIS) inflammation scores with incident CRC in the prospective National Institutes of Health–American Association of Retired Persons Diet and Health Study (N = 453 465). Methods The components of our previously developed and externally validated 19-component DIS and 4-component LIS were weighted based on their strengths of associations with a panel of circulating inflammation biomarker concentrations in a diverse subset (N = 639) of participants in the REasons for Geographic and Racial Differences in Stroke Study cohort. We calculated the components and applied their weights in the National Institutes of Health-American Association of Retired Persons cohort at baseline, summed the weighted components (higher scores reflect a higher balance of proinflammatory exposures), and investigated associations of the scores with incident CRC using Cox proportional hazards regression. All statistical tests were two-sided. Results Over a mean 13.5 years of follow-up, 10 336 participants were diagnosed with CRC. Among those in the highest relative to the lowest DIS and LIS quintiles, the multivariable-adjusted hazards ratios (HRs) and their 95% confidence intervals (CIs) were HR = 1.27 (95% CI = 1.19 to 1.35; Ptrend < .001) and 1.38 (95% CI = 1.30 to 1.48; Ptrend < .001), respectively. The associations were stronger among men and for colon cancers. The hazards ratio for those in the highest relative to the lowest joint DIS and LIS quintile was HR = 1.83 (95% CI = 1.68 to 1.99; Pinteraction < .001). Conclusions Aggregates of proinflammatory dietary and lifestyle exposures may be associated with higher risk for CRC.
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Affiliation(s)
- Doratha A Byrd
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Suzanne E Judd
- Department of Biostatistics, University of Alabama, Birmingham School of Public Health, Birmingham, AL, USA
| | - W Dana Flanders
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Terryl J Hartman
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Veronika Fedirko
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | | | - Roberd M Bostick
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA.,Winship Cancer Institute, Emory University, Atlanta, GA, USA
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24
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Gardner KG, Gebretsadik T, Hartman TJ, Rosa MJ, Tylavsky FA, Adgent MA, Moore PE, Kocak M, Bush NR, Davis RL, Lewinn KZ, Wright RJ, Carroll KN. Prenatal Omega-3 and Omega-6 Polyunsaturated Fatty Acids and Childhood Atopic Dermatitis. J Allergy Clin Immunol Pract 2020; 8:937-944. [PMID: 31626989 PMCID: PMC7064417 DOI: 10.1016/j.jaip.2019.09.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/16/2019] [Accepted: 09/19/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Atopic dermatitis is a common childhood disease, potentially influenced by prenatal nutritional exposures such as polyunsaturated fatty acids (PUFAs). OBJECTIVE In a racially diverse cohort, we hypothesized that childhood atopic dermatitis would be associated with higher prenatal omega-6 (n-6) and lower omega-3 (n-3) PUFAs. METHODS We included mother-child dyads, births 2006 to 2011, enrolled in the University of Tennessee Health Sciences Center Conditions Affecting Neurocognitive Development in Early Childhood cohort. Primary exposures included second trimester plasma n-3 and n-6 PUFA status and the ratio of the two (n-6:n-3). We assessed child current atopic dermatitis symptoms in the previous 12 months at age approximately 4 to 6 years. We investigated the association between PUFA exposures and atopic dermatitis using multivariable logistic regression, adjusting for potential confounders. We assessed for effect modification by maternal prenatal smoking, atopic disease history, and child sex. RESULTS Among 1131 women, 67% were African American and 42% had an atopic disease history; 17% of children had atopic dermatitis. Higher prenatal n-6 PUFAs were associated with increased relative odds of child atopic dermatitis (adjusted odds ratio: 1.25; confidence interval: 1.01-1.54 per interquartile range difference), and interaction models demonstrated that this association was seen in dyads in which the women had a history of atopic disease. Neither prenatal n-3 PUFAs nor n-6:n-3 were associated with child atopic dermatitis. CONCLUSION In this racially diverse cohort, higher second trimester n-6 PUFAs were associated with atopic dermatitis in children of women with atopy. PUFAs may represent a modifiable risk factor for atopic dermatitis, particularly in individuals with a familial predisposition.
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Affiliation(s)
- Kourtney G Gardner
- Division of Allergy, Immunology, and Pulmonology, Vanderbilt University Medical Center, Nashville, Tenn; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn
| | - Tebeb Gebretsadik
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tenn
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Ga
| | - Maria J Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, NY; Institute of Exposomic Research, Icahn School of Medicine at Mount Sinai, New York City, NY
| | - Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tenn
| | - Margaret A Adgent
- Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn
| | - Paul E Moore
- Division of Allergy, Immunology, and Pulmonology, Vanderbilt University Medical Center, Nashville, Tenn; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tenn
| | - Nicole R Bush
- Department of Psychiatry, University of California, San Francisco, Calif; Department of Pediatrics, University of California, San Francisco, Calif
| | - Robert L Davis
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tenn
| | - Kaja Z Lewinn
- Department of Psychiatry, University of California, San Francisco, Calif
| | - Rosalind J Wright
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, NY; Institute of Exposomic Research, Icahn School of Medicine at Mount Sinai, New York City, NY
| | - Kecia N Carroll
- Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn.
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Rosa MJ, Hartman TJ, Adgent M, Gardner K, Gebretsadik T, Moore PE, Davis RL, LeWinn KZ, Bush NR, Tylavsky F, Wright RJ, Carroll KN. Prenatal polyunsaturated fatty acids and child asthma: Effect modification by maternal asthma and child sex. J Allergy Clin Immunol 2019; 145:800-807.e4. [PMID: 31809758 DOI: 10.1016/j.jaci.2019.10.039] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/08/2019] [Accepted: 10/25/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Findings on prenatal polyunsaturated fatty acid (PUFA) intake and child wheeze and asthma have been inconsistent. OBJECTIVE We sought to examine associations between prenatal PUFA status and child wheeze/asthma and modifying effects of maternal asthma/atopy, child sex, and maternal race. METHODS Analyses included 1019 mother-child dyads with omega-3 (n-3) and omega-3 (n-6) PUFAs measured in second-trimester plasma; n-6/n-3 ratios were calculated. Child wheeze/asthma outcomes ascertained at age 4 to 6 years included ever physician-diagnosed asthma, current wheeze (symptoms past 12 months), current asthma (diagnosis and medication and/or symptoms past 12 months), and current diagnosed asthma. Each PUFA indicator and outcome was analyzed in separate models using modified Poisson regression with interaction terms. RESULTS In quartile (Q) analyses, higher n-6 PUFAs were associated with increased risk of ever (risk ratio [RR] high vs low [RR Q4 vs Q1], 1.70; 95% CI, 1.07-2.71) and current (RR Q4 vs Q1, 1.70; 95% CI, 1.07-2.71) diagnosed asthma, whereas n-3 PUFAs were associated with lower risk (RR Q4 vs Q1, 0.59; 95% CI, 0.33-1.03) of current diagnosed asthma (Ptrend < .05 for all). Higher n-6 PUFAs were associated with a higher risk of all respiratory outcomes among children born to women with asthma (Pinteraction < .05 for all outcomes). A significant 3-way interaction between child sex, maternal asthma, and n-6/n-3 PUFA indicated that male children born to women with asthma and a higher ratio had the highest risk across wheeze/asthma outcomes (Pinteraction < .05). CONCLUSIONS Associations between prenatal PUFA status and childhood wheeze/asthma were modified by maternal history of asthma and child sex.
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Affiliation(s)
- Maria José Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Ga
| | - Margaret Adgent
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn
| | - Kourtney Gardner
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn
| | - Tebeb Gebretsadik
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tenn
| | - Paul E Moore
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn
| | - Robert L Davis
- Center for Biomedical Informatics, University of Tennessee Health Sciences Center, Memphis, Tenn
| | - Kaja Z LeWinn
- Department of Psychiatry, Weill Institute for the Neurosciences, University of California San Francisco, San Francisco, Calif
| | - Nicole R Bush
- Department of Psychiatry, Weill Institute for the Neurosciences, University of California San Francisco, San Francisco, Calif; Department of Pediatrics, University of California San Francisco, San Francisco, Calif
| | - Frances Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center in Memphis, Memphis, Tenn
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY; Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kecia N Carroll
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn
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Wang A, Jeddy Z, Sjodin A, Taylor EV, Marks KJ, Hartman TJ. Prenatal exposure to Polychlorinated Biphenyls and body fatness in girls. Chemosphere 2019; 236:124315. [PMID: 31325828 PMCID: PMC8900658 DOI: 10.1016/j.chemosphere.2019.07.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/02/2019] [Accepted: 07/05/2019] [Indexed: 06/10/2023]
Abstract
Polychlorinated biphenyls (PCBs) are synthetic, organochlorine compounds previously used in industrial processes. Although banned in 1980's across Europe, these chemicals persist in the environment and are associated with adverse health outcomes in children. We investigated the association between in utero concentrations of PCBs and girls' body fatness. Concentrations of various PCB congeners (PCB 118, PCB 138, PCB 153, PCB 170, and PCB 180) were measured in maternal serum samples collected in the early 1990's. Body fatness was measured in the daughters at 9 y of age using body mass index (BMI) and dual-energy x-ray absorptiometry (DXA) for percent body fat. Using multivariable linear regression, we explored associations between prenatal PCB congener concentrations and body fatness outcomes. Among 339 mother-daughter dyads, the median and interquartile range (IQR) for PCB congeners ranged between 15.0 ng g-1 (11.0-20.8) for PCB 118 to 64.6 ng g-1 (48.6-86.3) for PCB 153. Among daughters, the median was 27.5% (21.7-34.6) for percent body fat, 39.6% (36.4-43.5) for percent trunk fat, 4.9 kg m-2 (3.5-7.0) for fat mass index and 18.1 kg m-2 (16.3-20.6) for body mass index. Multivariable-adjusted regression analyses showed little or no association between prenatal PCB concentrations with daughters' body fatness measures. Prenatal concentrations of PCB congeners were not strongly associated with measures of body fatness in girls.
