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Hozawa A, Nakaya K, Nakaya N, Nakamura T, Kogure M, Hatanaka R, Chiba I, Kanno I, Sugawara J, Kodama E, Hamanaka Y, Kobayashi T, Uruno A, Tsuchiya N, Hirata T, Narita A, Tsuboi A, Tamahara T, Otsuki A, Goto M, Taira M, Shimizu R, Suzuki K, Obara T, Kikuya M, Metoki H, Ishikuro M, Danjoh I, Ogishima S, Nagaie S, Minegishi N, Hiratsuka M, Kumada K, Nishijima I, Nobukuni T, Yamaguchi-Kabata Y, Nagami F, Kure S, Fuse N, Kinoshita K, Izumi Y, Kuriyama S, Yamamoto M. Progress report of the Tohoku Medical Megabank Community-Based Cohort Study: Study profile of the repeated center-based survey during second period in Miyagi Prefecture. J Epidemiol 2024:JE20230241. [PMID: 38403692 DOI: 10.2188/jea.je20230241] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND The purpose of this study was to report the basic profile of the Miyagi Prefecture part of a repeated center-based survey during the second period (2nd period survey) of the Tohoku Medical Megabank Community-Based Cohort Study (TMM CommCohort Study), as well as the participants' characteristics based on their participation type in the baseline survey. METHODS The 2nd period survey, conducted from June 2017 to March 2021, included participants of the TMM CommCohort Study (May 2013 to March 2016). In addition to the questionnaire, blood, urine, and physiological function tests were performed during the 2nd period survey. There were three main ways of participation in the baseline survey: Type 1, Type 1 additional, or Type 2 survey. The 2nd period survey was conducted in the same manner as the Type 2 survey, which was based on the community support center (CSC). RESULTS In Miyagi Prefecture, 29,383 (57.7%) of 50,967 participants participated in the 2nd period survey. The participation rate among individuals who had visited the CSC was approximately 80%. Although some factors differed depending on the participation type in the baseline survey, the 2nd period survey respondents in the Type 1 and Type 2 survey groups at baseline had similar traits. CONCLUSIONS The 2nd period survey of the TMM CommCohort Study provided detailed follow-up information. Following up on the health conditions of the participants will clarify the long-term effects of disasters and contribute to personalized prevention.
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Affiliation(s)
- Atsushi Hozawa
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Kumi Nakaya
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
- Faculty of Data Science, Kyoto Women's University
| | - Mana Kogure
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Rieko Hatanaka
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Ippei Chiba
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Ikumi Kanno
- Graduate School of Medicine, Tohoku University
| | - Junichi Sugawara
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
- Suzuki Memorial Hospital
| | - Eiichi Kodama
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Yohei Hamanaka
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Tomoko Kobayashi
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Akira Uruno
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Naho Tsuchiya
- Tohoku Medical Megabank Organization, Tohoku University
- Yamato Home Medical Care Clinic Kurihara
| | - Takumi Hirata
- Tohoku Medical Megabank Organization, Tohoku University
- Institute for Clinical and Translational Science, Nara Medical University Hospital
| | - Akira Narita
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Akito Tsuboi
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Toru Tamahara
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Akihito Otsuki
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Maki Goto
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Makiko Taira
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Ritsuko Shimizu
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Kichiya Suzuki
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
- Department of Hygiene and Public Health, Teikyo University School of Medicine
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Inaho Danjoh
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Soichi Ogishima
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Satoshi Nagaie
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Naoko Minegishi
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Masahiro Hiratsuka
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Kazuki Kumada
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Ichiko Nishijima
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Takahiro Nobukuni
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Yumi Yamaguchi-Kabata
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Fuji Nagami
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Shigeo Kure
- Tohoku Medical Megabank Organization, Tohoku University
- Miyagi Children's Hospital
| | - Nobuo Fuse
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Kengo Kinoshita
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
- Graduate School of Information Sciences, Tohoku University
- Institute of Development., aging, and cancer, Tohoku University
| | - Yoko Izumi
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
- International Research Institute of Disaster Science, Tohoku University
| | - Masayuki Yamamoto
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
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Wu G, Wu J, Lu Q, Cheng Y, Mei W. Association between cardiovascular risk factors and atrial fibrillation. Front Cardiovasc Med 2023; 10:1110424. [PMID: 37753167 PMCID: PMC10518410 DOI: 10.3389/fcvm.2023.1110424] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
Background The most prevalent sustained arrhythmia in medical practice, atrial fibrillation (AF) is closely associated with a high risk of cardiovascular disease. Nevertheless, the risk of AF associated with cardiovascular risk factors has not been well elucidated. We pooled all published studies to provide a better depiction of the relationship among cardiovascular risk factors with AF. Methods Studies were searched in the MEDLINE, Web of Science, and EMBASE databases since initiation until January 15, 2022. Prospective cohort studies assessing the relationship a minimum of single cardiovascular risk factors to AF incidence were included if they contained adequate data for obtaining relative risks (RR) and 95% confidence intervals (CI). Random-effects models were utilized to perform independent meta-analyses on each cardiovascular risk factor. PROSPERO registry number: CRD42022310882. Results A total of 17,098,955 individuals and 738,843 incident cases were reported for data from 101 studies included in the analysis. In all, the risk of AF was 1.39 (95% CI, 1.30-1.49) for obesity, 1.27 (95% CI, 1.22-1.32) per 5 kg/m2 for increase in body mass index, 1.19 (95% CI, 1.10-1.28) for former smokers, 1.23 (95% CI, 1.09-1.38) for current smokers, 1.31 (95% CI, 1.23-1.39) for diabetes mellitus, 1.68 (95% CI, 1.51-1.87) for hypertension, and 1.12 (95% CI, 0.95-1.32) for dyslipidemia. Interpretation Adverse cardiovascular risk factors correlate with an increased risk of AF, yet dyslipidemia does not increase the risk of AF in the general population, potentially providing new insights for AF screening strategies among patients with these risk factors. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, PROSPERO identifier (CRD42022310882).
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Affiliation(s)
- Guohao Wu
- Department of General Practice, Huadu District People's Hospital, Southern Medical University, Guangzhou, China
| | - Jingguo Wu
- Department of Emergency Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Qin Lu
- Department of General Practice, The First Affiliated Hospital, Sun Yat-Sen University,Guangzhou, China
| | - Yunjiu Cheng
- Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University,Guangzhou, China
| | - Weiyi Mei
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-Sen University,Guangzhou, China
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Qin GQ, Chen L, Zheng J, Wu XM, Li Y, Yang K, Liu TF, Fang ZZ, Zhang Q. Effect of passive smoking exposure on risk of type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies. Front Endocrinol (Lausanne) 2023; 14:1195354. [PMID: 37600719 PMCID: PMC10432686 DOI: 10.3389/fendo.2023.1195354] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/12/2023] [Indexed: 08/22/2023] Open
Abstract
Objective The effect of passive smoking exposure on the risk of type 2 diabetes has not been systematically studied. A meta-analysis was conducted to assess the association between passive smoking exposure and the risk of diabetes. Methods We searched three major databases up to 31 October 2022 to identify relevant prospective cohort studies on the association between passive smoking and the risk of type 2 diabetes. The pooled relative risk (RR) and 95% confidence interval (CI) for the association between passive smoking exposure and the risk of type 2 diabetes were analyzed using a fixed-effect model. Results Ten prospective cohort studies were included in this meta-analysis, with a total of 251,620 participants involved. The pooled RR showed a significantly positive association between nonsmokers exposed to passive smoking and type 2 diabetes as compared to non-smokers who were not exposed to passive smoking [RR = 1.27; 95% CI (1.19, 1.36); p < 0.001]. Sensitivity analysis indicated that the pooled RR was not substantially affected by any of the individual studies. Conclusion Exposure to passive smoking increases the risk of type 2 diabetes. This study may have a positive effect on the prevention of type 2 diabetes. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023372532.
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Affiliation(s)
- Guo-Qiang Qin
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Li Chen
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jun Zheng
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
| | - Xiao-Min Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yang Li
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Kai Yang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Tong-Feng Liu
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhong-Ze Fang
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- National Demonstration Center for Experimental Preventive Medicine Education, Tianjin Medical University, Tianjin, China
| | - Qiang Zhang
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
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Jessri M, Hennessey D, Bader Eddeen A, Bennett C, Sanmartin C, Manuel D. Mortality and Life Expectancy Lost in Canada Attributable to Dietary Patterns: Evidence From Canadian National Nutrition Survey Linked to Routinely Collected Health Administrative Databases. Am J Epidemiol 2023; 192:377-396. [PMID: 36288797 DOI: 10.1093/aje/kwac189] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 07/18/2022] [Accepted: 10/18/2022] [Indexed: 11/14/2022] Open
Abstract
Using 5 diet quality indexes, we estimated the mortality and life expectancy lost, at the national level, attributable to poor dietary patterns, which had previously been largely unknown. We used the Canadian Community Health Survey 2004, linked to vital statistics (n = 16,212 adults; representing n = 22,898,880). After a median follow-up of 7.5 years, 1,722 deaths were recorded. Population attributable fractions were calculated to estimate the mortality burden of poor dietary patterns (Dietary Guidelines for Americans Adherence Index 2015, Dietary Approaches to Stop Hypertension, Healthy Eating Index, Alternative Healthy Eating Index, and Mediterranean Style Dietary Pattern Score). Better diet quality was associated with a 32%-51% and 21%-43% reduction in all-cause mortality among adults aged 45-80 years and ≥20 years, respectively. Projected life expectancy at 45 years was longer for Canadians adhering to a healthy dietary pattern (average of 5.2-8.0 years (men) and 1.6-4.1 (women)). At the population level, 26.5%-38.9% (men) and 8.9%-22.9% (women) of deaths were attributable to poor dietary patterns. Survival benefit was greater for individuals with higher scores on all diet indexes, even with relatively small intake differences. The large attributable burden was likely from assessing overall dietary patterns instead of a limited range of foods and nutrients.
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George CM, Birindwa A, Li S, Williams C, Kuhl J, Thomas E, François R, Presence AS, Claude BRJ, Mirindi P, Bisimwa L, Perin J, Stine OC. Akkermansia muciniphila Associated with Improved Linear Growth among Young Children, Democratic Republic of the Congo. Emerg Infect Dis 2023; 29:81-88. [PMID: 36573546 PMCID: PMC9796213 DOI: 10.3201/eid2901.212118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
To investigate the association between enteric pathogens, fecal microbes, and child growth, we conducted a prospective cohort study of 236 children <5 years of age in rural eastern Democratic Republic of the Congo. We analyzed baseline fecal specimens by quantitative PCR and measured child height and weight at baseline and growth at a 6-month follow-up. At baseline, 66% (156/236) of children had >3 pathogens in their feces. We observed larger increases in height-for-age-z-scores from baseline to the 6-month follow-up among children with Akkermansia muciniphila in their feces (coefficient 0.02 [95% CI 0.0001-0.04]; p = 0.04). Children with Cryptosporidium in their feces had larger declines in weight-for-height/length z-scores from baseline to the 6-month follow-up (coefficient -0.03 [95% CI -0.05 to -0.005]; p = 0.02). Our study showed high prevalence of enteric pathogens among this pediatric cohort and suggests A. muciniphila can potentially serve as a probiotic to improve child growth.
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Chen P, Yang Z, Fan Z, Wang B, Tang Y, Xiao Y, Chen X, Luo D, Xiao S, Li J, Shen M. Associations of polysocial risk score with incident rosacea: a prospective cohort study of government employees in China. Front Public Health 2023; 11:1096687. [PMID: 37206873 PMCID: PMC10191232 DOI: 10.3389/fpubh.2023.1096687] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 04/10/2023] [Indexed: 05/21/2023] Open
Abstract
Background The associations between single risk factors and incident rosacea have been reported, but the effects of social risk factors from multiple domains coupled remain less studied. Objectives To quantify the influence of social determinants on rosacea comprehensively and investigate associations between the polysocial risk score (PsRS) with the risks of incident rosacea. Methods This was a prospective cohort study of government employees undertaken from January 2018 to December 2021 among participants aged >20 from five cities in Hunan province of China. At baseline, information was collected by a questionnaire and participants were involved in an examination of the skin. Dermatologists with certification confirmed the diagnosis of rosacea. The skin health status of participants was reassessed every year since the enrolment of study during the follow-up period. The PsRS was determined using the nine social determinants of health from three social risk domains (namely socioeconomic status, psychosocial factors, and living environment). Incident rosacea was estimated using binary logistic regression models adjusted for possible confounding variables. Results Among the 3,773 participants who completed at least two consecutive skin examinations, there were 2,993 participants included in the primary analyses. With 7,457 person-years of total follow-up, we detected 69 incident rosacea cases. After adjustment for major confounders, participants in the group with high social risk had significantly raised risks of incident rosacea with the adjusted odds ratio (aOR) being 2.42 (95% CI 1.06, 5.55), compared to those in low social risk group. Conclusion Our findings suggest that a higher PsRS was associated with an elevated risk of incident rosacea in our study population.
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Affiliation(s)
- Peng Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Ziye Yang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Zhihua Fan
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Ben Wang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Yan Tang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yi Xiao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China
| | - Dan Luo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Ji Li,
| | - Minxue Shen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
- Minxue Shen,
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Li T, Zhao Y, Yuan L, Zhang D, Feng Y, Hu H, Hu D, Liu J. Total dietary flavonoid intake and risk of cardiometabolic diseases: A dose-response meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr 2022; 64:2760-2772. [PMID: 36148848 DOI: 10.1080/10408398.2022.2126427] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Several epidemiological studies have suggested that flavonoid intake is associated with a decreased risk of cardiometabolic disease. However, the results remained inconsistent and there is no dose-response meta-analysis for specific outcomes. We conducted a meta-analysis to synthesize the knowledge about their associations and to explore their dose-response relationships. We comprehensively searched the PubMed, Embase, and Web of Science databases for prospective cohort studies published up to December 1, 2021. Summary relative risks (RR) and 95% confidence intervals (CI) were pooled for the association between flavonoid intake and cardiometabolic disease. Evaluations of linear or nonlinear dose-response were presented by restricted cubic splines. We identified 47 articles, including 1,346 676 participants and 127,507 cases in this meta-analysis. The summary of RR per 500 mg/d increase in flavonoid intake was 0.93 (95% CI 0.88-0.98) for cardiovascular disease, 0.89 (95% CI 0.84-0.94) for diabetes, and 0.97 (95% CI 0.94-0.99) for hypertension, respectively. We also found a linearity dose-response association between total flavonoid intake and cardiovascular disease (p nonlinearity = 0.541), and diabetes (p nonlinearity = 0.077). Our finding based on quantitative data suggested that a higher level of flavonoid intake is beneficial for the prevention of cardiometabolic diseases.