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Affiliation(s)
- Alice Wang
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA; National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Zuha Jeddy
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA; Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
| | - Andreas Sjodin
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Ethel V Taylor
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Kristin J Marks
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA; Emory University Rollins School of Public Health, Atlanta, GA, USA.
| | - Terryl J Hartman
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA; Emory University Rollins School of Public Health, Atlanta, GA, USA.
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Byrd DA, Judd SE, Flanders WD, Hartman TJ, Fedirko V, Bostick RM. Development and Validation of Novel Dietary and Lifestyle Inflammation Scores. J Nutr 2019; 149:2206-2218. [PMID: 31373368 PMCID: PMC6887697 DOI: 10.1093/jn/nxz165] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [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: 01/14/2019] [Revised: 04/03/2019] [Accepted: 06/19/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Chronically higher inflammation, which may partly result from diet and lifestyle, is implicated in risk for multiple chronic diseases. The dietary inflammatory index (DII) and empirical dietary inflammatory pattern (EDIP), developed to characterize dietary contributions to systemic inflammation, have several limitations. There are no scores to characterize contributions of lifestyle to inflammation. OBJECTIVES To reflect dietary/lifestyle contributions to inflammation, we developed novel, inflammation biomarker panel-weighted, dietary (DIS) and lifestyle (LIS) inflammation scores in a subset (n = 639) of the Reasons for Geographic and Racial Differences in Stroke Study (REGARDS) cohort. METHODS We selected a priori 19 food groups and 4 lifestyle characteristics to comprise the DIS and LIS, respectively. We calculated the components' weights based on their strengths of association with an inflammation biomarker score [comprising high-sensitivity C-reactive protein (hsCRP), IL-6, IL-8, and IL-10] using multivariable linear regression. The sums of the weighted components constitute the scores, such that higher scores reflect, on balance, more proinflammatory exposures. We calculated the DIS, LIS, DII, and EDIP with cross-sectional data from the remaining REGARDS cohort ( n = 14,210 with hsCRP measurements) and 2 other study populations with hsCRP and/or an 8-component inflammation biomarker panel, and investigated their associations with circulating inflammation biomarker concentrations using multivariable logistic regression. RESULTS In REGARDS, those in the highest relative to the lowest DIS, LIS, DII, and EDIP quintiles had statistically significant 1.66-, 4.29-, 1.56-, and 1.32-fold higher odds of a high hsCRP concentration (>3 mg/dL), respectively (all P-trend < 0.001). Those in the highest relative to the lowest joint DIS/LIS quintile had a statistically significant 7.26-fold higher odds of a high hsCRP concentration. Similar findings were noted in the other 2 validation populations. CONCLUSION Our results support that dietary and lifestyle exposures collectively contribute substantially to systemic inflammation, and support the use of our novel DIS and LIS.
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Affiliation(s)
- Doratha A Byrd
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Suzanne E Judd
- Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - W Dana Flanders
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Terryl J Hartman
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Veronika Fedirko
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Roberd M Bostick
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
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Cioffi CE, Welsh JA, Alvarez JA, Hartman TJ, Narayan KMV, Vos MB. Associations of Added Sugar from All Sources and Sugar-Sweetened Beverages with Regional Fat Deposition in US Adolescents: NHANES 1999-2006. Curr Dev Nutr 2019; 3:nzz130. [PMID: 32154500 PMCID: PMC7053569 DOI: 10.1093/cdn/nzz130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/24/2019] [Accepted: 11/07/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The relative distribution of upper- versus lower-body fat may be an important determinant of cardiometabolic disease risk in youths. Dietary components associated with adolescent regional body fat distribution require further investigation. OBJECTIVE To evaluate associations of added sugar intake overall and from sugar-sweetened beverages (SSBs) with relative upper-body fat deposition in US adolescents. METHODS This was a cross-sectional analysis of data from 6585 adolescents (aged 12-19 y) in the NHANES cycles 1999-2006. Trunk, leg, and total fat mass were assessed by DXA. Participants were grouped into categories of total and SSB added sugar intake as a percentage of total energy intake (TEI) in 5% increments. Stepwise multivariable linear regression was used to examine associations of added sugar intake with truncal-to-leg fat ratio (TLR) and truncal-to-total fat ratio (TTR). RESULTS There were no associations of total added sugar intake with TLR or TTR. For SSB added sugar, compared with the lowest category of intake (<2% TEI), the highest category (>22% TEI) was associated with higher log-TLR [β (95% CI): >22% TEI versus <2% TEI: 0.05 (0.01, 0.09)] and TTR [1.30 (0.53, 2.07)] in the partially adjusted model with sex, age, race/ethnicity, income, physical activity, and smoking status as covariates (P-trend = 0.0001 for both). When BMI z-score and TEI were added as covariates, the magnitude of the associations were attenuated, but remained significant [log-TLR β (95% CI): 0.03 (0.005, 0.06), P-trend = 0.0018; TTR β (95% CI): 0.75 (0.27, 1.23), P-trend = 0.0004]. CONCLUSIONS These findings support that added sugar from beverages is associated with higher upper-body adiposity, though the magnitude and clinical significance of the associations may be small, especially when adjusted for BMI and TEI. Additional studies are needed to elucidate the underlying biological mechanisms to explain these findings.
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Affiliation(s)
- Catherine E Cioffi
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
| | - Jean A Welsh
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Gastroenterology, Hepatology, and Nutrition, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Jessica A Alvarez
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Terryl J Hartman
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - K M Venkat Narayan
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Miriam B Vos
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Gastroenterology, Hepatology, and Nutrition, Children's Healthcare of Atlanta, Atlanta, GA, USA
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Donley GM, Taylor E, Jeddy Z, Namulanda G, Hartman TJ. Association between in utero perfluoroalkyl substance exposure and anti-Müllerian hormone levels in adolescent females in a British cohort. Environ Res 2019; 177:108585. [PMID: 31376627 PMCID: PMC8919509 DOI: 10.1016/j.envres.2019.108585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/21/2019] [Accepted: 07/12/2019] [Indexed: 05/04/2023]
Abstract
Evidence indicates that in utero environmental exposures could influence reproduction in female offspring. Perfluoroalkyl substances (PFAS) are synthetic, ubiquitous endocrine disrupting chemicals that can cross the placental barrier. Lower levels of anti-Müllerian hormone (AMH), a biomarker of ovarian reserve, are associated with reduced fertility. We investigated the association between in utero PFAS exposure and AMH levels in female adolescents using data from the Avon Longitudinal Study of Parents and Children, a British pregnancy cohort recruited between 1991 and 1992. Maternal serum samples were collected during pregnancy and analyzed for concentrations of commonly found PFAS-perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA). AMH levels were measured in serum of female offspring (mean age, 15.4 years) and log-transformed for analyses. We used a sample of 446 mother-daughter dyads for multivariable linear regression analyses, controlling for maternal age at delivery, pre-pregnancy body-mass index, and maternal education. Multiple imputation was utilized to impute missing values of AMH (61.2%) and covariates. Median PFAS concentrations (ng/mL) were as follows: PFOS 19.8 (IQR:15.1, 24.9), PFOA 3.7 (IQR: 2.8, 4.8), PFHxS 1.6 (IQR: 1.2, 2.2), PFNA 0.5 (IQR: 0.4, 0.7). The geometric mean AMH concentration was 3.9 ng/mL (95% CI: 3.8, 4.0). After controlling for confounders, mean differences in AMH per one ng/mL higher PFOA, PFOS, PFHxS, and PFNA were 3.6% (95% CI: 1.4%, 8.6%), 0.7% (95% CI: 0.2%, 1.5%), 0.9% (95% CI: 0.4%, 2.2%), and 12.0% (95% CI: 42.8%, 66.8%) respectively. These findings suggest there is no association between in utero PFAS exposure and AMH levels in female adolescents.