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Affiliation(s)
- Tianze Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Lijun Yuan
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongdong Zhang
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, China
| | - Yifei Feng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Huifang Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Jiaye Liu
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, China
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Xiao W, Huang J, Zhao C, Ding L, Wang X, Wu B. Diabetes and Risks of Right-Sided and Left-Sided Colon Cancer: A Meta-Analysis of Prospective Cohorts. Front Oncol 2022; 12:737330. [PMID: 35463382 PMCID: PMC9021717 DOI: 10.3389/fonc.2022.737330] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 03/17/2022] [Indexed: 11/22/2022] Open
Abstract
Background and Aims Diabetes is associated with an increased risk of colon cancer (CC). Epidemiologic studies previously reported a higher risk for right-sided colon cancer (RCC) compare to left-sided colon cancer (LCC), although data are conflicting. We performed a meta-analysis to investigate this issue. Methods We systematically searched the PubMed, EMBASE, Web of Science and Cochrane Library database for prospective cohort studies published up to June 2021. Studies were included if they reported site-specific estimates of the relative risk (RR) between diabetes and the risks of RCC and LCC. Random effects meta-analyses with inverse variance weighting were used to estimate the pooled site-specific RRs and the RCC-to-LCC ratio of RRs (RRRs). Results Data from 10 prospective cohort studies, representing 1,642,823 individuals (mainly white) and 17,624 CC patients, were included in the analysis. Diabetes was associated with an increased risk of both RCC (RR =1.35, 95% CI = 1.24-1.47) and LCC (RR = 1.18, 95% CI = 1.08-1.28). After adjusting for major risk factors, individuals with diabetes had a greater risk for RCC than for LCC (RRR = 1.13, 95% CI = 1.02-1.26), with no significant heterogeneity between studies (I2 = 0%). Conclusions This meta-analysis indicates that diabetes is associated with a higher risk for RCC than for LCC. Our findings suggest that colonoscopic surveillance in diabetic patients with careful examination of the right colon is warranted.
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Affiliation(s)
- Wenxuan Xiao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinglong Huang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chuanyi Zhao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lu Ding
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuan Wang
- Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bian Wu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Snowden JM, Klebanoff MA. Accurate identification of cohort study designs in perinatal research: a practical guide. Am J Obstet Gynecol 2022; 227:231-235.e1. [PMID: 35288086 DOI: 10.1016/j.ajog.2022.03.014] [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: 01/20/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/26/2022]
Abstract
Study designs are often mischaracterized in the obstetrics literature; in particular, the designation of studies as retrospective (historical) cohorts is frequently in error to describe studies that are prospective cohorts. This is especially true for studies based on electronic health records, which often should be properly considered as prospective cohorts. Epidemiologic study designs were developed in earlier eras of research and healthcare when researchers directly contacted study participants or relied on data from paper medical records. Accordingly, standard epidemiologic study design definitions are difficult to apply to digitized data, which have become common in the modern era of healthcare and computing. In this article, we briefly review the characteristics of the 3 main types of cohort studies. Afterward, we build on existing definitions by proposing several subdesignations of prospective cohort studies that we believe will reduce the confusion in terminology. We provide illustrative examples from obstetrics to concretely demonstrate connections and distinctions among study designs. First, a prospective cohort study can be "active" (participants are deliberately and explicitly enrolled in a prospective research study) or "passive" (participants are followed up in real time for some nonresearch activity, such as clinical care or quality improvement). An active prospective cohort study never stops being a prospective cohort study; however, when reused to answer a new, secondary question, we propose that this should be called a "reused (active) prospective cohort." The de novo cohort study that answered the original question should be considered an "intended (active) prospective cohort." Lastly, when a randomized controlled trial is reused to study some new questions where the randomization variable is not under study, this is also a subtype of a prospective cohort study, a "repurposed randomized controlled trial." The use of more detailed descriptors to describe prospective cohort studies will enable more accurate identification of this study design going forward. It is likely that further refinements will be needed in the future, given the ongoing evolution of how we engage with patients or participants and how data are collected, stored, and linked.
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10
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Kiran N, Prizment AE, Lazovich D, Mao Z, Bostick RM. Sucrose Intakes and Incident Colorectal Cancer Risk among Women. J Am Nutr Assoc 2022; 41:57-63. [PMID: 33315540 PMCID: PMC8428539 DOI: 10.1080/07315724.2020.1848661] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND High sucrose intakes are hypothesized to increase colorectal cancer (CRC) risk by several mechanisms, and sucrose intakes have been consistently positively associated with CRC risk in case-control studies. However, all but one prospective study reported a null sucrose-CRC association. The only prospective study to report a positive association was the Iowa Women's Health Study (IWHS) of 35,221 cancer-free Iowa women, aged 55 - 69 years old at baseline in 1986, after four years of follow up. MATERIALS AND METHODS To address the discrepant findings in the literature, after 26 years of follow up in the IWHS, we updated and expanded on our earlier reported analyses. During follow up through 2012, 1,731 women were diagnosed with CRC. Baseline dietary intakes were assessed with a Willett semiquantitative food frequency questionnaire. We used multivariable Cox proportional hazards regression models to estimate adjusted hazards ratios (HRs) and their 95% confidence intervals (CI). RESULTS For those in the highest relative to the lowest intake quintiles, the adjusted HRs (95% CI) for CRC were 1.04 (0.87-1.23; Ptrend = 0.59) for sucrose, 1.00 (0.82-1.21; Ptrend = 0.67) for sucrose-containing foods, and 1.01, (0.83-1.22; Ptrend = 0.56) for nondairy sucrose-containing foods, respectively. These findings did not differ substantially by colorectal site or according to categories of selected participant characteristics. CONCLUSIONS Our findings do not support that intakes of sucrose or sucrose-containing foods are substantially associated with CRC risk among older women.
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Affiliation(s)
- Nfn Kiran
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Anna E. Prizment
- Division of Hematology, Oncology and Transplantation, Medical School, University of Minnesota, Minneapolis, Minnesota.,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - DeAnn Lazovich
- Division of Hematology, Oncology and Transplantation, Medical School, University of Minnesota, Minneapolis, Minnesota.,Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Ziling Mao
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Roberd M. Bostick
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.,Winship Cancer Institute, Emory University, Atlanta, Georgia
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11
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Almeda N, Gómez-Gómez I. The Impact of the COVID-19 Pandemic on Smoking Consumption: A Systematic Review of Longitudinal Studies. Front Psychiatry 2022; 13:941575. [PMID: 35903638 PMCID: PMC9320170 DOI: 10.3389/fpsyt.2022.941575] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/09/2022] [Indexed: 11/24/2022] Open
Abstract
The COVID-19 pandemic has generated a global health crisis that has negatively impacted the mental health and wellbeing of the population. A large amount of scientific literature has emerged since 2019, but none of these studies have focused on assessing the impact of COVID-19 on smoking consumption. We aimed to analyse the changes in smoking consumption during the COVID-19 pandemic through longitudinal studies. This systematic review follows the PRISMA Statement. This study was registered on PROSPERO (CRD42021282235). MEDLINE, ERIC, PsycARTICLES, Scopus, Web of Science and PsycINFO databases were searched from inception to 24 October 2021. We completed an extensive assessment of all prospective cohort studies that aimed to explore the effect of the COVID-19 pandemic on tobacco consumption habits. According to the PICOS's acronym, we included all population (P) types and studies developed before and during the COVID-19 pandemic (I) with a change in nicotine consumption as the outcome (O), as well as prospective cohort studies. The risk of bias was assessed using the Newcastle-Ottawa Scale for observational studies. The results showed that 14 cohorts reported in 11 articles fulfilled the inclusion criteria. A total of 58,052 participants were included in the review. Most of the studies pointed out a reduction in the number of cigarettes and e-cigarettes consumed from baseline (before the pandemic) to follow-up (during the pandemic). Only two studies reported an increase in cigarette or e-cigarette consumption from baseline to follow-up. The majority of studies presented a low risk of bias. In conclusion, the impact of the COVID-19 pandemic on smoking behavior is complex and uncertain. The decrease in smoking consumption during the pandemic could be related to the fear of becoming infected by COVID-19, the advancement of COVID-19, and the reduction in social gatherings. In several cases, the increases in nicotine consumption can be explained by psychological distress. These findings can be used to create strategies to prevent relapses during the post-vaccination phases of the pandemic. Systematic Review Registration: PROSPERO, identifier: CRD42021282235.
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Affiliation(s)
- Nerea Almeda
- Department of Psychology, Universidad Loyola Andalucía, Sevilla, Spain
| | - Irene Gómez-Gómez
- Department of Psychology, Universidad Loyola Andalucía, Sevilla, Spain
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12
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Jiang L, Wang J, Xiong K, Xu L, Zhang B, Ma A. Intake of Fish and Marine n-3 Polyunsaturated Fatty Acids and Risk of Cardiovascular Disease Mortality: A Meta-Analysis of Prospective Cohort Studies. Nutrients 2021; 13:2342. [PMID: 34371852 DOI: 10.3390/nu13072342] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 12/17/2022] Open
Abstract
Previous epidemiological studies have investigated the association of fish and marine n-3 polyunsaturated fatty acids (n-3 PUFA) consumption with cardiovascular disease (CVD) mortality risk. However, the results were inconsistent. The purpose of this meta-analysis is to quantitatively evaluate the association between marine n-3 PUFA, fish and CVD mortality risk with prospective cohort studies. A systematic search was performed on PubMed, Web of Science, Embase and MEDLINE databases from the establishment of the database to May 2021. A total of 25 cohort studies were included with 2,027,512 participants and 103,734 CVD deaths. The results indicated that the fish consumption was inversely associated with the CVD mortality risk [relevant risk (RR) = 0.91; 95% confidence intervals (CI) 0.85−0.98]. The higher marine n-3 PUFA intake was associated with the reduced risk of CVD mortality (RR = 0.87; 95% CI: 0.85–0.89). Dose-response analysis suggested that the risk of CVD mortality was decreased by 4% with an increase of 20 g of fish intake (RR = 0.96; 95% CI: 0.94–0.99) or 80 milligrams of marine n-3 PUFA intake (RR = 0.96; 95% CI: 0.94–0.98) per day. The current work provides evidence that the intake of fish and marine n-3 PUFA are inversely associated with the risk of CVD mortality.
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13
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Liang Z, Li A, Xu Y, Qian X, Gao X. Hearing Loss and Dementia: A Meta-Analysis of Prospective Cohort Studies. Front Aging Neurosci 2021; 13:695117. [PMID: 34305572 PMCID: PMC8295986 DOI: 10.3389/fnagi.2021.695117] [Citation(s) in RCA: 12] [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: 04/16/2021] [Accepted: 05/31/2021] [Indexed: 12/25/2022] Open
Abstract
Background: Consensus is lacking with regard to whether hearing loss is an independent risk factor for dementia. We therefore conducted a meta-analysis to clarify the relationship of hearing loss and dementia. Methods: Prospective cohort studies investigating the association between hearing loss and the incidence of dementia in a community-derived population were included by searching electronic databases that included PubMed, Embase, and Cochrane's Library. A random-effects model was adopted to combine the results. Results: Fourteen cohorts including 726,900 participants were analyzed. It was shown that hearing loss was independently associated with dementia [adjusted hazard ratio (HR): 1.59, 95% confidence interval (CI): 1.37 to 1.86, p < 0.001; I2 = 86%]. Sensitivity analysis sequentially excluding any of the individual studies included showed similar results. Subgroup analysis according to the diagnostic methods for hearing loss, validation strategy for dementia, follow-up duration, and adjustment of apolipoprotein E genotype also showed consistent results (p-values for subgroup differences all > 0.05). Meta-analysis with five studies showed that hearing loss was also connected to higher risk of Alzheimer's disease (adjusted HR: 2.24, 95% CI: 1.32 to 3.79, p = 0.003; I2 = 2%). Conclusions: Hearing loss may increase the risk of dementia in the adult population. Whether effective treatment for hearing loss could reduce the incidence of dementia should be explored in the future.
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Affiliation(s)
- Zheng Liang
- Jiangsu Provincial Key Medical Discipline (Laboratory), Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Ao Li
- Jiangsu Provincial Key Medical Discipline (Laboratory), Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yuanyuan Xu
- Department of Neurology, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoyun Qian
- Jiangsu Provincial Key Medical Discipline (Laboratory), Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Xia Gao
- Jiangsu Provincial Key Medical Discipline (Laboratory), Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
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14
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Jafari S, Hezaveh E, Jalilpiran Y, Jayedi A, Wong A, Safaiyan A, Barzegar A. Plant-based diets and risk of disease mortality: a systematic review and meta-analysis of cohort studies. Crit Rev Food Sci Nutr 2021; 62:7760-7772. [PMID: 33951994 DOI: 10.1080/10408398.2021.1918628] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We aimed to examine the association between adherence to plant-based diets (PBDs) and the risk of mortality among the general population. Relevant investigations were identified through PubMed, Scopus, Embase, and ISI Web of Knowledge. Data were pooled using a random-effects or a fixed-effects model. Twelve prospective cohort studies with 42,697 deaths among 508,861 participants were included. The hazard ratios (HRs) for the highest compared to the lowest category of adherence to the PBDs were 0.90 (95% confidence interval [CI]: 0.82, 0.99; I2 = 91%, n = 12) for all-cause and 0.77 (95% CI: 0.70, 0.86; I2 = 36%, n = 8) for coronary heart disease (CHD) mortality. Among PBDs subtypes, there was an inverse association between healthy plant-based 0.92 (95% CI: 0.88, 0.96; I2 = 0%, n = 2), Pesco-vegetarian 0.81 (95% CI: 0.70, 0.92; I2 = 0%, n = 2), and Pro-vegetarian 0.74 (95% CI: 0.55, 0.88; I2 = 61.2%, n = 2) diets and the risk of all-cause mortality. A vegetarian diet was also associated with lower risk of mortality due to cardiovascular 0.92 (95% CI: 0.85, 0.99; I2 = 0%, n = 5) and CHD 0.76 (95% CI: 0.68, 0.85; I2 = 35%, n = 7). Our findings show the potential protective role of PBDs against chronic disease mortality. As there were certain limitations in some of the studies included in this systematic review and meta-analysis, further research is necessary to confirm our findings.