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Affiliation(s)
- Grayson M Donley
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, 30341, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA.
| | - Ethel Taylor
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, 30341, USA
| | - Zuha Jeddy
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, 30341, USA
| | - Gonza Namulanda
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, 30341, USA
| | - Terryl J Hartman
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, 30341, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
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Marks KJ, Jeddy Z, Flanders WD, Northstone K, Fraser A, Calafat AM, Kato K, Hartman TJ. Maternal serum concentrations of perfluoroalkyl substances during pregnancy and gestational weight gain: The Avon Longitudinal Study of Parents and Children. Reprod Toxicol 2019; 90:8-14. [PMID: 31415809 DOI: 10.1016/j.reprotox.2019.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 04/09/2019] [Revised: 07/23/2019] [Accepted: 08/02/2019] [Indexed: 10/26/2022]
Abstract
Perfluoroalkyl substances (PFAS) are chemicals used in the manufacture of consumer products. PFAS may act as endocrine disruptors, influencing metabolic pathways and weight-related outcomes. Previous studies observed an association between perfluorooctane sulfonic acid (PFOS) and higher gestational weight gain among under-/normal weight mothers. We analyzed associations of maternal serum pregnancy concentrations of PFAS with gestational weight gain (GWG) using data from 905 women in a subsample of the Avon Longitudinal Study of Parents and Children. Women were routinely weighed in antenatal check-ups; absolute GWG was determined by subtracting the first weight measurement from the last. Linear regression was used to explore associations of maternal PFAS concentrations with absolute GWG, stratified by prepregnancy body mass index. Associations of maternal PFOS, perfluorooctanoic acid (PFOA), and perfluorohexane sulfonic acid (PFHxS) concentrations with absolute GWG were null; 10% higher PFOS was associated with GWG of -0.03 kg (95% CI: -0.11, 0.06) among under-/normal weight mothers. Ten percent higher perfluorononanoic acid (PFNA) was associated with a higher GWG of 0.09 kg (95% CI: 0.02, 0.16) among under-/normal weight mothers. Overall, findings suggest no association between maternal PFOA, PFOS, and PFHxS concentrations and GWG, and a weak positive association between maternal PFNA and GWG.
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Affiliation(s)
- Kristin J Marks
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States; National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA 30341, United States.
| | - Zuha Jeddy
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA 30341, United States; Oak Ridge Institute for Science and Education, 100 ORAU Way, Oak Ridge, TN 37830, United States
| | - W Dana Flanders
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States; National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA 30341, United States
| | - Kate Northstone
- Department of Population Health Sciences, Bristol Medical School, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom
| | - Abigail Fraser
- Department of Population Health Sciences, Bristol Medical School, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom; The MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA 30341, United States
| | - Kayoko Kato
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA 30341, United States
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States; National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA 30341, United States
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Hanson SK, Munthali RJ, Micklesfield LK, Lobelo F, Cunningham SA, Hartman TJ, Norris SA, Stein AD. Longitudinal patterns of physical activity, sedentary behavior and sleep in urban South African adolescents, Birth-To-Twenty Plus cohort. BMC Pediatr 2019; 19:241. [PMID: 31319843 PMCID: PMC6639930 DOI: 10.1186/s12887-019-1619-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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] [Received: 06/26/2018] [Accepted: 07/10/2019] [Indexed: 01/24/2023] Open
Abstract
Background Adolescence is a critical phase of human development that lays the foundation for health in later life. Of the 1.8 billion adolescents in the world, roughly 90% live in low and middle-income countries. Yet most longitudinal studies of adolescent physical activity, sedentary behavior, and sleep come from high-income countries. There is a need for a better understanding of these behaviors to inform obesity and chronic disease prevention strategies. Aims The aim of this study is to identify longitudinal patterns and associations between physical activity, sedentary behavior and sleep in urban South African adolescents. Methods We analyzed data from the Birth-to-Twenty Plus Cohort (Bt20+), a longitudinal study of children in Soweto, Johannesburg, South Africa. Behaviors were self-reported annually between ages 12 and 17 y. We used Latent Class Growth Analysis to group participants into classes based on common longitudinal trajectories of time spent in informal physical activity, organized sports, walking to and from school, sedentary behavior, and school-night and weekend sleep, respectively. We performed group-based multi-trajectory modeling to identify latent clusters of individuals who followed similar trajectories of informal physical activity, organized sports and walking to and from school, and who followed similar trajectories of these three domains together with sedentary behavior and sleep. Results The large majority of males (82%) and all females failed to meet the World Health Organization (WHO) physical activity recommendation for adolescents of 60 min of moderate-vigorous intensity physical activity per day. The physical activity domains clustered together in three multi-trajectory groups that define individuals’ overall physical activity pattern. While two patterns indicated decreases in physical activity throughout adolescence, one pattern, including 29% of the sample in males and 17% of the sample in females, indicated higher levels of activity throughout adolescence. Sedentary behavior and sleep trajectories did not cluster together with the physical activity domains. Conclusion Most adolescents in this South African population did not meet WHO recommendations for physical activity. In this population, trajectories of sedentary behavior and sleep were independent of physical activity. Electronic supplementary material The online version of this article (10.1186/s12887-019-1619-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sara K Hanson
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA.,Medical Research Council of South Africa / University of the Witwatersrand Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard J Munthali
- Medical Research Council of South Africa / University of the Witwatersrand Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lisa K Micklesfield
- Medical Research Council of South Africa / University of the Witwatersrand Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Felipe Lobelo
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Solveig A Cunningham
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Terryl J Hartman
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Shane A Norris
- Medical Research Council of South Africa / University of the Witwatersrand Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. .,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Gapstur SM, McCullough ML, Hodge RA, Wang Y, Um CY, Hartman TJ, Gaudet MM. Abstract 966: Coffee consumption and invasive breast cancer incidence among postmenopausal women in the Cancer Prevention Study II Nutrition Cohort. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-966] [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: 11/16/2022]
Abstract
Abstract
Accumulating evidence suggests that coffee consumption may be inversely associated with breast cancer risk among postmenopausal women, with growing evidence of a stronger association for caffeinated than for decaffeinated coffee. However, few studies have examined this association by hormone receptor status or minimized confounding due to cigarette smoking. Recently, we found that caffeinated, but not decaffeinated coffee consumption was inversely associated with breast cancer mortality among nonsmoking women enrolled in the Cancer Prevention Study-II (CPS-II). Subsequently, the 2018 WCRF/AICR Diet, Nutrition, Physical Activity and Cancer Third Expert Report drew no conclusion regarding the association between coffee consumption and breast cancer risk. To provide further evidence, we examined total, caffeinated and decaffeinated coffee consumption in relation to postmenopausal invasive breast cancer incidence, overall, among nonsmokers and by estrogen and/or progesterone receptor (ER/PR) status among women enrolled in the CPS-II Nutrition Cohort, a subcohort of CPS-II. This analysis included 57,120 postmenopausal women who were cancer-free and reported coffee intake in 1999, and who were followed for cancer incidence through June 2013. During follow-up, 2,848 (2,349 ER or PR positive, and 252 ER and PR negative) women with a verified invasive breast cancer were identified. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI). Neither total nor decaffeinated coffee consumption was associated with risk of invasive breast cancer among all women or in any subgroup. For caffeinated coffee consumption, the HR (95% CI) for consumption of 2 or more cups/day, compared to less than 1 cup/month, was 0.90 (0.82-1.00) among all women, and 0.88 (0.80-0.98) among nonsmokers. Similarly, caffeinated coffee consumption was associated with a statistically significantly lower risk of ER+ or PR+ breast cancer (HR=0.88, 95% CI 0.79-0.99) and a nonsignificant lower risk of ER- and PR- breast cancer (HR=0.83, 95% CI 0.59-1.16) among all women. These findings underscore the importance of stratifying on type of coffee in studies examining the association between coffee consumption and risk of invasive postmenopausal breast cancer. Additionally, to better understand the role of caffeinated vs. decaffeinated coffee in breast cancer etiology we will examine the potential mediating effects of coffee metabolites on this association.
Citation Format: Susan M. Gapstur, Marjorie L. McCullough, Rebecca A. Hodge, Ying Wang, Caroline Y. Um, Terryl J. Hartman, Mia M. Gaudet. Coffee consumption and invasive breast cancer incidence among postmenopausal women in the Cancer Prevention Study II Nutrition Cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 966.
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Affiliation(s)
| | | | | | - Ying Wang
- 1American Cancer Society, Atlanta, GA
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Byrd D, Bostick RM, Judd SE, Flanders WD, Hartman TJ, Fedirko V, Reedy J, Agurs-Collins T. Abstract 627: Associations of novel dietary and lifestyle inflammation scores with incident colorectal cancer in the National Institutes of Health-American Association of Retired Persons Diet and Health study. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-627] [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: 11/16/2022]
Abstract
Abstract
Chronically higher inflammation may play a role in colorectal carcinogenesis. Contributors to inflammation likely include dietary and other lifestyle exposures, such as smoking, physical activity, alcohol intake, and obesity. We developed dietary (DIS) and lifestyle (LIS) inflammation scores to characterize the aggregate contributions of dietary and lifestyle exposures to systemic inflammation, and investigated associations of the scores with incident colorectal cancer (CRC) in the prospective National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study cohort (n = 453,465).
To develop the 19-component DIS, we selected a priori 18 whole food groups, including leafy greens, deep-orange/yellow vegetables, apples/berries, tomatoes/tomato products, other fruits and vegetables, processed meats, red meats, poultry, fish, nuts, legumes, refined grains or starchy vegetables, added sugars, saturated/trans fats, coffee and tea, high- and low-fat dairy, plus a supplemental micronutrient score. Similarly, for the 4-component LIS we selected a priori smoking status, physical activity, alcohol intake, and body mass index. The components were weighted based on the strengths of their associations with a panel of circulating inflammation biomarker concentrations (high sensitivity C-reactive protein and interleukin [IL]-6, IL-8, and IL-10) in a subset of 639 male and female, black and white participants in the Reasons for Geographic and Racial Differences in Stroke cohort study (REGARDS). The sums of the weighted components constitute the scores, such that higher scores reflect a higher balance of more pro-inflammatory exposures. Applying the component weights developed in REGARDS, we calculated a DIS and LIS using baseline data from the NIH-AARP study cohort and investigated their associations with incident CRC using multivariable Cox proportional hazards regression, adjusted for established risk factors for CRC.
Over an average of 13.5 years of follow-up, 10,336 participants were diagnosed with CRC. With increasing levels of the DIS and LIS, there was increasing risk for incident CRC. For men and women in the highest relative to the lowest quintiles of the DIS and LIS, the multivariable-adjusted hazards ratios (HR) and their 95% confidence intervals [CIs]) were: 1.3 (95% CI: 1.2, 1.4; Ptrend: <0.001) and 1.4 (95% CI: 1.3, 1.5; Ptrend: <0.001), respectively. The HR for those in the highest relative to the lowest joint DIS/LIS quintile was 1.8 (95% CI: 1.7, 2.0; Pinteraction: <0.001). The DIS and LIS associations were strongest among men and for cancers of the colon among men and women combined.
These results suggest that pro-inflammatory diet and lifestyle exposures may be associated with higher risk for incident colorectal cancer.
Citation Format: Doratha Byrd, Roberd M. Bostick, Suzanne E. Judd, William D. Flanders, Terryl J. Hartman, Veronika Fedirko, Jill Reedy, Tanya Agurs-Collins. Associations of novel dietary and lifestyle inflammation scores with incident colorectal cancer in the National Institutes of Health-American Association of Retired Persons Diet and Health study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 627.
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Affiliation(s)
| | | | | | | | | | | | - Jill Reedy
- 3National Institute of Health, National Cancer Institute, MD
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Troeschel AN, Jacobs EJ, Flanders WD, Stevens VL, Hartman TJ, McCullough LE, Gansler T, Wang Y. Abstract LB-179: Pre- and post-diagnosis body mass index, weight change, and prostate cancer-specific mortality among prostate cancer survivors in the US. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-lb-179] [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: 11/16/2022]
Abstract
Abstract
Accumulating evidence suggests that excess body fatness is associated with an increased risk of aggressive prostate cancer. However, the roles of body mass index (BMI -kg/m2), reported before and after diagnosis, and weight change in long-term prostate cancer survival remain unclear. Prospective data from men diagnosed with non-metastatic prostate cancer between 1992 and 2013 were obtained from the American Cancer Society’s Cancer Prevention Study II Nutrition Cohort. Weight was self-reported on surveys completed at enrollment into the Nutrition Cohort in 1992, in 1997, and every 2 years thereafter. Pre-diagnosis BMI was from the first survey completed >1 year before diagnosis and post-diagnosis BMI from the first survey completed > 2 years after diagnosis to allow for treatment completion. BMI was classified as ideal (18.5-<25), overweight (25-<30), and obese (30+). Weight change was the difference in weight (lbs.) from pre- to post-diagnosis. Follow-up began on the date of diagnosis in pre-diagnosis analyses (n=9,867) and, to reduce the potential for reserve causation, 4-years after the post-diagnosis survey in post-diagnosis analyses (n=6,860). Follow-up ended at death or December 2014, whichever came first. Cox proportional hazard models were used to estimate cause-specific hazard ratios (HR) and 95% confidence intervals (95% CI), adjusted for age, race, education, initial treatment, stage, Gleason score, node involvement, comorbidities, pre-diagnosis BMI (weight change models only), smoking, alcohol, and physical activity. A total of 614 and 330 prostate cancer deaths occurred in the pre- and post-diagnosis cohorts, respectively. The median follow-up time was 10.6 years (interquartile range (IQR) =7.9) and 5.5 years (IQR=6.1) in the pre- and post-diagnosis cohorts, respectively. In pre-diagnosis multivariable models, BMI was not associated with prostate cancer-specific mortality (e.g., Obese vs Ideal: HR=1.09, 95% CI: 0.83, 1.42). In post-diagnosis models, compared to men with an ideal BMI, the hazard of prostate cancer-specific death was similar among overweight men (HR=1.08, 95%CI: 0.84, 1.39) and higher among obese men (HR=1.41, 95% CI: 1.02, 1.97). Compared to men who maintained their weight (± 5 lbs.), the hazard of prostate cancer-specific mortality was higher among men who gained > 10 lbs. (HR=1.33, 95%CI: 0.99, 1.77) or lost > 10 lbs. (HR=1.33, 95%CI: 0.92, 1.92), but was similar among men who gained or lost 5-10 lbs. Our results suggest that post-diagnosis obesity and weight gain may be associated with increased risk of prostate cancer-specific mortality. The suggestion of an inverse association between weight loss and higher prostate cancer-specific mortality in our study should be interpreted with caution as it is unknown whether weight loss occurring was intentional or due to advanced disease.
Citation Format: Alyssa N. Troeschel, Eric J. Jacobs, W. Dana Flanders, Victoria L. Stevens, Terryl J. Hartman, Lauren E. McCullough, Ted Gansler, Ying Wang. Pre- and post-diagnosis body mass index, weight change, and prostate cancer-specific mortality among prostate cancer survivors in the US [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr LB-179.
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Affiliation(s)
| | | | | | | | | | | | | | - Ying Wang
- 2American Cancer Society, Atlanta, GA
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Marks KJ, Cutler AJ, Jeddy Z, Northstone K, Kato K, Hartman TJ. Maternal serum concentrations of perfluoroalkyl substances and birth size in British boys. Int J Hyg Environ Health 2019; 222:889-895. [PMID: 30975573 PMCID: PMC6571162 DOI: 10.1016/j.ijheh.2019.03.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 02/05/2019] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 01/25/2023]
Abstract
Per- and polyfluoroalkyl substances (PFAS) have been widely used in commercial and industrial manufacturing processes since the 1950s. Inverse associations between prenatal exposure to PFAS and birth size have been found in populations around the globe. This study examined the association of prenatal maternal serum concentrations of perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA) and birth size in British boys. The study included 457 mother-son dyads participating in the Avon Longitudinal Study of Parents and Children (ALSPAC). Birth weight (g), crown to heel length (cm), and head circumference (cm) were collected at delivery. PFAS were detected in all maternal serum samples during pregnancy (median: 30 weeks gestation (interquartile range: 12-33)). Median concentrations (interquartile range) were 13.8 ng/mL (11.0, 17.7), 3.0 ng/mL (2.3, 3.8), 1.9 ng/mL (1.4, 2.5), and 0.4 ng/mL (0.3, 0.5) for PFOS, PFOA, PFHxS, and PFNA, respectively. In multivariable linear regression models, inverse associations were detected between PFOS (continuous) and birth weight (β = -8.50 g, 95% CI = -15.93, -1.07 g), crown to heel length (β = -0.04 cm, 95% CI = -0.08, -0.01 cm), and head circumference (β = -0.02 cm, 95% CI = -0.04, -0.002 cm). In conclusion, prenatal exposure to high levels of PFOS may be associated with reduced birth size in male infants.