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Affiliation(s)
- Sahar Jafari
- Department of Community Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Erfan Hezaveh
- Department of Biochemistry and Dietetics, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yahya Jalilpiran
- Department of Clinical Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Jayedi
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, VA, USA
| | - Abdolrasoul Safaiyan
- Department of Biostatistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Barzegar
- Department of Community Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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15
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Chan WC, Millwood IY, Kartsonaki C, Du H, Guo Y, Chen Y, Bian Z, Walters RG, Lv J, He P, Hu C, Li L, Yang L, Chen Z. Spicy food consumption and risk of gastrointestinal-tract cancers: findings from the China Kadoorie Biobank. Int J Epidemiol 2021; 50:199-211. [PMID: 33484129 PMCID: PMC7938514 DOI: 10.1093/ije/dyaa275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 11/12/2020] [Accepted: 12/14/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Previous case-control studies have reported positive associations of spicy food consumption with risks of certain gastrointestinal-tract (GI) cancers. However, there is no prospective evidence on such associations, particularly from China, where there are high incidence rates of GI cancers and spicy food is widely consumed. METHODS The prospective China Kadoorie Biobank study recruited >512 000 adults aged 30-79 years from 10 areas in China during 2004-2008; 2350 oesophageal, 3350 stomach and 3061 colorectal incident cancer cases were recorded by 1 January 2017, after a median of 10.1 years of follow-up. Cox regression yielded adjusted hazard ratios (HRs) for each cancer associated with spicy food intake. RESULTS Overall, 30% of participants reported daily spicy food consumption at baseline. Spicy food consumption was inversely associated with oesophageal cancer risk, with adjusted HRs of 1.00, 0.88, 0.76, 0.84 and 0.81 for those who never/rarely consumed (reference) and consumed monthly, 1-2 days/week, 3-5 days/week and 6-7 days/week, respectively (ptrend < 0.002). The association remained similar after excluding the first 3 years of follow-up but appeared stronger in participants who did not smoke or drink alcohol regularly (ptrend < 0.0001). The corresponding HRs for stomach cancer were 1.00, 0.97, 0.95, 0.92 and 0.89 (ptrend = 0.04), with the association disappearing after excluding the first 3 years of follow-up. For colorectal cancer, the HRs were 1.00, 1.00, 0.95, 0.87 and 0.90, respectively (ptrend = 0.04) and the inverse association appeared to be restricted to rectal rather than colon cancer (pheterogeneity = 0.004). The types and strength of spice used showed little additional effects on these associations. CONCLUSION In Chinese adults, higher spicy food consumption was associated with lower risks of certain GI cancers, particularly among individuals who never smoked or drank alcohol regularly.
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Affiliation(s)
- Wing Ching Chan
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Iona Y Millwood
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Christiana Kartsonaki
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Huaidong Du
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Robin G Walters
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Pan He
- NCDs Prevention and Control Department, Huixian Center for Disease Control and Prevention, Henan, China
| | - Chen Hu
- NCDs Prevention and Control Department, Huixian Center for Disease Control and Prevention, Henan, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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16
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Jalilpiran Y, Jayedi A, Djafarian K, Shab-Bidar S. The Nordic diet and the risk of non-communicable chronic disease and mortality: a systematic review and dose-response meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr 2020; 62:3124-3136. [PMID: 33354987 DOI: 10.1080/10408398.2020.1863906] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We aimed to investigate the association between adherence to the Nordic diet (ND) and the risk of chronic disease. PubMed, Scopus, and ISI Web of Science were searched to February 2020 to find prospective cohort studies. The relative risks (RRs) were calculated using a fixed-effects/random-effects model. The certainty of evidence was rated using the GRADE approach. Thirteen prospective cohort studies with 930,153 participants were included. The RRs for the highest compared to the lowest category of adherence to the ND were 0.78 (95%CI: 0.69, 0.87; I2 = 51%, n = 6) for all-cause mortality, 0.78 (95%CI: 0.74, 0.83; I2 = 70%, n = 4) for cardiovascular mortality, 0.86 (95%CI: 0.80, 0.93; I2 = 83%, n = 4) for cancer mortality, 0.88 (95%CI: 0.79, 0.98; I2 = 3%, n = 3) for stroke, 0.80 (95%CI: 0.68, 0.95; I2 = 47%, n = 3) for myocardial infarction, and 0.90 (95%CI: 0.82, 0.99; I2 = 33%, n = 4) for type 2 diabetes. There was an inverse linear association between the ND score and the risk of mortality, and an inverse monotonic association for type 2 diabetes. The certainty in the estimates ranged from very low to low.
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Affiliation(s)
- Yahya Jalilpiran
- Department of Clinical Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ahmad Jayedi
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Food Safety Research Center (Salt), Semnan University of Medical Sciences, Semnan, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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17
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Zhang Y, Ding J, Guo H, Liang J, Li Y. Associations of Fish and Omega-3 Fatty Acids Consumption With the Risk of Venous Thromboembolism. A Meta-Analysis of Prospective Cohort Studies. Front Nutr 2020; 7:614784. [PMID: 33425977 PMCID: PMC7793732 DOI: 10.3389/fnut.2020.614784] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 10/07/2020] [Accepted: 11/25/2020] [Indexed: 12/18/2022] Open
Abstract
Objective: This study aims to investigate the effect of fish and omega-3 fatty acids consumption on the risk of VTE. Methods: A comprehensive literature search in the databases of PubMed, Web of Science, and Embase (up to September 2020), was conducted to identify the prospective cohort studies concerning the associations of fish and omega-3 fatty acids consumption with the risk of VTE. The pooled relative risk (RR) of VTE for the highest vs. lowest category of fish and omega-3 fatty acids consumption, as well as their corresponding 95% confidence interval (CI) were calculated. Results: A total of seven articles with eight prospective cohort studies were included. Specifically, six studies were related to fish consumption, and the overall multi-variable adjusted RR showed no significant relationship between fish consumption and the risk of VTE (RR = 1.02, 95% CI: 0.93-1.11; P = 0.709). In the four studies related to omega-3 fatty acids consumption, the overall multi-variable adjusted RR suggested that omega-3 fatty acids consumption was associated with a lower risk of VTE (RR = 0.89, 95% CI: 0.80-0.98; P = 0.024). Moreover, two studies were related to recurrent VTE, and the overall multi-variable adjusted RR demonstrated a significant inverse association between omega-3 fatty acids consumption and the risk of recurrent VTE (RR = 0.45, 95% CI: 0.25-0.81; P = 0.008). Conclusion: Although current evidence is still insufficient to demonstrate any relationship between fish consumption and the risk of VTE, omega-3 fatty acids consumption seems to be associated with a lower risk of both VTE and recurrent VTE. Further large well-designed prospective cohort studies are warranted to elaborate the issues examined in this study.
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Affiliation(s)
- Yi Zhang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Jun Ding
- Changsha Social Work College, Changsha, China
| | - Hongbin Guo
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Jieyu Liang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Yusheng Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
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18
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Li XY, Zhang M, Xu W, Li JQ, Cao XP, Yu JT, Tan L. Midlife Modifiable Risk Factors for Dementia: A Systematic Review and Meta-analysis of 34 Prospective Cohort Studies. Curr Alzheimer Res 2020; 16:1254-1268. [PMID: 31902364 DOI: 10.2174/1567205017666200103111253] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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: 01/11/2019] [Revised: 11/25/2019] [Accepted: 12/29/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The aim of this study is to assess the association between midlife risk factors and dementia. METHODS PubMed and Cochrane library were systematically searched on May 24, 2018, to retrieve prospective cohort studies. The summary Relative Risk (RR) and 95% Confidence Interval (CI) were calculated by the random-effect model to explore the association between midlife risk factors and dementia. Sensitivity analysis and meta-regression were conducted to explore the source of heterogeneity. Publication bias was examined using Begg's and Egger's tests. RESULTS Thirty-four prospective cohort studies were included, among which 24 were eligible for metaanalysis. A total of 159,594 non-demented adults were enrolled at baseline before 65 years and 13,540 people were diagnosed with dementia after follow-up. The pooled results revealed that five factors could significantly increase the dementia risk by 41 to 78%, including obesity (RR, 1.78; 95% CI: 1.31-2.41), diabetes mellitus (RR, 1.69; 95% CI: 1.38-2.07), current smoking (RR, 1.61; 95%, CI: 1.32-1.95), hypercholesterolemia (RR, 1.57; 95% CI: 1.19-2.07), and hypertension (borderline blood pressure RR, 1.41; 95% CI: 1.23-1.62 and high Systolic Blood Pressure (SBP) RR, 1.72; 95% CI: 1.25-2.37). However, the sensitivity analyses found that the results of hypercholesterolemia and high SBP were not reliable, which need to be confirmed by more high-quality studies. No influences due to publication bias were revealed. In the systematic review, another three factors (hyperhomocysteinemia, psychological stress, and heavy drinking) were found to be associated with elevated dementia risk. In addition, physical exercise, a healthy diet, and hormone therapy in middle age were associated with the reduction of dementia risk. CONCLUSIONS Middle-aged people with obesity, diabetes, hypertension, or hypercholesterolemia, and current smokers in midlife are at higher risk of developing dementia later in life.
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Affiliation(s)
- Xiao-Ying Li
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Min Zhang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Wei Xu
- College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China
| | - Jie-Qiong Li
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Xi-Peng Cao
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jin-Tai Yu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.,Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.,College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China
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19
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Dreher ML, Ford NA. A Comprehensive Critical Assessment of Increased Fruit and Vegetable Intake on Weight Loss in Women. Nutrients 2020; 12:nu12071919. [PMID: 32610460 PMCID: PMC7399879 DOI: 10.3390/nu12071919] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 12/16/2022] Open
Abstract
No previous reviews or meta-analyses have specifically assessed the effects of increased fruit and vegetable (FV) intake on weight loss with a primary focus on women. Several studies show differences between men and women in how increased FV intake affects their weight loss and maintenance, risk of becoming overweight or obese, and the influence of eating speed and frequency on weight control. This analysis provides a comprehensive and visual assessment of the effects of increasing FV intake and long-term weight change from observational studies and weight loss from randomized controlled trials (RCTs) in women. Consistent evidence from prospective studies and RCTs shows that increased intake of FV is a chief contributor to weight loss in women. This effect is enhanced with concurrent dietary restriction of high energy density (ED) or high-fat foods. Yet, the type of FV differentially impacts weight loss in women. Whole FV intake may influence weight through a variety of mechanisms including a reduction in eating rate, providing a satisfying, very-low to low energy density, low glycemic load or low-fat content. Also, FV are the primary source of dietary fiber, which can provide additional support for weight loss in women when consumed at adequate levels.
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Affiliation(s)
- Mark L. Dreher
- Nutrition Science Solutions, LLC, 900 S Rainbow Ranch Rd, Wimberley, TX 78676, USA;
| | - Nikki A. Ford
- Avocado Nutrition Center, 25212 Marguerite Pkwy Ste. 250, Mission Viejo, CA 92692, USA
- Correspondence: ; Tel.: +1-949-341-3250
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20
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Szemik S, Gajda M, Kowalska M. [The review of prospective studies on mental health and the quality of life of physicians and medical students]. Med Pr 2020; 71:483-491. [PMID: 32644055 DOI: 10.13075/mp.5893.00958] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Psychosocial determinants play a significant role in shaping mental health and the quality of life of workers, including physicians. The results of the presented review indicate that mental health problems of physicians are particularly manifested by chronic fatigue syndrome and burnout syndrome, and are related to chronic stress exposure at the workplace. Moreover, published data suggest that the most important mental health problems of medical students and young doctors include alcohol addiction and risky alcohol consumption, depression, and potential suicidal ideation. The studies on mental health and the quality of life of physicians, including their determinants, as presented in this paper, were mostly conducted on the basis of prospective observations that enable the tracking of changes over time. Med Pr. 2020;71(4):483-91.
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Affiliation(s)
- Szymon Szemik
- Śląski Uniwersytet Medyczny / Medical University of Silesia, Katowice, Poland (Wydział Nauk o Zdrowiu w Katowicach, Katedra Pielęgniarstwa, Zakład Propedeutyki Pielęgniarstwa / School of Health Sciences in Katowice, Chair of Nursing, Department of Nursing Propaedeutics)
| | - Maksymilian Gajda
- Śląski Uniwersytet Medyczny / Medical University of Silesia, Katowice, Poland (Wydział Nauk Medycznych w Katowicach, Katedra i Zakład Epidemiologii / School of Medicine in Katowice, Chair and Department of Epidemiology)
| | - Małgorzata Kowalska
- Śląski Uniwersytet Medyczny / Medical University of Silesia, Katowice, Poland (Wydział Nauk Medycznych w Katowicach, Katedra i Zakład Epidemiologii / School of Medicine in Katowice, Chair and Department of Epidemiology)
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21
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Wagner M, Grodstein F, Proust-Lima C, Samieri C. Long-Term Trajectories of Body Weight, Diet, and Physical Activity From Midlife Through Late Life and Subsequent Cognitive Decline in Women. Am J Epidemiol 2020; 189:305-313. [PMID: 31781745 DOI: 10.1093/aje/kwz262] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 11/05/2019] [Accepted: 11/07/2019] [Indexed: 12/21/2022] Open
Abstract
Healthy lifestyles are promising targets for prevention of cognitive aging, yet the optimal time windows for interventions remain unclear. We selected a case-control sample nested within the Nurses' Health Study (starting year 1976, mean age = 51 years), including 14,956 women aged ≥70 years who were free of both stroke and cognitive impairment at enrollment in a cognitive substudy (1995-2001). Cases (n = 1,496) were women with the 10% worst slopes of cognitive decline, and controls (n = 7,478) were those with slopes better than the median. We compared the trajectories of body mass index (weight (kg)/height (m)2), alternate Mediterranean diet (A-MeDi) score, and physical activity between groups, from midlife through 1 year preceding the cognitive substudy. In midlife, cases had higher body mass index than controls (mean difference (MD) = 0.59 units, 95% confidence interval (CI): 0.39, 0.80), lower physical activity (MD = -1.41 metabolic equivalent of task-hours/week, 95% CI: -2.07, -0.71), and worse A-MeDi scores (MD = -0.16 points, 95% CI: -0.26, -0.06). From midlife through later life, compared with controls, cases had consistently lower A-MeDi scores but a deceleration of weight gain and a faster decrease in physical activity. In conclusion, maintaining a healthy lifestyle since midlife may help reduce cognitive decline in aging. At older ages, both deceleration of weight gain and a decrease in physical activity may reflect early signs of cognitive impairment.
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Affiliation(s)
- Maude Wagner
- Bordeaux Population Health Research Center, Institut National de la Santé et de la Recherche Médicale Unité 1219, and University of Bordeaux, Institut de Santé Publique d’Epidémiologie et de Développement, Bordeaux, France
| | - Francine Grodstein
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Cécile Proust-Lima
- Bordeaux Population Health Research Center, Institut National de la Santé et de la Recherche Médicale Unité 1219, and University of Bordeaux, Institut de Santé Publique d’Epidémiologie et de Développement, Bordeaux, France
| | - Cécilia Samieri
- Bordeaux Population Health Research Center, Institut National de la Santé et de la Recherche Médicale Unité 1219, and University of Bordeaux, Institut de Santé Publique d’Epidémiologie et de Développement, Bordeaux, France
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22
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Zhao B, Deng H, Li B, Chen L, Zou F, Hu L, Wei Y, Zhang W. Association of magnesium consumption with type 2 diabetes and glucose metabolism: A systematic review and pooled study with trial sequential analysis. Diabetes Metab Res Rev 2020; 36:e3243. [PMID: 31758631 DOI: 10.1002/dmrr.3243] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 11/17/2019] [Accepted: 11/18/2019] [Indexed: 12/15/2022]
Abstract
Prevention of type 2 diabetes (T2D) with diet or diet supplementation is challenging. This article aims to draw conclusive associations between magnesium intake and T2D incidence and evaluate the effect of magnesium supplementation on glucose metabolism. Databases were searched for related articles from inception to May 15, 2019. Prospective cohort studies investigating the relevant relationship as well as randomized controlled trials (RCTs) assessing the effect of magnesium supplementation were eligible. We conducted trial sequential analysis (TSA) to prove the sufficiency of the current evidence. Twenty-six publications involving 35 cohorts were included in the analysis. Compared to the lowest magnesium intake, the highest level was associated with a 22% lower risk for T2D; the risk was reduced by 6% for each 100 mg increment in daily magnesium intake. Additional analysis of 26 RCTs (1168 participants) was performed, revealing that magnesium supplementation significantly reduced the fasting plasma glucose (FPG) level (SMD, -0.32 [95% CI, -0.59 to -0.05], 2-hour oral glucose tolerance test (2-h OGTT) result (SMD, -0.30 [-0.58 to -0.02]), fasting insulin level (SMD, -0.17 [-0.30 to -0.04]), homeostatic model assessment-insulin resistance (HOMA-IR) score (SMD, -0.41 [-0.71 to -0.11]), triglyceride (TG) level, systolic blood pressure (SBP) and diastolic blood pressure (DBP). TSA showed an inverse association, with most benefits of magnesium supplementation on glucose metabolism being stable. In conclusion, magnesium intake has an inverse dose-response association with T2D incidence, and supplementation appears to be advisable in terms of glucose parameters in T2D/high-risk individuals.
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Affiliation(s)
- Binghao Zhao
- Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huan Deng
- Department of Endocrinology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Bo Li
- Department of Endocrinology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Lian Chen
- Department of Endocrinology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Fang Zou
- Department of Endocrinology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lei Hu
- Department of Endocrinology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yiping Wei
- Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wenxiong Zhang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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23
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Hozawa A, Tanno K, Nakaya N, Nakamura T, Tsuchiya N, Hirata T, Narita A, Kogure M, Nochioka K, Sasaki R, Takanashi N, Otsuka K, Sakata K, Kuriyama S, Kikuya M, Tanabe O, Sugawara J, Suzuki K, Suzuki Y, Kodama EN, Fuse N, Kiyomoto H, Tomita H, Uruno A, Hamanaka Y, Metoki H, Ishikuro M, Obara T, Kobayashi T, Kitatani K, Takai-Igarashi T, Ogishima S, Satoh M, Ohmomo H, Tsuboi A, Egawa S, Ishii T, Ito K, Ito S, Taki Y, Minegishi N, Ishii N, Nagasaki M, Igarashi K, Koshiba S, Shimizu R, Tamiya G, Nakayama K, Motohashi H, Yasuda J, Shimizu A, Hachiya T, Shiwa Y, Tominaga T, Tanaka H, Oyama K, Tanaka R, Kawame H, Fukushima A, Ishigaki Y, Tokutomi T, Osumi N, Kobayashi T, Nagami F, Hashizume H, Arai T, Kawaguchi Y, Higuchi S, Sakaida M, Endo R, Nishizuka S, Tsuji I, Hitomi J, Nakamura M, Ogasawara K, Yaegashi N, Kinoshita K, Kure S, Sakai A, Kobayashi S, Sobue K, Sasaki M, Yamamoto M. Study Profile of the Tohoku Medical Megabank Community-Based Cohort Study. J Epidemiol 2020; 31:65-76. [PMID: 31932529 PMCID: PMC7738642 DOI: 10.2188/jea.je20190271] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [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] [Indexed: 12/02/2022] Open
Abstract
Background We established a community-based cohort study to assess the long-term impact of the Great East Japan Earthquake on disaster victims and gene-environment interactions on the incidence of major diseases, such as cancer and cardiovascular diseases. Methods We asked participants to join our cohort in the health check-up settings and assessment center based settings. Inclusion criteria were aged 20 years or over and living in Miyagi or Iwate Prefecture. We obtained information on lifestyle, effect of disaster, blood, and urine information (Type 1 survey), and some detailed measurements (Type 2 survey), such as carotid echography and calcaneal ultrasound bone mineral density. All participants agreed to measure genome information and to distribute their information widely. Results As a result, 87,865 gave their informed consent to join our study. Participation rate at health check-up site was about 70%. The participants in the Type 1 survey were more likely to have psychological distress than those in the Type 2 survey, and women were more likely to have psychological distress than men. Additionally, coastal residents were more likely to have higher degrees of psychological distress than inland residents, regardless of sex. Conclusion This cohort comprised a large sample size and it contains information on the natural disaster, genome information, and metabolome information. This cohort also had several detailed measurements. Using this cohort enabled us to clarify the long-term effect of the disaster and also to establish personalized prevention based on genome, metabolome, and other omics information.
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Affiliation(s)
- Atsushi Hozawa
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Kozo Tanno
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,School of Medicine, Iwate Medical University
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Saitama Prefectural University
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Naho Tsuchiya
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Takumi Hirata
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Akira Narita
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Mana Kogure
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Kotaro Nochioka
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Tohoku University Hospital, Tohoku University
| | - Ryohei Sasaki
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,School of Medicine, Iwate Medical University
| | - Nobuyuki Takanashi
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University
| | - Kotaro Otsuka
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,School of Medicine, Iwate Medical University
| | - Kiyomi Sakata
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,School of Medicine, Iwate Medical University
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,International Research Institute of Disaster Science, Tohoku University
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Teikyo University School of Medicine
| | - Osamu Tanabe
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Radiation Effects Research Foundation
| | - Junichi Sugawara
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Tohoku University Hospital, Tohoku University
| | - Kichiya Suzuki
- Tohoku Medical Megabank Organization, Tohoku University.,Tohoku University Hospital, Tohoku University
| | - Yoichi Suzuki
- Tohoku Medical Megabank Organization, Tohoku University.,Ageo Central General Hospital
| | - Eiichi N Kodama
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Tohoku University Hospital, Tohoku University.,International Research Institute of Disaster Science, Tohoku University
| | - Nobuo Fuse
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Hideyasu Kiyomoto
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Hiroaki Tomita
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Tohoku University Hospital, Tohoku University.,International Research Institute of Disaster Science, Tohoku University
| | - Akira Uruno
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Yohei Hamanaka
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University.,Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Tohoku University Hospital, Tohoku University
| | - Tomoko Kobayashi
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Kazuyuki Kitatani
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Setsunan University
| | - Takako Takai-Igarashi
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Soichi Ogishima
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Mamoru Satoh
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,Institute for Biomedical Sciences, Iwate Medical University
| | - Hideki Ohmomo
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University
| | - Akito Tsuboi
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Dentistry, Tohoku University
| | - Shinichi Egawa
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,International Research Institute of Disaster Science, Tohoku University
| | - Tadashi Ishii
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Tohoku University Hospital, Tohoku University
| | - Kiyoshi Ito
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,International Research Institute of Disaster Science, Tohoku University
| | - Sadayoshi Ito
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Tohoku University Hospital, Tohoku University
| | - Yasuyuki Taki
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Institute of Development, Aging and Cancer, Tohoku University
| | - Naoko Minegishi
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Naoto Ishii
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Masao Nagasaki
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Graduate School of Information Sciences, Tohoku University.,Kyoto University Graduate School of Medicine Faculty of Medicine
| | - Kazuhiko Igarashi
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Seizo Koshiba
- Tohoku Medical Megabank Organization, Tohoku University
| | - Ritsuko Shimizu
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Gen Tamiya
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Center for Advanced Intelligence Project, RIKEN
| | - Keiko Nakayama
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Hozumi Motohashi
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Institute of Development, Aging and Cancer, Tohoku University
| | - Jun Yasuda
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Miyagi Cancer Center
| | - Atsushi Shimizu
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University
| | - Tsuyoshi Hachiya
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University
| | - Yuh Shiwa
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University
| | - Teiji Tominaga
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Tohoku University Hospital, Tohoku University
| | - Hiroshi Tanaka
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Tokyo Medical and Dental University
| | - Kotaro Oyama
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,School of Medicine, Iwate Medical University
| | - Ryoichi Tanaka
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,School of Medicine, Iwate Medical University
| | - Hiroshi Kawame
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,The JIKEI University School of Medicine
| | - Akimune Fukushima
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,School of Medicine, Iwate Medical University
| | - Yasushi Ishigaki
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,School of Medicine, Iwate Medical University
| | - Tomoharu Tokutomi
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,School of Medicine, Iwate Medical University
| | - Noriko Osumi
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | | | - Fuji Nagami
- Tohoku Medical Megabank Organization, Tohoku University
| | | | - Tomohiko Arai
- Tohoku Medical Megabank Organization, Tohoku University
| | | | | | | | - Ryujin Endo
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,Iwate Medical University School of Nursing
| | - Satoshi Nishizuka
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,Institute for Biomedical Sciences, Iwate Medical University
| | - Ichiro Tsuji
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
| | - Jiro Hitomi
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,School of Medicine, Iwate Medical University
| | | | - Kuniaki Ogasawara
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,School of Medicine, Iwate Medical University
| | - Nobuo Yaegashi
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Tohoku University Hospital, Tohoku University
| | - Kengo Kinoshita
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Information Sciences, Tohoku University
| | - Shigeo Kure
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University.,Tohoku University Hospital, Tohoku University
| | | | | | | | - Makoto Sasaki
- Iwate Tohoku Medical Megabank Organization, Disaster Reconstruction Center, Iwate Medical University.,Institute for Biomedical Sciences, Iwate Medical University
| | - Masayuki Yamamoto
- Tohoku Medical Megabank Organization, Tohoku University.,Graduate School of Medicine, Tohoku University
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24
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Li M, Rahman ML, Wu J, Ding M, Chavarro JE, Lin Y, Ley SH, Bao W, Grunnet LG, Hinkle SN, Thuesen ACB, Yeung E, Gore-Langton RE, Sherman S, Hjort L, Kampmann FB, Bjerregaard AA, Damm P, Tekola-Ayele F, Liu A, Mills JL, Vaag A, Olsen SF, Hu FB, Zhang C. Genetic factors and risk of type 2 diabetes among women with a history of gestational diabetes: findings from two independent populations. BMJ Open Diabetes Res Care 2020; 8:8/1/e000850. [PMID: 31958311 PMCID: PMC7039588 DOI: 10.1136/bmjdrc-2019-000850] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/22/2019] [Accepted: 12/10/2019] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Women with a history of gestational diabetes mellitus (GDM) have an exceptionally high risk for type 2 diabetes (T2D). Yet, little is known about genetic determinants for T2D in this population. We examined the association of a genetic risk score (GRS) with risk of T2D in two independent populations of women with a history of GDM and how this association might be modified by non-genetic determinants for T2D. RESEARCH DESIGN AND METHODS This cohort study included 2434 white women with a history of GDM from the Nurses' Health Study II (NHSII, n=1884) and the Danish National Birth Cohort (DNBC, n=550). A GRS for T2D was calculated using 59 candidate single nucleotide polymorphisms for T2D identified from genome-wide association studies in European populations. An alternate healthy eating index (AHEI) score was derived to reflect dietary quality after the pregnancy affected by GDM. RESULTS Women on average were followed for 21 years in NHSII and 13 years in DNBC, during which 446 (23.7%) and 155 (28.2%) developed T2D, respectively. The GRS was generally positively associated with T2D risk in both cohorts. In the pooled analysis, the relative risks (RRs) for increasing quartiles of GRS were 1.00, 0.97, 1.25 and 1.19 (p trend=0.02). In both cohorts, the association appeared to be stronger among women with poorer (AHEI <median) than better dietary quality (AHEI ≥median), although the interaction was not significant. For example, in NHSII, the RRs across increasing quartiles of GRS were 1.00, 0.99, 1.51 and 1.29 (p trend=0.06) among women with poorer dietary quality and 1.00, 0.83, 0.81 and 0.94 (p trend=0.79) among women with better dietary quality (p interaction=0.11). CONCLUSIONS Among white women with a history of GDM, higher GRS for T2D was associated with an increased risk of T2D.