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Affiliation(s)
- Kristin J Marks
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, United States; National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, United States.
| | - Anya J Cutler
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, United States; National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, United States
| | - Zuha Jeddy
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, United States
| | - Kate Northstone
- Department of Population Health Sciences, Bristol Medical School, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Kayoko Kato
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, United States
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, United States; National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, United States
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Vereen S, Gebretsadik T, Johnson N, Hartman TJ, Veeranki SP, Piyathilake C, Mitchel EF, Kocak M, Cooper WO, Dupont WD, Tylavsky F, Carroll KN. Association Between Maternal 2nd Trimester Plasma Folate Levels and Infant Bronchiolitis. Matern Child Health J 2019; 23:164-172. [PMID: 30027465 DOI: 10.1007/s10995-018-2610-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objectives Viral bronchiolitis is the most common cause of infant hospitalization. Folic acid supplementation is important during the periconceptional period to prevent neural tube defects. An area of investigation is whether higher prenatal folate is a risk factor for childhood respiratory illnesses. We investigated the association between maternal 2nd trimester plasma folate levels and infant bronchiolitis. Methods We conducted a retrospective cohort analysis in a subset of mother-infant dyads (n = 676) enrolled in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood study and Tennessee Medicaid. Maternal folate status was determined using 2nd trimester (16-28 weeks) plasma samples. Bronchiolitis diagnosis in the first year of life was ascertained using International Classification of Diagnosis-9 codes from Medicaid administrative data. We used multivariable logistic regression to assess the adjusted association of prenatal folate levels and infant bronchiolitis outcome. Results Half of the women in this lower-income and predominately African-American (84%) study population had high levels of folate (median 2nd trimester level 19.2 ng/mL) and 21% of infants had at least one bronchiolitis healthcare visit. A relationship initially positive then reversing between maternal plasma folate and infant bronchiolitis was observed that did not reach statistical significance (poverall = .112, pnonlinear effect = .088). Additional adjustment for dietary methyl donor intake did not significantly alter the association. Conclusions for Practice Results did not confirm a statistically significant association between maternal 2nd trimester plasma folate levels and infant bronchiolitis. Further work is needed to investigate the role of folate, particularly higher levels, in association with early childhood respiratory illnesses.
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Affiliation(s)
- Shanda Vereen
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Divisions of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Center for Asthma Health Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tebeb Gebretsadik
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.,Center for Asthma Health Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Sreenivas P Veeranki
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Divisions of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Center for Asthma Health Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Chandrika Piyathilake
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Edward F Mitchel
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - William O Cooper
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Divisions of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - William D Dupont
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.,Center for Asthma Health Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Frances Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Kecia N Carroll
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. .,Divisions of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. .,Center for Asthma Health Research, Vanderbilt University Medical Center, Nashville, TN, USA. .,Vanderbilt University School of Medicine, 313 Oxford House, 1313 21st Avenue South, Nashville, TN, 37232-4313, USA.
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Adams SN, Adgent MA, Gebretsadik T, Hartman TJ, Vereen S, Ortiz C, Tylavsky FA, Carroll KN. Prenatal vitamin D levels and child wheeze and asthma. J Matern Fetal Neonatal Med 2019; 34:323-331. [PMID: 30983439 DOI: 10.1080/14767058.2019.1607286] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background: Maternal vitamin D status during pregnancy may influence lung development and risk of childhood wheeze and asthma. We investigated the relationship between prenatal vitamin D and child asthma in a racially diverse cohort with a high burden of vitamin D insufficiency and child asthma.Materials and methods: We included mother-child dyads in the prenatal Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) cohort (2006-2011, Shelby County, Tennessee). Maternal plasma vitamin D [25(OH)D] was measured from second trimester (n = 1091) and delivery specimens (n = 907). At age 4-6 years, we obtained parent report of current child wheeze (symptoms within the past 12 months) and asthma (physician diagnosis and/or medication or symptoms within the past 12 months). We used multivariable logistic regression to assess associations of 25(OH)D and child wheeze/asthma, including an interaction term for maternal race.Results: Median second trimester 25(OH)D levels were 25.1 and 19.1 ng/ml in White (n = 366) and Black women (N = 725), respectively. We detected significant interactions by maternal race for second-trimester plasma 25(OH)D and child current wheeze (p = .014) and asthma (p = .011). Odds of current wheeze and asthma decreased with increasing 25(OH)D in dyads with White mothers and increased in dyads with Black mothers, e.g. adjusted odds ratio (95% confidence interval) for asthma: 0.63 (0.36-1.09) and 1.41 (1.01-1.97) per interquartile range (15-27 ng/ml 25[OH]D) increase, respectively. At delivery, protective associations in White dyads were attenuated.Conclusion: We detected effect modification by maternal race in associations between prenatal 25(OH)D and child wheeze/asthma. Further research in racially diverse populations is needed.
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Affiliation(s)
- Sarah N Adams
- Division of Allergy and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Margaret A Adgent
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tebeb Gebretsadik
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Shanda Vereen
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christina Ortiz
- Division of Allergy and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Kecia N Carroll
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
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Ferranti EP, Hartman TJ, Elliott AJ, Mitchell DC, Angal J, Nickleach D, Bellissimo M, Breslow R. Diet Quality of Pregnant American Indian Women in the Northern Plains. Prev Chronic Dis 2019; 16:E53. [PMID: 31022368 PMCID: PMC6513482 DOI: 10.5888/pcd16.180536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION We examined diet quality and intake of pregnancy-specific micronutrients among pregnant American Indian women in the Northern Plains. METHODS We conducted an analysis of nutrition data from the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network Safe Passage Study and the PASS Diet Screener study (N = 170). Diet intake, including dietary supplementation, was assessed by using three 24-hour recalls conducted on randomly selected, nonconsecutive days. Diet intake data were averaged across the participant's recalls and scored for 2 dietary indices: the Healthy Eating Index 2010 (HEI-2010) and the Alternate Healthy Eating Index for Pregnancy (AHEI-P). We also assessed nutrient adequacy with Dietary Reference Intakes for pregnancy. RESULTS On average, participants were aged 26.9 (standard deviation [SD], 5.5) years with a pre-pregnancy body mass index of 29.8 (SD, 7.5) kg/m2. Mean AHEI-P and HEI-2010 scores (52.0 [SD, 9.0] and 49.2 [SD, 11.1], respectively) indicated inadequate adherence to dietary recommendations. Micronutrient intake for vitamins D and K, choline, calcium, and potassium were lower than recommended, and sodium intake was higher than recommended. CONCLUSION Our findings that pregnant American Indian women are not adhering to dietary recommendations is consistent with studies in other US populations. Identifying opportunities to partner with American Indian communities is necessary to ensure effective and sustainable interventions to promote access to and consumption of foods and beverages that support the adherence to recommended dietary guidelines during pregnancy.
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Affiliation(s)
- Erin P Ferranti
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322.
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Amy J Elliott
- Avera Research Institute for Pediatric and Community Research, Sioux Falls, South Dakota
| | - Diane C Mitchell
- Diet Assessment Center, Department of Nutritional Sciences, Penn State University, University Park, Pennsylvania
| | - Jyoti Angal
- Avera Research Institute for Pediatric and Community Research, Sioux Falls, South Dakota
| | - Dana Nickleach
- Winship Cancer Institute, Emory University, Atlanta, Georgia
| | | | - Rosalind Breslow
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
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Jeddy Z, Kordas K, Allen K, Taylor EV, Northstone K, Dana Flanders W, Namulanda G, Sjodin A, Hartman TJ. Prenatal exposure to organochlorine pesticides and early childhood communication development in British girls. Neurotoxicology 2018; 69:121-129. [PMID: 30292654 DOI: 10.1016/j.neuro.2018.10.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/18/2018] [Accepted: 10/02/2018] [Indexed: 01/29/2023]
Abstract
BACKGROUND The developing brain is susceptible to exposure to neurodevelopmental toxicants such as pesticides. AIMS We explored associations of prenatal serum concentrations of hexachlorobenzene (HCB), beta-Hexachlorocyclohexane (β-HCH), 2,2-Bis(4-chlorophenyl)-1,1-dichloroethene (p,p'-DDE) and 2,2-Bis(4-chlorophenyl-1,1,1-trichloroethane (p,p'-DDT) with maternal-reported measures of verbal and non-verbal communication in young girls. STUDY DESIGN AND METHODS We studied a sample of 400 singleton girls and their mothers participating in the Avon Longitudinal Study of Parents and Children (ALSPAC) using multivariable linear regression models adjusting for parity, Home Observation Measurement of the Environment (HOME) score, maternal age and education status, and maternal tobacco use during the first trimester of pregnancy. EXPOSURE AND OUTCOME MEASURES Maternal serum samples (collected at median 15 wks. gestation [IQR 10, 28]) were assessed for selected organochlorine pesticide levels. Communication was assessed at 15 and 38 months, using adapted versions of the MacArthur Bates Communicative Development Inventories for Infants and Toddlers (MCDI). RESULTS At 15 months, girls born to mothers with prenatal concentrations of HCB in the highest tertile had vocabulary comprehension and production scores approximately 16% (p = 0.007) lower than girls born to mothers with concentrations in the lowest tertile. This association varied by maternal parity in that the evidence was stronger for daughters of nulliparous mothers. At 38 months, girls born to mothers with prenatal concentrations of HCB in the highest tertile had mean adjusted intelligibility scores that were 3% (p = 0.03) lower than those born to mothers with concentrations in the lowest tertile; however, results did not vary significantly by parity. Maternal concentrations of β-HCH and p,p'-DDE were not significantly associated with MCDI scores at 15 or 36 months. p,p'-DDT had an inconsistent pattern of association; a significant positive association was observed between p,p'-DDT with verbal comprehension scores at 15 months; however, at 38 months a significant inverse association was observed for p,p'-DDT with communicative scores. This inverse association for p,p'-DDT among older girls tended to be stronger among daughters of mothers who had lower depression scores. CONCLUSIONS Organochlorine pesticide exposure in utero may affect communication development.