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Affiliation(s)
- Mengying Li
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Mohammad L Rahman
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
- Department of Population Medicine and Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Jing Wu
- Glotech, Rockville, Maryland, USA
| | - Ming Ding
- Department of Nutrition, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Yuan Lin
- Epidemiology Department, Richard M. Fairbanks School of Public Health, Indiana University, Bloomington, Indiana, USA
| | - Sylvia H Ley
- Department of Nutrition, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Louise G Grunnet
- Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark
| | - Stefanie N Hinkle
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Anne Cathrine B Thuesen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Edwina Yeung
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | | | - Seth Sherman
- The Emmes Company, LLC, Rockville, Maryland, USA
| | - Line Hjort
- Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark
- Departments of Obstetrics, Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark
| | - Freja Bach Kampmann
- Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark
- Division for Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | | | - Peter Damm
- Departments of Obstetrics, Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Fasil Tekola-Ayele
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Aiyi Liu
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - James L Mills
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Allan Vaag
- Early Clinical Development and Innovative Medicines, AstraZeneca, Mölndal, Sweden
| | - Sjurdur F Olsen
- Nutrition Group, Statens Serum Institut, Copenhagen, Denmark
| | - Frank B Hu
- Department of Nutrition, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Cuilin Zhang
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
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Soltani S, Jayedi A, Shab-Bidar S, Becerra-Tomás N, Salas-Salvadó J. Adherence to the Mediterranean Diet in Relation to All-Cause Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Adv Nutr 2019; 10:1029-1039. [PMID: 31111871 PMCID: PMC6855973 DOI: 10.1093/advances/nmz041] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/11/2018] [Accepted: 03/25/2019] [Indexed: 02/07/2023] Open
Abstract
A previous meta-analysis provided convincing evidence for an inverse association between adherence to a Mediterranean diet (MedDiet) and the risk of all-cause mortality. Since then, 19 prospective studies have been published. We updated the evidence from these prospective studies and conducted a dose-response meta-analysis to test the linear and potential nonlinear dose-response associations between adherence to a MedDiet and the risk of all-cause mortality. The PubMed, Scopus, ISI Web of Knowledge, and Embase bibliographic databases were systematically searched up to August 24, 2018. Summary HRs were estimated with the use of a random-effects meta-analysis to assess the association between a 2-point increment in MedDiet adherence and the risk of all-cause mortality. Sensitivity and subgroup analyses were performed and potential publication bias was tested. Twenty-nine prospective studies with 1,676,901 participants and 221,603 cases of all-cause mortality were included in the final analysis. The pooled HR of all-cause mortality was 0.90 (95% CI: 0.89, 0.91; I2 = 81.1%) for a 2-point increment in adherence to a MedDiet. Subgroup analyses showed that a significant inverse association was stronger in participants who lived in the Mediterranean region compared with non-Mediterranean areas (HRs: 0.82 compared with 0.92, respectively), and in studies that used the Panagiotakos MedDiet score. A nonlinear dose-response meta-analysis indicated that the risk of all-cause mortality linearly decreased with the increase in adherence to a MedDiet. The robustness of findings was confirmed in the sensitivity analyses. In conclusion, low-quality evidence from prospective cohort studies suggests an inverse association between adherence to a MedDiet and the risk of all-cause mortality, especially in Mediterranean regions. An inverse linear dose-response relation was also observed between adherence to a MedDiet and the risk of all-cause mortality.
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Affiliation(s)
- Sepideh Soltani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Jayedi
- Food (Salt) Safety Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran,Address correspondence to SS-B (e-mail: )
| | - Nerea Becerra-Tomás
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
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26
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Satija A, Malik V, Rimm EB, Sacks F, Willett W, Hu FB. Changes in intake of plant-based diets and weight change: results from 3 prospective cohort studies. Am J Clin Nutr 2019; 110:574-582. [PMID: 31127828 PMCID: PMC6735841 DOI: 10.1093/ajcn/nqz049] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [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: 11/16/2018] [Accepted: 03/12/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Studies have found beneficial effects of plant-based diets on weight. However, not all plant foods are necessarily beneficial. OBJECTIVES The aim of this study was to examine associations of changes in intake of 3 variations of plant-based diet indices (overall, healthful, and unhealthful) with weight change over 4-y intervals spanning >20 y. METHODS Data from 3 ongoing prospective observational cohort studies in the United States were used, namely the Nurses' Health Study (NHS), NHS2, and the Health Professionals Follow-up Study (HPFS), with 126,982 adult men and women. Self-reported diet data were collected every 4 y, and self-reported weight data were used to compute weight change every 4 y over >20 y of follow-up. RESULTS On average, participants gained a mean of 0.90 kg (HPFS) to 1.98 kg (NHS2) over 4-y intervals. Different types of plant-based diet indices were associated with different amounts of weight gain. After adjusting for several potential confounders, including concomitant changes in other lifestyle factors, a 1-SD increase in intake of an overall plant-based diet index was associated with 0.04 kg less weight gain over 4-y periods (95% CI: 0.05, 0.02 kg; P < 0.001). A 1-SD increase in intake of a healthful version of a plant-based diet index (emphasizing whole grains, fruits/vegetables, nuts/legumes, vegetable oils, tea/coffee) was associated with 0.68 kg less weight gain over 4-y periods (95% CI: 0.69, 0.66 kg; P < 0.001). Conversely, a 1-SD increase in an unhealthful version of a plant-based diet index (emphasizing refined grains, potato/fries, sweets, sweetened drinks/juices) was associated with 0.36 kg more weight gain (95% CI: 0.34, 0.37 kg, P < 0.001). CONCLUSION Plant-based diets, especially when rich in healthier plant foods, are associated with less weight gain over 4-y intervals. This supports current recommendations to increase intake of healthy plant foods, and reducing intake of less-healthy plant foods and animal foods, for improved health outcomes.
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Affiliation(s)
| | | | - Eric B Rimm
- Departments of Nutrition
- Epidemiology, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | | | - Walter Willett
- Departments of Nutrition
- Epidemiology, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Frank B Hu
- Departments of Nutrition
- Epidemiology, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
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27
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Wang Y, Lv H, Li D, Chen C, Gu G, Sun Y, Yang X, Liu Y, Fang F, Liu J, Tse G, Xia Y. Efficacy and Safety of Direct Oral Anticoagulants for Secondary Prevention of Cancer-Associated Thrombosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Prospective Cohort Studies. Front Pharmacol 2019; 10:773. [PMID: 31354488 PMCID: PMC6635657 DOI: 10.3389/fphar.2019.00773] [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] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 06/14/2019] [Indexed: 01/08/2023] Open
Abstract
Background: Venous thromboembolism (VTE) is a common complication in patients with cancer. Direct oral anticoagulants (DOACs) have been proved to be effective on anticoagulation therapy in many diseases. However, the efficacy and the safety of DOACs in the secondary prevention of cancer-associated thrombosis (CAT) remain unclear. To assess the value of DOACs in patients with CAT, we performed a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. Methods: Medline, Embase, and the Cochrane Library were searched from their earliest date through to June 2018. Two investigators independently assessed eligibility. Data were extracted by one investigator and verified by the second investigator. The efficacy outcome of this study was recurrent VTE, whereas the safety outcome was major and clinically relevant nonmajor bleeding. Relative risks (RRs) and their corresponding 95% confidence interval (CI) were determined. To pool the results, the Mantel-Haenszel fixed-effects or random-effects models were used. Results: A total of nine articles (six randomized controlled trials and three prospective studies) involving 2,697 patients with CAT who were prescribed DOACs (apixaban, edoxaban, rivaroxaban, or dabigatran) and 2,852 patients who were prescribed traditional anticoagulants [vitamin K antagonists (VKAs), low molecular weight heparin (LMWH), dalteparin, or enoxaparin] were compared. VTE recurrence in the DOAC group was significantly lower than that observed in the traditional anticoagulant group (RR: 0.60; 95%CI: 0.49-0.75; I 2: 0%; p < 0.00001). No significant difference in bleeding risk between both groups was found (RR: 0.95; 95%CI: 0.67-1.36; I 2: 75%; p = 0.79). Conclusions: Our findings showed that anticoagulant therapy with DOACs may be more effective than traditional anticoagulants to prevent recurrent VTE in patients with CAT, while the safety of DOACs may be equal to that of traditional anticoagulants. These findings support the use of DOACs as the first-line therapy for secondary prevention of CAT in most cancer patients.
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Affiliation(s)
- Yunsong Wang
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Haichen Lv
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Daobo Li
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Cheng Chen
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Guangming Gu
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yang Sun
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiaolei Yang
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ying Liu
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Fengqi Fang
- Department of Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jiwei Liu
- Department of Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Gary Tse
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, Hong Kong
- Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yunlong Xia
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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28
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Glenn AJ, Viguiliouk E, Seider M, Boucher BA, Khan TA, Blanco Mejia S, Jenkins DJA, Kahleová H, Rahelić D, Salas-Salvadó J, Kendall CWC, Sievenpiper JL. Relation of Vegetarian Dietary Patterns With Major Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Front Nutr 2019; 6:80. [PMID: 31263700 PMCID: PMC6585466 DOI: 10.3389/fnut.2019.00080] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 05/16/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Vegetarian dietary patterns are recommended for cardiovascular disease (CVD) prevention and management due to their favorable effects on cardiometabolic risk factors, however, the role of vegetarian dietary patterns in CVD incidence and mortality remains unclear. Objective: To update the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy, we undertook a systematic review and meta-analysis of the association of vegetarian dietary patterns with major cardiovascular outcomes in prospective cohort studies that included individuals with and without diabetes using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Methods: MEDLINE, EMBASE, and Cochrane databases were searched through September 6th, 2018. We included prospective cohort studies ≥1 year of follow-up including individuals with or without diabetes reporting the relation of vegetarian and non-vegetarian dietary patterns with at least one cardiovascular outcome. Two independent reviewers extracted data and assessed study quality (Newcastle-Ottawa Scale). The pre-specified outcomes included CVD incidence and mortality (total CVD, coronary heart disease (CHD) and stroke). Risk ratios for associations were pooled using inverse variance random effects model and expressed as risk ratios (RRs) with 95% confidence intervals (CIs). Heterogeneity was assessed (Cochran Q-statistic) and quantified (I2-statistic). The overall certainty of the evidence was assessed using GRADE. Results: Seven prospective cohort studies (197,737 participants, 8,430 events) were included. A vegetarian dietary pattern was associated with reduced CHD mortality [RR, 0.78 (CI, 0.69, 0.88)] and incidence [0.72 (0.61, 0.85)] but were not associated with CVD mortality [0.92 (0.84, 1.02)] and stroke mortality [0.92 (0.77, 1.10)]. The overall certainty of the evidence was graded as “very low” for all outcomes, owing to downgrades for indirectness and imprecision. Conclusions: Very low-quality evidence indicates that vegetarian dietary patterns are associated with reductions in CHD mortality and incidence but not with CVD and stroke mortality in individuals with and without diabetes. More research, particularly in different populations, is needed to improve the certainty in our estimates. Clinical Trial Registration:Clinicaltrials.gov, identifier: NCT03610828.
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Affiliation(s)
- Andrea J Glenn
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Effie Viguiliouk
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Maxine Seider
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Beatrice A Boucher
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Tauseef A Khan
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Sonia Blanco Mejia
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - David J A Jenkins
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada.,Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Hana Kahleová
- Physicians Committee for Responsible Medicine, Washington, DC, United States.,Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Dario Rahelić
- Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain.,Human Nutrition Department, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Cyril W C Kendall
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada.,College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada
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29
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Kaluza J, Harris HR, Linden A, Wolk A. Alcohol Consumption and Risk of Chronic Obstructive Pulmonary Disease: A Prospective Cohort Study of Men. Am J Epidemiol 2019; 188:907-916. [PMID: 30877760 DOI: 10.1093/aje/kwz020] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 12/18/2022] Open
Abstract
Studies indicate an inverse association between moderate alcohol consumption and chronic inflammatory diseases; however, the association between alcohol consumption and chronic obstructive pulmonary disease (COPD) incidence has not been widely studied. We investigated the associations of total alcohol consumption and intake of specific alcoholic beverages with risk of COPD in a population-based prospective cohort study, the Cohort of Swedish Men (n = 44,254). Alcohol consumption was assessed with a self-administered questionnaire in 1997. During follow-up (1998-2014), 2,177 COPD cases were ascertained. Moderate alcohol consumption was associated with the lowest risk of COPD. A J-shaped association was observed for ethanol consumption (P for nonlinearity = 0.003) and beer consumption (P for nonlinearity < 0.001); for wine consumption, a U-shaped association was observed (P for nonlinearity < 0.001). Defining a "standard drink" as 12 g of ethanol, the multivariable-adjusted hazard ratios were 0.77 (95% confidence interval (CI): 0.66, 0.90) and 0.92 (95% CI: 0.81, 1.05) for beer consumption of 4.1-6.0 and >6.0 standard drinks/week (SDW) versus <1.0 SDW, respectively; 0.80 (95% CI: 0.69, 0.93) and 1.00 (95% CI: 0.83, 1.21) for wine consumption of 2.0-4.0 and >4.0 SDW versus <1.0 SDW, respectively; and 1.10 (95% CI: 0.98, 1.24) and 1.20 (95% CI: 0.99, 1.44) for liquor consumption of 2.0-4.0 and >4.0 SDW versus <1.0 SDW, respectively. In conclusion, our findings suggest that moderate beer and wine consumption, but not liquor consumption, may decrease risk of COPD. Additional studies are needed to confirm these associations.
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Affiliation(s)
- Joanna Kaluza
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Human Nutrition, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Anders Linden
- Unit for Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
| | - Alicja Wolk
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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30
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Abstract
In a recent review, Mukadam, Sommerlad, and Livingston (2017) argue that bilingualism offers no protection against cognitive decline. The authors examined the results of 13 studies (five prospective, eight retrospective) in which monolinguals and bilinguals were compared for cognitive decline and onset of dementia symptoms. Analysis of four of the five prospective studies resulted in the conclusion that there was no difference between monolinguals and bilinguals, whereas seven of the eight retrospective studies actually showed bilingualism to result in a four-to-five year delay of symptom onset. The authors decided to ignore the results from the retrospective studies in favor of those from the prospective studies, reasoning that the former may be confounded by participants' cultural background and education levels. In this commentary, we argue that most of these studies actually controlled for these two variables and still found a positive effect of bilingualism. Furthermore, we argue that the meta-analysis of the prospective studies is not complete, lacking the results of two crucial reports. We conclude that the literature offers substantial evidence for a bilingual effect on the development of cognitive decline and dementia.
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Affiliation(s)
- Evy Woumans
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Jan Versijpt
- Department of Neurology, Brussels University Hospital, Vrije Universiteit Brussel, Brussels, Belgium
| | - Anne Sieben
- Department of Neurology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Patrick Santens
- Department of Neurology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Wouter Duyck
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
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31
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Wei EX, Li X, Nan H. Extremity nevus count is an independent risk factor for basal cell carcinoma and melanoma, but not squamous cell carcinoma. J Am Acad Dermatol 2019; 80:970-978. [PMID: 30713015 DOI: 10.1016/j.jaad.2018.09.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 08/04/2018] [Accepted: 09/11/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND The presence of nevi portends an increased risk for melanoma. OBJECTIVE We sought to examine the association between extremity nevus count and the risk of melanoma and keratinocyte cancers. METHODS We evaluated prospective cohorts of 176,317 women (the Nurses' Health Study, 1986-2012 and the Nurses' Health Study 2, 1989-2013) and 32,383 men (Health Professionals Follow-up Study, 1986-2012). Information on nevus count (none, 1-5, 6-14, ≥15) on the extremity was collected at baseline. RESULTS There were 1704 incident cases of melanoma, 2296 incident cases of squamous cell carcinoma, and 30,457 incident cases of basal cell carcinoma, with a total of 4,655,043 person-years for melanoma and 4,267,708 person-years for keratinocyte cancers. The presence of an extremity nevus was associated with an increased risk of melanoma in all anatomic areas and increased risk of basal cell carcinoma (BCC). Individuals with ≥15 nevi had the highest risk of melanoma and BCC compared to those without any extremity nevi (melanoma hazard ratio 2.79 [95% confidence interval 2.04-3.83]; BCC HR 1.40 [95% confidence interval 1.32-1.49]). No significant association was observed for squamous cell carcinoma. LIMITATIONS Limitations of our study included self-reported nevus count and detection bias. CONCLUSIONS Extremity nevus count is a helpful clinical marker in risk-stratifying individuals for BCC and melanoma on all body sites.
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Affiliation(s)
- Erin X Wei
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Xin Li
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana
| | - Hongmei Nan
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana; Indiana University Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, Indiana.
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32
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Min M, Shi T, Sun C, Liang M, Zhang Y, Wu Y, Sun Y. The association between orthostatic hypotension and dementia: A meta-analysis of prospective cohort studies. Int J Geriatr Psychiatry 2018; 33:1541-1547. [PMID: 30247788 DOI: 10.1002/gps.4964] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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] [Received: 02/05/2018] [Accepted: 07/22/2018] [Indexed: 01/23/2023]
Abstract
OBJECTIVES As for the association between orthostatic hypotension (OH) and dementia, results of published studies are inconsistent; therefore, current substantive conclusions have yet been obtained. This meta-analysis was conducted in hopes of producing progress in this topic. METHODS A systematic database search was performed towards electronic databases including Chinese Biomedical Database, PubMed, Web of Science, Wiley Online Library, ScienceDirect, and the Cochrane Library. Five prospective cohort studies were included. Summary hazard ratio (HR) estimates with 95% confidence intervals (CIs) were calculated by random-effects model. Statistical heterogeneity was assessed with the Cochran Q test and I2 statistic. A sensitivity analysis was also conducted in this meta-analysis. RESULTS A 22.4% higher prevalence of dementia in subjects with OH was obtained (adjusted pooled HR was 1.224; 95% CI: 1.106-1.354; P < .001). This meta-analysis also showed significant associations between OH and 2 dementia subtypes: Alzheimer disease (adjusted pooled HR was 1.175; 95% CI: 1.022-1.351; P = .023) and Vascular dementia (adjusted pooled HR was 1.403; 95% CI: 1.042-1.889; P = .026), respectively. CONCLUSIONS Orthostatic hypotension is positively associated with the overall prevalence of dementia, and it may contribute to the prevalence of Alzheimer disease and Vascular dementia as well.
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Affiliation(s)
- Min Min
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Tingting Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Chenyu Sun
- The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yun Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yile Wu
- The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.,Centre for Evidence-Based Practice, Anhui Medical University, Hefei, Anhui, China
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Petimar J, O'Reilly É, Adami HO, van den Brandt PA, Buring J, English DR, Freedman DM, Giles GG, Håkansson N, Kurth T, Larsson SC, Robien K, Schouten LJ, Weiderpass E, Wolk A, Smith-Warner SA. Coffee, tea, and caffeine intake and amyotrophic lateral sclerosis mortality in a pooled analysis of eight prospective cohort studies. Eur J Neurol 2018; 26:468-475. [PMID: 30326172 DOI: 10.1111/ene.13840] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 05/10/2018] [Accepted: 09/10/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Caffeine is associated with a lower risk of some neurological diseases, but few prospective studies have investigated caffeine intake and risk of amyotrophic lateral sclerosis (ALS) mortality. We therefore determined associations between coffee, tea and caffeine intake, and risk of ALS mortality. METHODS We conducted pooled analyses of eight international, prospective cohort studies, including 351 565 individuals (120 688 men and 230 877 women). We assessed coffee, tea and caffeine intake using validated food-frequency questionnaires administered at baseline. We used Cox regression to estimate study- and sex-specific risk ratios and 95% confidence intervals (CI) for ALS mortality, which were then pooled using a random-effects model. We conducted analyses using cohort-specific tertiles, absolute common cut-points and continuous measures of all exposures. RESULTS During follow-up, 545 ALS deaths were documented. We did not observe statistically significant associations between coffee, tea or caffeine intake and risk of ALS mortality. The pooled multivariable risk ratio (MVRR) for ≥3 cups per day vs. >0 to <1 cup per day was 1.04 (95% CI, 0.74-1.47) for coffee and 1.17 (95% CI, 0.77-1.79) for tea. The pooled MVRR comparing the highest with the lowest tertile of caffeine intake (mg/day) was 0.99 (95% CI, 0.80-1.23). No statistically significant results were observed when exposures were modeled as tertiles or continuously. CONCLUSIONS Our results do not support associations between coffee, tea or total caffeine intake and risk of ALS mortality.
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Affiliation(s)
- J Petimar
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - É O'Reilly
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.,School of Public Health, College of Medicine, University College Cork, Cork, Ireland
| | - H-O Adami
- Karolinska Institutet, Stockholm, Sweden
| | | | - J Buring
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - D R English
- Cancer Council Victoria, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - D M Freedman
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - G G Giles
- Cancer Council Victoria, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - T Kurth
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - K Robien
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - L J Schouten
- Caphri School, Maastricht University, Maastricht, The Netherlands
| | - E Weiderpass
- Karolinska Institutet, Stockholm, Sweden.,Institute of Population-Based Cancer Research, Oslo, Norway
| | - A Wolk
- Karolinska Institutet, Stockholm, Sweden
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Satija A, Stampfer MJ, Rimm EB, Willett W, Hu FB. Perspective: Are Large, Simple Trials the Solution for Nutrition Research? Adv Nutr 2018; 9:378-387. [PMID: 30032229 PMCID: PMC6054238 DOI: 10.1093/advances/nmy030] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 03/28/2018] [Accepted: 04/19/2018] [Indexed: 12/14/2022] Open
Abstract
Nutritional research and policies have been criticized for relying on observational evidence, using self-report diet assessment methods, and supposedly being unable to present a consensus on what constitutes a healthy diet. In particular, it is often asserted that for progress to occur in nutrition science, large, simple trials, which have worked well in evaluating the efficacy of drugs, need to replace most observational research and small trials in nutrition. However, this idea is infeasible, and is unlikely to advance nutritional sciences or improve policies. This article addresses some commonly held and unfounded "myths" surrounding dietary assessments, effect sizes, and confounding, demonstrating how carefully conducted observational studies can provide reliable and reproducible evidence on diet and health. Also, there is a strong consensus among nutritional researchers and practitioners about the basic elements of a healthy diet. To move forward, we should continue to improve study design and diet assessment methodologies, reduce measurement errors, and leverage new technologies. Advances in the field lie in coalescing evidence from multiple study designs, methodologies, and technologies, and translating what we already know into policy and practice, so we can improve diet quality and enhance health in an equitable and sustainable manner across the world.
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Affiliation(s)
- Ambika Satija
- Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
| | - Meir J Stampfer
- Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
- Departments of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Eric B Rimm
- Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
- Departments of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Walter Willett
- Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
- Departments of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Frank B Hu
- Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
- Departments of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
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Ma X, Tang WG, Yang Y, Zhang QL, Zheng JL, Xiang YB. Association between whole grain intake and all-cause mortality: a meta-analysis of cohort studies. Oncotarget 2018; 7:61996-62005. [PMID: 27566558 PMCID: PMC5308706 DOI: 10.18632/oncotarget.11491] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 03/24/2016] [Accepted: 08/09/2016] [Indexed: 12/26/2022] Open
Abstract
Some observational studies have examined the association between dietary whole grain intake and all-cause mortality, but the results were inconclusive. We therefore conducted a meta-analysis to summarize the evidence from cohort studies regarding the association between whole grain intake and all-cause mortality. Pertinent studies were identified by searching PubMed, Embase and Web of Knowledge, up to February 28, 2016. Study-specific estimates were combined using random-effects models. Eleven prospective cohort studies involving 101,282 deaths and 843,749 participants were included in this meta-analysis. The pooled relative risk of all-cause mortality for the highest category of whole grain intake versus lowest category was 0.82 (95% confidence interval: 0.78, 0.87). There was a 7% reduction in risk associated with each 1 serving/day increase in whole grain intake (relative risk = 0.93; 95% confidence interval: 0.89, 0.97). No publication bias was found. This analysis indicates that higher intake of whole grain is associated with a reduced risk of all-cause mortality. The findings support current recommendations for increasing whole grain consumption to promote health and overall longevity.
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Affiliation(s)
- Xiao Ma
- State Key Laboratory of Oncogenes and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei-Guo Tang
- State Key Laboratory of Oncogenes and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yang Yang
- State Key Laboratory of Oncogenes and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qing-Li Zhang
- State Key Laboratory of Oncogenes and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jia-Li Zheng
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Yong-Bing Xiang
- State Key Laboratory of Oncogenes and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Grosso G, Marventano S, Yang J, Micek A, Pajak A, Scalfi L, Galvano F, Kales SN. A comprehensive meta-analysis on evidence of Mediterranean diet and cardiovascular disease: Are individual components equal? Crit Rev Food Sci Nutr 2018; 57:3218-3232. [PMID: 26528631 DOI: 10.1080/10408398.2015.1107021] [Citation(s) in RCA: 268] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Many studies have reported that higher adherence to Mediterranean diet may decrease cardiovascular disease (CVD) incidence and mortality. We performed a meta-analysis to explore the association in prospective studies and randomized control trials (RCTs) between Mediterranean diet adherence and CVD incidence and mortality. The PubMed database was searched up to June 2014. A total of 17 studies were extracted and 11 qualified for the quantitative analysis. Individuals in the highest quantile of adherence to the diet had lower incidence [relative risk (RR): 0.76, 95% confidence intervals (CI): 0.68, 0.83] and mortality (RR: 0.76, 95% CI: 0.68, 0.83) from CVD compared to those least adherent. A significant reduction of risk was found also for coronary heart disease (CHD) (RR: 0.72, 95% CI: 0.60, 0.86), myocardial infarction (MI) (RR: 0.67; 95% CI: 0.54, 0.83), and stroke (RR: 0.76; 95% CI: 0.60, 0.96) incidence. Pooled analyses of individual components of the diet revealed that the protective effects of the diet appear to be most attributable to olive oil, fruits, vegetables, and legumes. An average reduced risk of 40% for the aforementioned outcomes has been retrieved when pooling results of RCTs. A Mediterranean dietary pattern is associated with lower risks of CVD incidence and mortality, including CHD and MI. The relative effects of specific food groups should be further investigated.
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Affiliation(s)
- Giuseppe Grosso
- a Integrated Cancer Registry of Catania-Messina-Siracusa-Enna , Catania , Italy
| | - Stefano Marventano
- b Department of Medical, Surgical Sciences, and Advanced Technologies "G.F. Ingrassia," Section of Hygiene and Preventive Medicine, University of Catania , Catania , Italy
| | - Justin Yang
- c Department of Environmental Health , Environmental & Occupational Medicine & Epidemiology, Harvard TH Chan School of Public Health , Boston , Massachusetts , USA.,d St. Elizabeth's Medical Center , Tufts University School of Medicine , Boston , Massachusetts , USA
| | - Agnieszka Micek
- e Department of Epidemiology and Population Studies , Jagiellonian University Medical College , Krakow , Poland
| | - Andrzej Pajak
- e Department of Epidemiology and Population Studies , Jagiellonian University Medical College , Krakow , Poland
| | - Luca Scalfi
- f Department of Food Science , "Federico II" University Medical School , Naples , Italy
| | - Fabio Galvano
- g Department of Biomedical and Biotechnological Sciences, Section of Pharmacology and Biochemistry , University of Catania , Catania , Italy
| | - Stefanos N Kales
- c Department of Environmental Health , Environmental & Occupational Medicine & Epidemiology, Harvard TH Chan School of Public Health , Boston , Massachusetts , USA.,h The Cambridge Health Alliance, Harvard Medical School , Cambridge , Massachusetts , USA
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Evins AE, Korhonen T, Kinnunen TH, Kaprio J. Prospective association between tobacco smoking and death by suicide: a competing risks hazard analysis in a large twin cohort with 35-year follow-up. Psychol Med 2017; 47:2143-2154. [PMID: 28399944 PMCID: PMC5551385 DOI: 10.1017/s0033291717000587] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 01/02/2017] [Accepted: 02/14/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND The relationship between smoking and suicide remains controversial. METHOD A total of 16 282 twin pairs born before 1958 in Finland and alive in 1974 were queried with detailed health and smoking questionnaires in 1975 and 1981, with response rates of 89% and 84%. Smoking status and dose, marital, employment, and socio-economic status, and indicators of psychiatric and somatic illness were assessed at both time points. Emergent psychiatric and medical illness and vital status, including suicide determined by forensic autopsy, were evaluated over 35-year follow-up through government registries. The association between smoking and suicide was determined in competing risks hazard models. In twin pairs discordant for smoking and suicide, the prospective association between smoking and suicide was determined using a matched case-control design. RESULTS Smokers had a higher cumulative suicide incidence than former or never smokers. Heavy smokers had significantly higher suicide risk [hazard ratio (HR) 3.47, 95% confidence interval (CI) 2.31-5.22] than light smokers (HR 2.30, 95% CI 1.61-3.23) (p = 0.017). Compared with never smokers, smokers, but not former smokers, had increased suicide risk (HR 2.56, 95% CI 1.43-4.59), adjusting for depressive symptoms, alcohol and sedative-hypnotic use, and excluding those who developed serious somatic or psychiatric illness. In twin pairs discordant for smoking and suicide, suicide was more likely in smokers [odds ratio (OR) 6.0, 95% CI 2.06-23.8]. CONCLUSIONS Adults who smoked tobacco were more likely to die by suicide, with a large, dose-dependent effect. This effect remained after consideration of many known predictors of suicide and shared familial effects, consistent with the hypothesis that exposure to tobacco smoke increases the risk of suicide.