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Affiliation(s)
- Zuha Jeddy
- Centers for Disease Control and Prevention, Atlanta, GA, 30341, United States
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York, Buffalo, NY, 14214, United States
| | - Kristen Allen
- Centers for Disease Control and Prevention, Atlanta, GA, 30341, United States
| | - Ethel V Taylor
- Centers for Disease Control and Prevention, Atlanta, GA, 30341, United States
| | | | - W Dana Flanders
- Centers for Disease Control and Prevention, Atlanta, GA, 30341, United States; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, United States; Winship Cancer Institute, Emory University, Atlanta, GA, 30322, United States
| | - Gonza Namulanda
- Centers for Disease Control and Prevention, Atlanta, GA, 30341, United States
| | - Andreas Sjodin
- Centers for Disease Control and Prevention, Atlanta, GA, 30341, United States
| | - Terryl J Hartman
- Centers for Disease Control and Prevention, Atlanta, GA, 30341, United States; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, United States; Winship Cancer Institute, Emory University, Atlanta, GA, 30322, United States.
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Patel JF, Hartman TJ, Sjodin A, Northstone K, Taylor EV. Prenatal exposure to polychlorinated biphenyls and fetal growth in British girls. Environ Int 2018; 116:116-121. [PMID: 29677556 PMCID: PMC6392071 DOI: 10.1016/j.envint.2018.04.007] [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] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/04/2018] [Accepted: 04/05/2018] [Indexed: 05/06/2023]
Abstract
Polychlorinated biphenyls (PCBs) are synthetic chemicals that bioaccumulate in the food chain. PCBs were used primarily for industrial applications due to their insulating and fire retardant properties, but were banned in the 1970s in the United States and in the 1980s in the United Kingdom, as adverse health effects following exposure were identified. Previous studies of populations with high PCB exposure have reported inverse associations with birth weight and gestational length. Birth weight is a powerful predictor of infant survival, and low birth weight can predispose infants to chronic conditions in adult life such as diabetes and cardiovascular diseases. Using data from the Avon Longitudinal Study of Parents and Children, we investigated the association between prenatal exposure to PCBs and fetal growth in a sample of 448 mother-daughter dyads. Concentrations of three common PCB analytes, PCB-118, PCB-153 and PCB-187, were measured in maternal serum collected during pregnancy, and fetal growth was measured by birth weight and birth length. Multivariable linear regression was used to examine the associations between PCB analytes and measures of fetal growth, after adjusting for parity, maternal age, pre-pregnancy BMI, educational status, tobacco use and gestational age of infant at sample collection. Birth length, ponderal index and gestational age were not associated with any of the PCB analytes. Mothers' educational status modified associations for PCB analytes with birthweight. We observed significant inverse associations with birth weight only among daughters of mothers with less education. Daughter's birth weight was -138.4 g lower (95% CI: -218.0, -58.9) for each 10 ng/g lipid increase in maternal serum PCB-118. Similarly, every 10 ng/g lipid increase in maternal serum PCB-153 was associated with a -41.9 g (95% CI: -71.6, -12.2) lower birth weight. Every 10 ng/g lipids increase in maternal serum PCB-187, was associated with a -170.4 g (95% CI: -306.1, -34.7) lower birth weight, among girls with mothers in the lowest education group. Our findings suggest that prenatal exposure to PCBs is inversely associated with daughters' birth weight and that mothers' education, which is a possible marker for socioeconomic status, significantly modified the association between maternal PCB concentrations and birth weight in female newborns.
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Affiliation(s)
- Jill F Patel
- Centers for Disease Control and Prevention, Atlanta, GA 30341, United States; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, United States
| | - Terryl J Hartman
- Centers for Disease Control and Prevention, Atlanta, GA 30341, United States; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, United States; Winship Cancer Institute, Emory University, Atlanta, GA 30322, United States.
| | - Andreas Sjodin
- Centers for Disease Control and Prevention, Atlanta, GA 30341, United States
| | - Kate Northstone
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK; School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Ethel V Taylor
- Centers for Disease Control and Prevention, Atlanta, GA 30341, United States
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Wang Y, Gapstur SM, Carter BD, Hartman TJ, Stevens VL, Gaudet MM, McCullough ML. Untargeted Metabolomics Identifies Novel Potential Biomarkers of Habitual Food Intake in a Cross-Sectional Study of Postmenopausal Women. J Nutr 2018; 148:932-943. [PMID: 29767735 DOI: 10.1093/jn/nxy027] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 02/01/2018] [Indexed: 12/20/2022] Open
Abstract
Background Recent studies suggest that untargeted metabolomics is a promising tool to identify novel biomarkers of individual foods. However, few large cross-sectional studies with comprehensive data on habitual diet and circulating metabolites have been conducted. Objective We aimed to identify potential food biomarkers and evaluate their predictive accuracy. Methods We conducted a cross-sectional analysis of consumption of 91 food groups or items, assessed by a 152-item food-frequency questionnaire, in relation to 1186 serum metabolites measured by mass spectrometry-based platforms from 1369 nonsmoking postmenopausal women (mean age = 68.3 y). Diet-metabolite associations were selected by Pearson's partial correlation analysis (P < 4.63 × 10-7, |r| > 0.2). The predictive accuracy of the selected food metabolites was evaluated from the area under the curve (AUC) calculated from receiver operating characteristic analysis conducted among women in the top and bottom quintiles of dietary intake. Results We identified 379 diet-metabolite associations. Forty-two food groups or items were correlated with 199 serum metabolites. We replicated 63 metabolites as biomarkers of habitual food intake reported in previous cross-sectional studies. Among those not previously shown to be associated with habitual diet, several are biologically plausible and were reported in acute feeding studies including: banana and dopamine 3-O-sulfate (r = 0.34, AUC = 76%) and dopamine 4-O-sulfate (r = 0.33, AUC = 74%), garlic and alliin (r = 0.24, AUC = 69%), N-acetylalliin (r = 0.27, AUC = 70%), and S-allylcysteine (r = 0.23, AUC = 69). Two unannotated metabolites were the strongest predictors for dark fish (X-02269, r = 0.51, AUC = 94%) and coffee intake (X-21442, r = 0.62, AUC = 98%). Conclusion In this comprehensive, cross-sectional analysis of habitual food intake and serum metabolites among postmenopausal women, we identified several potentially novel food biomarkers and replicated others. Our findings contribute to the limited literature on food-based biomarkers and highlight the significant and promising role that large cohort studies with archived blood samples could play in this field. This study was registered at clinicaltrials.gov as NCT03282812.
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Affiliation(s)
- Ying Wang
- Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Brian D Carter
- Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA
| | | | - Mia M Gaudet
- Epidemiology Research Program, American Cancer Society, Atlanta, GA
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Mo A, Wu R, Grady JP, Hanley MP, Toro M, Swede H, Devers TJ, Hartman TJ, Rosenberg DW. Associations of dietary fat with risk of early neoplasia in the proximal colon in a population-based case-control study. Cancer Causes Control 2018; 29:667-674. [PMID: 29846845 DOI: 10.1007/s10552-018-1039-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 03/31/2017] [Accepted: 05/12/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE Excess dietary fat consumption is strongly associated with the risk of colorectal cancer, but less is known about its role in the earliest stages of carcinogenesis, particularly within the proximal colon. In the following case-control study, we evaluated the relationship between the intake of dietary fats and the frequency of early proximal neoplasia [aberrant crypt foci (ACF) or polyps], detectable by high-definition colonoscopy with contrast dye-spray. METHODS Average-risk screening individuals underwent a high-definition colonoscopy procedure as part of larger ongoing clinical study of precancerous lesions in the proximal colon. Dietary fat intake was assessed using the Block Brief Food Frequency Questionnaire, which estimates average dietary intake based on 70 food items. The diets of individuals with no endoscopically identifiable lesions (n = 36) were compared to those with either ACF or polyps detected in the proximal colon. RESULTS In multivariate analysis, high dietary intake of total polyunsaturated fatty acids (PUFAs) and intake of omega-6 and omega-3 fatty acids were positively associated with neoplastic lesions in the proximal colon. When comparing ACF and polyp groups separately, a positive association was observed for both proximal polyps (OR 2.28; CI 1.16-7.09) and ACF (OR 2.86; CI 1.16-7.09) for total PUFA intake. Furthermore, the prevalence of proximal ACF was increased with higher intake of omega-6 (OR 3.54; CI 1.32-9.47) and omega-3 fatty acids (OR 2.29; CI 1.02-5.13), although there was no discernible difference in the omega-6/omega-3 ratio. CONCLUSIONS These results suggest that dietary PUFAs may be positively associated with risk of early neoplasia in the proximal colon. This study provides further evidence that dietary PUFA composition may play an important role in altering the microenvironment within the human colon.