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Affiliation(s)
- A. E. Evins
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - T. Korhonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- National Institute for Health and Welfare, Helsinki, Finland
| | - T. H. Kinnunen
- Behavioral Science Consulting, Hopkinton, MA, USA
- Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland
| | - J. Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
- Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland
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Martens AL, Slottje P, Timmermans DRM, Kromhout H, Reedijk M, Vermeulen RCH, Smid T. Modeled and Perceived Exposure to Radiofrequency Electromagnetic Fields From Mobile-Phone Base Stations and the Development of Symptoms Over Time in a General Population Cohort. Am J Epidemiol 2017; 186:210-219. [PMID: 28398549 DOI: 10.1093/aje/kwx041] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/29/2016] [Indexed: 12/18/2022] Open
Abstract
We assessed associations between modeled and perceived exposure to radiofrequency electromagnetic fields (RF-EMF) from mobile-phone base stations and the development of nonspecific symptoms and sleep disturbances over time. A population-based Dutch cohort study, the Occupational and Environmental Health Cohort Study (AMIGO) (n = 14,829; ages 31-65 years), was established in 2011/2012 (T0), with follow-up of a subgroup (n = 3,992 invited) in 2013 (T1; n = 2,228) and 2014 (T2; n = 1,740). We modeled far-field RF-EMF exposure from mobile-phone base stations at the home addresses of the participants using a 3-dimensional geospatial model (NISMap). Perceived exposure (0 = not at all; 6 = very much), nonspecific symptoms, and sleep disturbances were assessed by questionnaire. We performed cross-sectional and longitudinal analyses, including fixed-effects regression. We found small correlations between modeled and perceived exposure in AMIGO participants at baseline (n = 14,309; rSpearman = 0.10). For 222 follow-up participants, modeled exposure increased substantially (>0.030 mW/m2) between T0 and T1. This increase in modeled exposure was associated with an increase in perceived exposure during the same time period. In contrast to modeled RF-EMF exposure from mobile-phone base stations, perceived exposure was associated with higher symptom reporting scores in both cross-sectional and longitudinal analyses, as well as with sleep disturbances in cross-sectional analyses.
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Abstract
Previous studies have indicated that statins intake was associated with liver cancer risk, but presented controversial results.Studies in PubMed and EMBASE were searched update to February 2017 to identify and quantify the potential dose-response association between statins intake and liver cancer.Six eligible studies involving a total of 11,8961 participants with 9530 incident cases were included in this meta-analysis. Statistically significant association was observed between increasing statins intake and liver cancer risk reduction (OR = 0.46, 95%CI: 0.24-0.68, P <.001). Furthermore, the summary relative risk of liver cancer for an increase of 50 cumulative defined daily dose per year was 0.86 (95%CI: 0.81-0.90, P <.001). Evidence of a nonlinear dose-response relationship between statins intake and liver cancer risk was found (P for nonlinearity <.01). Subgroups analysis indicated that statins intake was associated with a significantly risk of liver cancer risk reduction in Asia (OR = 0.44, 95%CI: 0.11-0.77, P <.001) and Caucasian (OR = 0.49, 95%CI: 0.36-0.61, P <.001). Subgroup meta-analyses in study design, study quality, number of participants, and number of cases showed consistency with the primary findings.Additional statins intake is associated with liver cancer risk reduction.
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Affiliation(s)
- Changhong Yi
- Department of Interventional, Jingzhou Central Hospital
- The Second Clinical Medical College Yangtze University, Jingzhou
| | - Zhenggui Song
- Department of Interventional, Zigui County Hospital of traditional Chinese Medicine, Yichang, Hubei Province, People's Republic of China
| | - Maolin Wan
- Department of Interventional, Jingzhou Central Hospital
| | - Ya Chen
- Department of Interventional, Jingzhou Central Hospital
| | - Xiang Cheng
- Department of Hepatobiliary surgery, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan
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Ma P, Yao Y, Sun W, Dai S, Zhou C. Daily sedentary time and its association with risk for colorectal cancer in adults: A dose-response meta-analysis of prospective cohort studies. Medicine (Baltimore) 2017; 96:e7049. [PMID: 28562564 PMCID: PMC5459729 DOI: 10.1097/md.0000000000007049] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Sedentary behavior is emerging as an independent risk factor for health. However, previous studies have indicated that sedentary behaviors are associated with the colorectal cancer risk, but presented controversial results.Studies in PubMed and EMBASE were searched update to February 2017 to identify and quantify the potential dose-response association between daily sedentary time and colorectal cancer.Twenty-eight eligible studies involving a total of 47,84,339 participants with 46,071 incident cases were included in this meta-analysis. Our results showed statistically significant association between prolong television viewing time and colorectal cancer (odds ratio [OR] 1.17, 95% confidence interval [CI] 1.09-1.24, P < .001). Additionally, we obtained the best fit at an inflection point of 2 hours per day in piecewise regression analysis, the summary relative risk (RR) of colorectal cancer for an increase of 2 hours per day television viewing was 1.07 (95% CI 1.05-1.10, P < .001). Furthermore, prolong occupational sitting time was correlated with a significantly higher risk of colorectal cancer (OR 1.15, 95% CI 1.08-1.22, P < .001), increasing 2 hours per day of occupational sitting time per day was associated with a 4% incremental in the risk of colorectal cancer (RR 1.04, 95% CI 1.01-1.08). Additionally, prolong total sitting time was associated with a significantly higher risk of colorectal cancer (OR 1.06, 95% CI 1.03-1.09, P < .001). Increasing 2 hours of total sitting time per day was associated with a 2% incremental in the risk of colorectal cancer (RR 1.02, 95% CI 1.01-1.06). Subgroup meta-analyses in study design, study quality, number of participants, and number of cases showed consistent with the primary findings.Prolonged television viewing, occupational sitting time, and total sitting time are associated with increased risks of colorectal cancer.
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Abstract
OBJECTIVES This study investigated whether psychological distress predicts the development of type 2 diabetes mellitus (T2DM) and if the association differs between populations at a high or low diabetes risk level among Chinese police officers. DESIGN Prospective cohort study. SETTING Single centre. PARTICIPANTS 6559 participants underwent clinical measurements at the hospital in April 2007. 5811 police officers participated in the follow-up consisting of new-onset diabetes (NOD) events occurring annually between 2008 and 2011. PRIMARY OUTCOME MEASURES Baseline data were collected from policemen who completed the Symptom Checklist 90-Revised (SCL-90-R) questionnaire and a self-designed questionnaire. Psychological distress was measured by the SCL-90-R questionnaire. Hong Kong Chinese Diabetes Risk Score (HKCDRS) was used to evaluate the risk of T2DM, and the participants were divided into low-risk group and high-risk group based on the HKCDRS. Cox proportional hazards regression was used to calculate the HRs of the incidence of T2DM related to psychological distress and further stratified the analysis based on HKCDRS. RESULTS Among 5811 participants, 179 subjects developed NOD during the 4-year follow-up. 54 subjects (1.63%) with a HKCDRS 0-7 vs 125 subjects (4.98%) with a HKCDRS>7 developed NOD (p<0.05). There was a significant association between psychological distress and T2DM (HR=1.46; 95% CI 1.05 to 2.02). Among the participants with a high-risk score (HKCDRS>7), 7.07% of those with psychological distress developed T2DM compared with 4.43% of participants without psychological distress (p<0.05). The corresponding adjusted HR for psychological distress was 1.61 (95% CI 1.10 to 2.37). CONCLUSIONS Psychological distress is an independent risk factor for T2DM in this prospective cohort study. Stratification analysis indicated that psychological distress was associated with T2DM in a high-risk level population.
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Affiliation(s)
- C Li
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - J C Liu
- Tongling University, Tongling, Anhui, China
| | - X Xiao
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Department of Cardiology, Tianjin 4 Center Hospital, The 4 Center Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Emergency Medical Center, Tianjin, China
| | - X Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - S Yue
- Medical Center of Police Hospital, Tianjin, China
| | - H Yu
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - F S Tian
- Department of Cardiology, Tianjin 4 Center Hospital, The 4 Center Hospital of Tianjin Medical University, Tianjin, China
| | - N J Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
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Prescott J, Farland LV, Tobias DK, Gaskins AJ, Spiegelman D, Chavarro JE, Rich-Edwards JW, Barbieri RL, Missmer SA. A prospective cohort study of endometriosis and subsequent risk of infertility. Hum Reprod 2016; 31:1475-82. [PMID: 27141041 DOI: 10.1093/humrep/dew085] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 03/08/2016] [Indexed: 12/20/2022] Open
Abstract
STUDY QUESTION Is there a temporal relationship between endometriosis and infertility? SUMMARY ANSWER Endometriosis is associated with a higher risk of subsequent infertility, but only among women age <35 years. WHAT IS KNOWN ALREADY Endometriosis is the most commonly observed gynecologic pathology among infertile women undergoing laparoscopic examination. Whether endometriosis is a cause of infertility or an incidental discovery during the infertility examination is unknown. STUDY DESIGN, SIZE, DURATION This study included data collected from 58 427 married premenopausal female nurses <40 years of age from 1989 to 2005, who are participants of the Nurses' Health Study II prospective cohort. PARTICIPANTS/MATERIALS, SETTING, METHODS Our exposure was laparoscopically confirmed endometriosis. Multivariate Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for infertility risk (defined as attempting to conceive for >12 months) among women with and without endometriosis. MAIN RESULTS AND THE ROLE OF CHANCE We identified 4612 incident cases of infertility due to any cause over 362 219 person-years of follow-up. Compared with women without a history of endometriosis, women with endometriosis had an age-adjusted 2-fold increased risk of incident infertility (HR = 2.12, 95% CI = 1.76-2.56) that attenuated slightly after accounting for parity. The relationship with endometriosis was only observed among women <35 years of age (multivariate HR <35 years = 1.77, 95% CI = 1.46-2.14; multivariate HR 35-39 years = 1.20, 95% CI = 0.94-1.53; P-interaction = 0.008). Risk of primary versus secondary infertility was similar subsequent to endometriosis diagnosis. Among women with primary infertility, 50% became parous after the endometriosis diagnosis, and among all women with endometriosis, 83% were parous by age 40 years. LIMITATIONS, REASONS FOR CAUTION We did not have information on participants' intentions to conceive, but by restricting the analytic population to married women we increased the likelihood that pregnancies were planned (and therefore infertility would be recognized). Women in our cohort with undiagnosed asymptomatic endometriosis will be misclassified as unexposed. However, the small proportion of these women are diluted among the >50 000 women accurately classified as endometriosis-free, minimizing the impact of exposure misclassification on the effect estimates. WIDER IMPLICATIONS OF THE FINDINGS This study supports a temporal association between endometriosis and infertility risk. Our prospective analysis indicates a possible detection bias in previous studies, with our findings suggesting that the infertility risk posed by endometriosis is about half the estimates observed in cross-sectional analyses. STUDY FUNDING/COMPETING INTERESTS This work was supported by the National Institutes of Health (grant numbers: UM1 CA176726, HD52473, HD57210, T32DK007703, T32HD060454, K01DK103720). We have no competing interests to declare.
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Affiliation(s)
- J Prescott
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - L V Farland
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - D K Tobias
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - A J Gaskins
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - D Spiegelman
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - J E Chavarro
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - J W Rich-Edwards
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA Connors Center for Women's Health and Gender Biology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - R L Barbieri
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - S A Missmer
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
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Angelo G, Drake VJ, Frei B. Efficacy of Multivitamin/mineral Supplementation to Reduce Chronic Disease Risk: A Critical Review of the Evidence from Observational Studies and Randomized Controlled Trials. Crit Rev Food Sci Nutr 2016; 55:1968-91. [PMID: 24941429 DOI: 10.1080/10408398.2014.912199] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We reviewed recent scientific evidence regarding the effects of multivitamin/mineral (MVM) supplements on risk of chronic diseases, including cancer, cardiovascular disease, and age-related eye diseases. Data from randomized controlled trials (RCTs) and observational, prospective cohort studies were examined. The majority of scientific studies investigating the use of MVM supplements in chronic disease risk reduction reported no significant effect. However, the largest and longest RCT of MVM supplements conducted to date, the Physicians' Health Study II (PHS II), found a modest and significant reduction in total and epithelial cancer incidence in male physicians, consistent with the Supplémentation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) trial. In addition, PHS II found a modest and significant reduction in the incidence of nuclear cataract, in agreement with several other RCTs and observational, prospective cohort studies. The effects of MVM use on other subtypes of cataract and age-related macular degeneration remain unclear. Neither RCTs nor prospective cohort studies are without their limitations. The placebo-controlled trial design of RCTs may be inadequate for nutrient interventions, and residual confounding, measurement error, and the possibility of reverse causality are inherent to any observational study. National surveys show that micronutrient inadequacies are widespread in the US and that dietary supplements, of which MVMs are the most common type, help fulfill micronutrient requirements in adults and children.
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Affiliation(s)
- Giana Angelo
- a Linus Pauling Institute, Oregon State University , Corvallis , Oregon , USA
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Sapra KJ, Buck Louis GM, Sundaram R, Joseph KS, Bates LM, Galea S, Ananth CV. Signs and symptoms associated with early pregnancy loss: findings from a population-based preconception cohort. Hum Reprod 2016; 31:887-96. [PMID: 26936888 DOI: 10.1093/humrep/dew010] [Citation(s) in RCA: 21] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 01/11/2016] [Indexed: 11/15/2022] Open
Abstract
STUDY QUESTION What is the relationship between signs and symptoms of early pregnancy and pregnancy loss <20 weeks' gestation? SUMMARY ANSWER Vaginal bleeding is associated with increased incidence of early pregnancy loss, with more severe bleeding and bleeding accompanied by lower abdominal cramping associated with greater incidence of loss; conversely, vomiting is associated with decreased incidence of early pregnancy loss, even in the setting of vaginal bleeding, while nausea alone is not. WHAT IS KNOWN ALREADY Two previous cohort studies with preconception enrollment suggested that bleeding is associated with loss while nausea is inversely associated with loss though these studies were limited by small study size and reporting after loss ascertainment. No prior preconception cohort study has examined multiple signs and symptoms in relation to pregnancy loss. STUDY DESIGN, SIZE, DURATION Population-based preconception cohort of 501 couples discontinuing contraception to try for pregnancy in 16 counties in Michigan and Texas, USA. Participants were followed daily until positive home pregnancy test or 12 months of trying without an hCG pregnancy; women who became pregnant were followed daily from 2 to 7 weeks post-conception. PARTICIPANTS, SETTING, METHODS Three hundred and forty-seven women had a positive home pregnancy test denoting hCG pregnancy. Three hundred and forty-one women remained after excluding ineligible pregnancies. Women recorded daily from 2 to 7 weeks post-conception their signs and symptoms, including vaginal bleeding (none, spotting, light, moderate and heavy), lower abdominal cramping, nausea and vomiting. Pregnancy losses were ascertained by a subsequent negative home pregnancy test, clinical confirmation or onset of menses, depending on gestational age at loss; time-to-loss was measured in days post-conception. Cumulative incidence functions and 95% confidence intervals (CIs) were constructed for each sign or symptom, and hazard ratios (HRs) and 95% CIs for presence compared with absence of signs or symptoms were estimated using Cox proportional hazard models. MAIN RESULTS AND THE ROLE OF CHANCE Women experienced lower abdominal cramping (85%), nausea (48%), vomiting (46%) and light/moderate/heavy vaginal bleeding (24%) during early pregnancy. Ninety-five (28%) women experienced a loss. Cumulative incidence of pregnancy loss varied by symptomatology: 19% for vomiting, 27% for lower abdominal cramping, 35% for nausea only, 52% for vaginal bleeding, 81% for vaginal bleeding with lower abdominal cramping. Incidence of pregnancy loss was increased among women with vaginal bleeding (HR: 3.62, 95% CI: 2.29-5.74) and among women with vaginal bleeding and lower abdominal cramping (HR: 5.03, 95% CI: 2.07-12.20). Incidence of pregnancy loss was decreased for women with vomiting (HR: 0.51, 95% CI: 0.30-0.86). In the setting of vaginal bleeding with lower abdominal cramping, vomiting reduced the incidence of pregnancy loss (HR: 0.24, 95% CI: 0.11-0.56). LIMITATIONS, REASONS FOR CAUTION There were few losses beyond 14 weeks gestation; thus, the precision of our findings related to losses occurring after the first trimester is limited. WIDER IMPLICATIONS OF THE FINDINGS By using sensitive home pregnancy tests, we are able to document and characterize the cumulative incidence of the earliest pregnancy losses, which constitute the majority of losses. The use of daily, prospective capture of signs and symptoms relative to ascertainment of pregnancy loss minimizes potential biases associated with reporting after rather than before a loss, which could potentially distort the relationship between signs and symptoms and pregnancy loss. The findings of our study suggest that it may be useful to develop prognostic models for pregnancy loss based on signs and symptoms. STUDY FUNDING/COMPETING INTERESTS This study was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (contract numbers N01-HD-3-3355; N01-HD-3-3356; N01-HD-3-3358). The authors have no conflict of interest to declare.
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Affiliation(s)
- K J Sapra
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA
| | - G M Buck Louis
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA
| | - R Sundaram
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA
| | - K S Joseph
- Department of Obstetrics and Gynaecology, School of Population and Public Health, University of British Columbia, The Children's and Women's Hospital of British Columbia, Vancouver, Canada
| | - L M Bates
- Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA
| | - S Galea
- Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA School of Public Health, Boston University, Boston, MA, USA
| | - C V Ananth
- Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA Department of Obstetrics and Gynecology, College of Physicians and Surgeons, New York, NY, USA
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Haftenberger M, Mensink GB, Vogt S, Thorand B, Peters A, Herzog B, Hartwig S, Greiser KH, Ittermann T, Schipf S, Völzke H, Merz B, Nöthlings U, Koch M, Neamat-Allah J, Katzke V, Kaaks R, Boeing H, Bachlechner U, Scheidt-Nave C, Schienkiewitz A. Changes in Waist Circumference among German Adults over Time - Compiling Results of Seven Prospective Cohort Studies. Obes Facts 2016; 9:332-343. [PMID: 27701174 PMCID: PMC5644885 DOI: 10.1159/000446964] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 05/16/2016] [Indexed: 11/19/2022] Open
Abstract
AIM This study aims to quantify longitudinal changes in waist circumference (WC) among adults aged 45-64 years in Germany. METHODS Data of 15,444 men and 17,207 women from one nationwide and six regional prospective German cohort studies were analyzed. The sex-specific mean change in WC per year of follow-up was assessed for each study separately. Findings from the cohort-by-cohort analysis were combined by applying meta-analytic methods. Progression to central obesity (WC ≥ 102 cm in men and ≥ 88 cm in women) within a standardized period of 10 years was described for each study. RESULTS The estimated mean change in WC per year of follow-up for all cohorts combined was 0.53 (95% confidence interval 0.29-0.76) cm/year for men and 0.63 (0.48-0.77) cm/year for women, but varied between the included studies. Within 10 years, about 20% of individuals with low WC (<94 cm in men; <80 cm in women) and about 50% of individuals with intermediate WC (94-102 cm in men; 80-88 cm in women) progressed to central obesity. CONCLUSION The increase in mean WC with aging along with a profound increase of central adiposity is obviously and may have several adverse health effects. Obesity prevention programs should also focus on abdominal obesity.
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Affiliation(s)
- Marjolein Haftenberger
- Robert Koch Institute, Department of Epidemiology and Health Reporting, Berlin, Germany
- *Marjolein Haftenberger, Department of Epidemiology and Health Reporting, Robert Koch Institute Berlin, Postbox 65 02 61, 13302 Berlin, Germany,
| | - Gert B.M. Mensink
- Robert Koch Institute, Department of Epidemiology and Health Reporting, Berlin, Germany
| | - Susanne Vogt
- Institute of Epidemiology II, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Barbara Thorand
- Institute of Epidemiology II, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Beatrice Herzog
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Saskia Hartwig
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Center for Diabetes Research (DZD), Halle, Germany
| | - Karin Halina Greiser
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ) in the Helmholtz-Association, Heidelberg, Germany
| | - Till Ittermann
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
| | - Sabine Schipf
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
- German Center of Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
| | - Benedikt Merz
- Department of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - Ute Nöthlings
- Department of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - Manja Koch
- Institute of Epidemiology, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Jasmine Neamat-Allah
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ) in the Helmholtz-Association, Heidelberg, Germany
| | - Verena Katzke
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ) in the Helmholtz-Association, Heidelberg, Germany
| | - Rudolf Kaaks
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ) in the Helmholtz-Association, Heidelberg, Germany
| | - Heiner Boeing
- German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany
| | - Ursula Bachlechner
- German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany
| | - Christa Scheidt-Nave
- Robert Koch Institute, Department of Epidemiology and Health Reporting, Berlin, Germany
| | - Anja Schienkiewitz
- Robert Koch Institute, Department of Epidemiology and Health Reporting, Berlin, Germany
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Cao Y, Hou L, Wang W. Dietary total fat and fatty acids intake, serum fatty acids and risk of breast cancer: A meta-analysis of prospective cohort studies. Int J Cancer 2015; 138:1894-904. [PMID: 26595162 DOI: 10.1002/ijc.29938] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 10/25/2015] [Accepted: 11/18/2015] [Indexed: 01/01/2023]
Abstract
Results from prospective cohort studies on the association between dietary total fat and fatty acids intake and risk of breast cancer remain controversial. Pertinent prospective cohort studies were identified by a search of Embase and PubMed from inception to September 2015. Study-specific relative risks (RRs) with 95% confidence intervals were pooled using a random-effect model. Between-study heterogeneity and publication bias were assessed, and sensitivity analysis was conducted. Twenty-four independent studies on dietary total fat and fatty acids intake and seven studies on serum fatty acids were included. The pooled RR of breast cancer for the highest vs. lowest category of dietary total fat intake was 1.10 (1.02-1.19); however, no association was observed in studies adjusting for traditional risk factors of breast cancer. No association was observed between animal fat, vegetable fat, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), n-3 PUFA, n-6 PUFA, eicosapentaenoic acid, docosahexaenoic acid, alpha-linolenic acid, oleic acid, linoleic acid and arachidonic acid and risk of breast cancer. The pooled RRs of breast cancer for the highest vs. lowest category of serum SFA, MUFA, PUFA, n-3 PUFA and n-6 PUFA were 1.00 (0.78-1.28), 1.41 (0.99-2.03), 0.59 (0.27-1.30), 0.81 (0.60-1.10) and 0.84 (0.60-1.18), respectively. Results from this meta-analysis suggested that dietary total fat and fatty acids might be not associated with risk of breast cancer.
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Affiliation(s)
- Yi Cao
- Department of Biochemistry, Qingdao University Medical College, Qingdao, China
| | - Lin Hou
- Department of Biochemistry, Qingdao University Medical College, Qingdao, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, Qingdao University Medical College, Qingdao, China
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Teras LR, Gaudet MM, Blase JL, Gapstur SM. Parental Age at Birth and Risk of Hematological Malignancies in Older Adults. Am J Epidemiol 2015; 182:41-8. [PMID: 25964260 DOI: 10.1093/aje/kwu487] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 12/29/2014] [Indexed: 01/15/2023] Open
Abstract
The proportion of parents aged ≥35 years at the birth of their child continues to increase, but long-term health consequences for these children are not fully understood. A recent prospective study of 110,999 adult women showed an association between paternal-but not maternal-age at birth and sporadic hematological cancer risk. To further investigate this topic, we examined these associations in women and men in the American Cancer Society Cancer Prevention Study-II Nutrition Cohort. Among 138,003 Cancer Prevention Study-II participants, 2,532 incident hematological cancers were identified between 1992 and 2009. Multivariable-adjusted hazard ratios and 95% confidence intervals were computed by using Cox proportional hazards regression. There was no clear linear trend in the risk of hematological malignancies by either paternal or maternal age. However, there was a strong, positive association with paternal age among participants without siblings. In that group, the hazard ratio for fathers aged ≥35 years compared with <25 years at birth was 1.63 (95% confidence interval: 1.19, 2.23), and a linear dose-response association was suggested (Pspline = 0.002).There were no differences by subtype of hematological cancer. Results of this study support the need for further research to better understand the association between paternal age at birth and hematological malignancies.
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Dash C, Bostick RM, Goodman M, Flanders WD, Patel R, Shah R, Campbell PT, McCullough ML. Oxidative balance scores and risk of incident colorectal cancer in a US prospective cohort study. Am J Epidemiol 2015; 181:584-94. [PMID: 25693772 DOI: 10.1093/aje/kwu318] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 10/15/2014] [Indexed: 12/17/2022] Open
Abstract
Although oxidative stress is implicated in colorectal carcinogenesis, human studies on associations of individual prooxidants and antioxidants with colorectal cancer (CRC) have been inconclusive. We incorporated individual environmental factors known to affect oxidative stress into 4 oxidative balance scores (OBS) and investigated their associations with CRC in the Cancer Prevention Study II Nutrition Cohort. During 1999-2009, a total of 1,109 incident CRC cases were identified among 80,063 participants in the Nutrition Cohort who had completed detailed questionnaires. Four OBS with different weighting methods (equal weights, literature review-based, a posteriori data-based, and weights based on Bayesian analysis) were created by combining 16 dietary and nondietary lifestyle factors. Higher values for all 4 OBS, representing more antioxidant exposures than prooxidant exposures, were associated with 41%-53% lower risks of CRC; for example, the relative risk for the highest OBS quartile versus the lowest in the Bayesian analysis was 0.50 (95% confidence interval: 0.41, 0.61). The associations were more modest when OBS was restricted to either dietary or nondietary components. These results, obtained using comprehensive summary measures of oxidative balance-especially considering the similarity of the findings derived using the different weighting methods-support the hypothesis that a predominance of antioxidant lifestyle exposures (both dietary and nondietary) over prooxidant lifestyle exposures reduces risk of CRC.
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Abstract
Nutritional epidemiology has recently been criticized on several fronts, including the inability to measure diet accurately, and for its reliance on observational studies to address etiologic questions. In addition, several recent meta-analyses with serious methodologic flaws have arrived at erroneous or misleading conclusions, reigniting controversy over formerly settled debates. All of this has raised questions regarding the ability of nutritional epidemiologic studies to inform policy. These criticisms, to a large degree, stem from a misunderstanding of the methodologic issues of the field and the inappropriate use of the drug trial paradigm in nutrition research. The exposure of interest in nutritional epidemiology is human diet, which is a complex system of interacting components that cumulatively affect health. Consequently, nutritional epidemiology constantly faces a unique set of challenges and continually develops specific methodologies to address these. Misunderstanding these issues can lead to the nonconstructive and sometimes naive criticisms we see today. This article aims to clarify common misunderstandings of nutritional epidemiology, address challenges to the field, and discuss the utility of nutritional science in guiding policy by focusing on 5 broad questions commonly asked of the field.
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Affiliation(s)
- Ambika Satija
- Department of Nutrition and Department of Epidemiology, Harvard School of Public Health, Boston, MA; and
| | | | - Walter C Willett
- Department of Nutrition and Department of Epidemiology, Harvard School of Public Health, Boston, MA; and Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA
| | - Frank B Hu
- Department of Nutrition and Department of Epidemiology, Harvard School of Public Health, Boston, MA; and Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA
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50
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Zhang X, Zhou G, Sun B, Zhao G, Liu D, Sun J, Liu C, Guo H. Impact of obesity upon prostate cancer-associated mortality: A meta-analysis of 17 cohort studies. Oncol Lett 2014; 9:1307-1312. [PMID: 25663903 PMCID: PMC4315023 DOI: 10.3892/ol.2014.2841] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 11/13/2014] [Indexed: 12/11/2022] Open
Abstract
A number of epidemiological studies have suggested that obesity is associated, albeit inconsistently, with the incidence of prostate cancer (PCa). In order to provide a quantitative assessment of this association, the present study examined the correlation between obesity and the incidence and associated mortalities of PCa in an updated meta-analysis of cohort studies. The cohort studies were identified by searching the EMBASE and MEDLINE databases on January 1, 2014. The summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated using random-effects models. In total, 17 studies, which included 3,569,926 individuals overall, were selected according to predefined inclusion criteria. Based upon the results of the random-effects models, obesity was not significantly correlated with the incidence of PCa (RR, 1.00; 95% CI, 0.95–1.06). However, further analysis revealed that obesity was significantly correlated with an increased risk of aggressive PCa (RR, 1.14; 95% CI, 1.04–1.25). Furthermore, an increased risk of PCa-associated mortality was significantly associated with obesity (RR, 1.24; 95% CI, 1.15–2.33), without any heterogeneity between the studies (I2=0.0%; P=0.847). The present study provides preliminary evidence to demonstrate that obesity is a significant risk factor for aggressive PCa and PCa-specific mortality. The low survival rates observed among obese males with PCa may be a likely explanation for this association.
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Affiliation(s)
- Xiaoyi Zhang
- Department of Urology, The Second Artillery General Hospital People's Liberation Army, Beijing 100088, P.R. China
| | - Guiqin Zhou
- Center of Integrated Traditional Chinese and Western Medicine, Beijing Ditan Hospital Affiliated to Capital Medical University, Beijing 100088, P.R. China
| | - Bo Sun
- Department of Urology, The Second Artillery General Hospital People's Liberation Army, Beijing 100088, P.R. China
| | - Guohua Zhao
- Department of Urology, The Second Artillery General Hospital People's Liberation Army, Beijing 100088, P.R. China
| | - Dezhong Liu
- Department of Urology, The Second Artillery General Hospital People's Liberation Army, Beijing 100088, P.R. China
| | - Jiage Sun
- Department of Urology, The Second Artillery General Hospital People's Liberation Army, Beijing 100088, P.R. China
| | - Chuanhai Liu
- Department of Urology, The Second Artillery General Hospital People's Liberation Army, Beijing 100088, P.R. China
| | - Hui Guo
- Department of Urology, The Second Artillery General Hospital People's Liberation Army, Beijing 100088, P.R. China
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