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Affiliation(s)
- Allen Mo
- Center for Molecular Medicine, University of Connecticut Health Center, 263 Farmington Ave., Farmington, CT, 06030-3101, USA.,Colon Cancer Prevention Program, Neag Comprehensive Cancer Center, UConn Health, Farmington, CT, USA
| | - Rong Wu
- Connecticut Institute for Clinical and Translational Science, UConn Health, Farmington, CT, USA
| | - James P Grady
- Connecticut Institute for Clinical and Translational Science, UConn Health, Farmington, CT, USA
| | - Matthew P Hanley
- Center for Molecular Medicine, University of Connecticut Health Center, 263 Farmington Ave., Farmington, CT, 06030-3101, USA.,Colon Cancer Prevention Program, Neag Comprehensive Cancer Center, UConn Health, Farmington, CT, USA
| | - Margaret Toro
- Clinal Trials Office, UConn Health, Farmington, CT, USA
| | - Helen Swede
- Community Medicine and Health Care, UConn Health, Farmington, CT, USA
| | - Thomas J Devers
- Division of Gastroenterology, School of Medicine, UConn Health, Farmington, CT, USA
| | - Terryl J Hartman
- Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Daniel W Rosenberg
- Center for Molecular Medicine, University of Connecticut Health Center, 263 Farmington Ave., Farmington, CT, 06030-3101, USA. .,Colon Cancer Prevention Program, Neag Comprehensive Cancer Center, UConn Health, Farmington, CT, USA.
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Marks KJ, Hartman TJ, Judd SE, Ilori TO, Cheung KL, Warnock DG, Gutiérrez OM, Goodman M, Cushman M, McClellan WM. Dietary Oxidative Balance Scores and Biomarkers of Inflammation among Individuals with and without Chronic Kidney Disease. Nephron Extra 2018; 8:11-23. [PMID: 30279696 PMCID: PMC6158582 DOI: 10.1159/000490499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 05/29/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Oxidative stress and inflammation are proposed mechanisms of nonspecific kidney injury and progressive kidney failure. Higher dietary oxidative balance scores (OBS) are associated with lower prevalence of chronic kidney disease (CKD). METHODS We investigated the association between OBS and biomarkers of inflammation using data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Nutrient estimates from the Block Food Frequency Questionnaires were used to define tertiles of 11 pro- and antioxidant factors. Points for each OBS component were summed, with a higher score indicating predominance of antioxidant exposures. Multivariable linear regression models were used to estimate the association between OBS and biomarkers of inflammation (interleukin-6 [IL-6], interleukin-8 [IL-8], interleukin-10 [IL-10], fibrinogen, C-reactive protein [CRP], white blood cell count, and cystatin C). An interaction term was included to determine if associations between OBS and inflammatory markers differed between individuals with and without CKD. RESULTS Of 682 participants, 22.4% had CKD. In adjusted models, OBS was associated with CRP and IL-6. For every 5-unit increase in OBS, the CRP concentration was -15.3% lower (95% CI: -25.6, -3.6). The association of OBS with IL-6 differed by CKD status; for every 5-unit increase in OBS, IL-6 was -10.7% lower (95% CI: -16.3, -4.7) among those without CKD, but there was no association among those with CKD (p = 0.03). CONCLUSION This study suggests that a higher OBS is associated with more favorable levels of IL-6 and CRP, and that the association of OBS and IL-6 may be modified by CKD status.
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Affiliation(s)
- Kristin J. Marks
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Terryl J. Hartman
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Suzanne E. Judd
- University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | | | | | | | - Michael Goodman
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Wilson RT, Masters LD, Barnholtz-Sloan JS, Salzberg AC, Hartman TJ. Ancestry-Adjusted Vitamin D Metabolite Concentrations in Association With Cytochrome P450 3A Polymorphisms. Am J Epidemiol 2018; 187:754-766. [PMID: 28673024 DOI: 10.1093/aje/kwx187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 01/27/2017] [Indexed: 12/29/2022] Open
Abstract
We investigated the association between genetic polymorphisms in cytochrome P450 (CYP2R1, CYP24A1, and the CYP3A family) with nonsummer plasma concentrations of vitamin D metabolites (25-hydroxyvitamin D3 (25(OH)D3) and proportion 24,25-dihydroxyvitamin D3 (24,25(OH)2D3)) among healthy individuals of sub-Saharan African and European ancestry, matched on age (within 5 years; n = 188 in each ancestral group), in central suburban Pennsylvania (2006-2009). Vitamin D metabolites were measured using high-performance liquid chromatography with tandem mass spectrometry. Paired multiple regression and adjusted least-squares mean analyses were used to test for associations between genotype and log-transformed metabolite concentrations, adjusted for age, sex, proportion of West-African genetic ancestry, body mass index, oral contraceptive (OC) use, tanning bed use, vitamin D intake, days from summer solstice, time of day of blood draw, and isoforms of the vitamin D receptor (VDR) and vitamin D binding protein. Polymorphisms in CYP2R1, CYP3A43, vitamin D binding protein, and genetic ancestry proportion remained associated with plasma 25(OH)D3 after adjustment. Only CYP3A43 and VDR polymorphisms were associated with proportion 24,25(OH)2D3. Magnitudes of association with 25(OH)D3 were similar for CYP3A43, tanning bed use, and OC use. Significant least-squares mean interactions (CYP2R1/OC use (P = 0.030) and CYP3A43/VDR (P = 0.013)) were identified. A CYP3A43 genotype, previously implicated in cancer, is strongly associated with biomarkers of vitamin D metabolism. Interactive associations should be further investigated.
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Affiliation(s)
- Robin Taylor Wilson
- Penn State Cancer Institute, Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Loren D Masters
- Penn State Methodology Center, College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania
| | - Jill S Barnholtz-Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Anna C Salzberg
- Penn State Institute for Personalized Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Terryl J Hartman
- Rollins School of Public Health, Department of Epidemiology, Emory University, Atlanta, Georgia
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45
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Brantley KD, Hartman TJ, Patel AV, Gapstur SM, Flanders WD, McCullough ML. Test-Retest Reproducibility of Adult-Reported High School Diet Varies among Racially and Ethnically Diverse US Men and Women. J Nutr 2018; 148:599-606. [PMID: 29659953 DOI: 10.1093/jn/nxy001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 12/28/2017] [Indexed: 01/11/2023] Open
Abstract
Background Adolescent diet is thought to play an important role in future chronic disease risk. However, few studies have examined the reproducibility of adult-reported adolescent diet, and evidence for possible differences in reproducibility by demographic characteristics is limited. Objective We assessed the ability of adults to consistently report past high school diet over a 1-y period and examined differences in reproducibility by selected demographic characteristics. Methods By using age-adjusted partial Spearman (ρ) or Pearson (r) correlations, we assessed 1-y reproducibility for 33 line items, 20 food groups, and 2 dietary patterns of high school diet reported in adulthood via a questionnaire completed by 742 participants in the Cancer Prevention Study 3 (CPS-3) Diet Substudy. Results Participants' median age was 53 y (range: 31-70 y), 65.2% were women, 59.8% were non-Hispanic white, 24.8% were non-Hispanic black, and 15.4% were Hispanic. The mean Spearman correlation assessing reproducibility across the 33 line items was 0.60 and ranged from 0.44 to 0.72, with no differences in mean correlations by age, sex, race/ethnicity, education, or body mass index (BMI). Reproducibility was similar across food groups (ρ = 0.62; range: 0.44-0.68), with differences by sex, ethnicity, age, or BMI observed for some food groups (e.g., sugar-sweetened beverages). Pearson correlations for the reproducibility of 2 major eating patterns, "fast food" and "whole food," were 0.73 and 0.72, respectively. Conclusion These results show good 1-y reproducibility of assessed high school diet, as reported from memory in adulthood, by line item, food group, and dietary pattern, with noted differences by demographic characteristics.
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Affiliation(s)
- Kristen D Brantley
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.,Winship Cancer Institute, Atlanta, GA
| | - Alpa V Patel
- Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - W D Flanders
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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46
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Roy A, Kocak M, Hartman TJ, Vereen S, Adgent M, Piyathilake C, Tylavsky FA, Carroll KN. Association of prenatal folate status with early childhood wheeze and atopic dermatitis. Pediatr Allergy Immunol 2018; 29:144-150. [PMID: 29168294 PMCID: PMC6087709 DOI: 10.1111/pai.12834] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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] [Accepted: 11/17/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Prenatal folic acid supplementation is recommended to prevent birth defects. Some foods are fortified in the USA to ensure sufficient intake among reproductive-aged women. However, high prenatal folate exposure may be a risk factor for childhood atopic diseases. We investigated associations between prenatal folate and early childhood wheeze and atopic dermatitis in a US cohort. METHODS We studied 858 mother-child dyads, enrolled prenatally. Folate was measured in 2nd and 3rd trimester maternal plasma. Parents reported current wheeze (previous 12 months) and healthcare provider diagnosis of atopic dermatitis at 3 years. We examined associations using logistic regression, modeling folate continuously and dichotomously (< or ≥20 ng/mL), a level often considered supraphysiologic. RESULTS Over half of women were African American and on Medicaid. Median (interquartile range) folate levels were 22.6 (15.9-30.0) and 23.1 (16.1-30.0) ng/mL for 2nd and 3rd trimesters, respectively. Current wheeze and atopic dermatitis were reported for 20.4% and 26.8% of children, respectively. Second trimester folate as a continuous exposure was not significantly associated with outcomes. Decreased odds of current wheeze were observed in children born to mothers who had 2nd trimester folate ≥20 ng/mL (adjusted odds ratios = 0.67, 95% confidence interval = 0.46, 0.97) compared to children with maternal levels <20 ng/mL. Third trimester folate was not associated with outcomes. CONCLUSIONS High plasma folate in mid-pregnancy was associated with decreased odds of current wheeze at age 3. Our findings do not support harmful effects of high prenatal folate levels on childhood atopic diseases in this setting.
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Affiliation(s)
- A Roy
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Center for Asthma and Environmental Health Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - M Kocak
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - T J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - S Vereen
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Center for Asthma and Environmental Health Research, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida
| | - M Adgent
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Center for Asthma and Environmental Health Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - C Piyathilake
- Department of Nutritional Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - F A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - K N Carroll
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Division of General Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Center for Asthma and Environmental Health Research, Vanderbilt University Medical Center, Nashville, TN, USA
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47
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Bettermann EL, Hartman TJ, Easley KA, Ferranti EP, Jones DP, Quyyumi AA, Vaccarino V, Ziegler TR, Alvarez JA. Higher Mediterranean Diet Quality Scores and Lower Body Mass Index Are Associated with a Less-Oxidized Plasma Glutathione and Cysteine Redox Status in Adults. J Nutr 2018; 148:245-253. [PMID: 29490099 PMCID: PMC6251672 DOI: 10.1093/jn/nxx045] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 05/21/2017] [Accepted: 11/16/2017] [Indexed: 02/07/2023] Open
Abstract
Background Both systemic redox status and diet quality are associated with risk outcomes in chronic disease. It is not known, however, the extent to which diet quality influences plasma thiol/disulfide redox status. Objective The purpose of this study was to investigate the influence of diet, as measured by diet quality scores and other dietary factors, on systemic thiol/disulfide redox status. Methods We performed a cross-sectional study of 685 working men and women (ages ≥18 y) in Atlanta, GA. Diet was assessed by 3 diet quality scores: the Alternative Healthy Eating Index (AHEI), Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean Diet Score (MDS). We measured concentrations of plasma glutathione (GSH), cysteine, their associated oxidized forms [glutathione disulfide (GSSG) and cystine (CySS), respectively], and their redox potentials (EhGSSG and EhCySS) to determine thiol/disulfide redox status. Linear regression modeling was performed to assess relations between diet and plasma redox after adjustment for age, body mass index (BMI), sex, race, and history of chronic disease. Results MDS was positively associated with plasma GSH (β = 0.02; 95% CI: 0.003, 0.03) and total GSH (GSH + GSSG) (β = 0.02; 95% CI: 0.003, 0.03), and inversely associated with the CySS:GSH ratio (β = -0.02; 95% CI: -0.04, -0.004). There were significant independent associations between individual MDS components (dairy, vegetables, fish, and monounsaturated fat intake) and varying plasma redox indexes (P < 0.05). AHEI and DASH diet quality indexes and other diet factors of interest were not significantly correlated with plasma thiol and disulfide redox measures. Conclusion Adherence to the Mediterranean diet was significantly associated with a favorable plasma thiol/disulfide redox profile, independent of BMI, in a generally healthy working adult population. Although longitudinal studies are warranted, these findings contribute to the feasibility of targeting a Mediterranean diet to improve plasma redox status.
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Affiliation(s)
- Erika L Bettermann
- Departments of Epidemiology and Biostatistics and Bioinformatics, Rollins
School of Public Health, Emory University, Atlanta, GA
| | - Terryl J Hartman
- Departments of Epidemiology and Biostatistics and Bioinformatics, Rollins
School of Public Health, Emory University, Atlanta, GA
| | - Kirk A Easley
- Departments of Biostatistics and Bioinformatics, Rollins School of Public
Health, Emory University, Atlanta, GA
| | - Erin P Ferranti
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA
| | - Dean P Jones
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine,Center for Clinical and Molecular Nutrition and Divisions of Cardiology and
Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of
Medicine, Atlanta, GA
| | - Arshed A Quyyumi
- Divisions of Cardiology and Endocrinology, Metabolism & Lipids, Department
of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Viola Vaccarino
- Departments of Epidemiology and Biostatistics and Bioinformatics, Rollins
School of Public Health, Emory University, Atlanta, GA
| | - Thomas R Ziegler
- Center for Clinical and Molecular Nutrition and Divisions of Cardiology and
Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of
Medicine, Atlanta, GA,Center for Clinical and Molecular Nutrition and Divisions of Endocrinology,
Metabolism & Lipids, Department of Medicine, Emory University School of Medicine,
Atlanta, GA,Section of Endocrinology, Atlanta Veterans Affairs Medical Center, Atlanta,
GA
| | - Jessica A Alvarez
- Center for Clinical and Molecular Nutrition and Divisions of Cardiology and
Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of
Medicine, Atlanta, GA,Center for Clinical and Molecular Nutrition and Divisions of Endocrinology,
Metabolism & Lipids, Department of Medicine, Emory University School of Medicine,
Atlanta, GA,Address correspondence to JAA (E-mail: )
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48
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Hartman TJ, McCullough ML, Hodge JM, Gaudet MM, Wang Y, Gapstur SM. Dietary Energy Density, Glycemic Load, Glycemic Index, and Risk for Endometrial Cancer in the CPS-II Nutrition Cohort. Cancer Epidemiol Biomarkers Prev 2017; 27:113-115. [DOI: 10.1158/1055-9965.epi-17-0964] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 10/26/2017] [Accepted: 10/30/2017] [Indexed: 11/16/2022] Open
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Hartman TJ, Haardörfer R, Greene BM, Parulekar S, Kegler MC. Beverage Consumption Patterns among Overweight and Obese African American Women. Nutrients 2017; 9:nu9121344. [PMID: 29232928 PMCID: PMC5748794 DOI: 10.3390/nu9121344] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/04/2017] [Accepted: 12/06/2017] [Indexed: 01/10/2023] Open
Abstract
The goal of this research was to assess patterns of beverage consumption and the contribution of total beverages and classes of beverages to overall energy intake and weight status. We conducted an analysis in a community-based study of 280 low-income overweight and obese African American women residing in the rural South. Participants provided baseline data including demographic characteristics, weight and two 24-h food and beverage dietary recalls. Mean energy intake from beverages was approximately 273 ± 192 kcal/day or 18.3% of total energy intake. The most commonly reported beverage was plain water, consumed by 88.2% of participants, followed closely by sweetened beverages (soft drinks, fruit drinks, sweetened teas, sweetened coffees and sweetened/flavored waters) consumed by 78.9% of participants. In multiple regression analyses total energy and percent energy from beverages and specific categories of beverages were not significantly associated with current body mass index (BMI). It is widely accepted that negative energy balance may lead to future weight loss. Thus, reducing consumption of beverages that contribute energy but not important nutrients (e.g., sugar sweetened beverages) could be an effective strategy for promoting future weight loss in this population.
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Affiliation(s)
- Terryl J Hartman
- Department of Epidemiology and Emory Prevention Research Center, Rollins School of Public Health and Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA.
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education and Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
| | - Brenda M Greene
- Southwest Health District, 8-2, Division of Public Health, Georgia Department of community Health, Albany, GA 31710, USA.
| | - Shruti Parulekar
- Department of Epidemiology and Emory Prevention Research Center, Rollins School of Public Health and Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA.
| | - Michelle C Kegler
- Department of Behavioral Sciences and Health Education and Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
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Vereen S, Kocak M, Potukuchi PK, Hartman TJ, Tylavsky F, Carroll KN. The association of maternal prenatal vitamin D levels and child current wheeze. Ann Allergy Asthma Immunol 2017; 120:98-99. [PMID: 29162316 DOI: 10.1016/j.anai.2017.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/19/2017] [Accepted: 10/04/2017] [Indexed: 12/23/2022]
Affiliation(s)
- Shanda Vereen
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Praveen K Potukuchi
- Division of Nephrology, University of Tennessee Health Science Center, Memphis,Tennessee
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Frances Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Kecia N Carroll
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
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