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Biomedical subjects

A Ascherio

Publications and source records attributed to A Ascherio.

At least 55 records · Page 3Linked to original sources
PubMed1999

Geographic variation of MS incidence in two prospective studies of US women.

OBJECTIVE: To estimate the incidence of MS and its relation to latitude in two ongoing prospective studies of US women. BACKGROUND: A higher incidence of MS has been found in northern areas compared with southern areas of the United States and other countries, but the attenuation of this gradient in Europe in the last few decades and the consideration of ethnic factors have led some authors to question the existence of a strong association between MS and latitude. METHODS: The authors identified new cases of MS among participants in the Nurses' Health Study (NHS), which took place between 1976 and 1994, and in the Nurses' Health Study II (NHS II), which took place between 1989 and 1995. The NHS included women born between 1920 and 1946, and the NHS II included women born between 1947 and 1964. RESULTS: The incidence of MS among NHS participants (181 definite/probable patients) increased significantly with latitude (p = 0.03, trend). Adjusted rate ratios were 3.5 (95% CI, 1.1, 11.3) for the north and 2.7 (95% CI, 0.8, 8.9) for the middle tiers relative to the southern tier. Among NHS II women (131 definite/probable patients), no association between latitude and MS was found (p = 0.89, trend). Adjusted rate ratios were 0.8 (95% CI, 0.4, 1.6) for the northern areas and 0.9 (95%, 0.4, 1.8) for the middle areas, relative to the southern areas. CONCLUSION: The association between latitude and risk of MS in the United States was corroborated, but there was an attenuation of the north-south gradient over time. If confirmed, this finding could provide new clues to identifying environmental causes of the disease.

Adult↗
PubMed1999

Prospective study of snoring and risk of hypertension in women.

Whether snoring increases the risk of hypertension remains unclear. The authors examined the association between snoring and risk of hypertension in a cohort of 73,231 US female nurses aged 40-65 years and without diagnosed cardiovascular disease or cancer in 1986. Blood pressure levels and physician-diagnosed hypertension were self-reported through validated questionnaires. During 8 years of follow-up, 7,622 incident cases of physician-diagnosed hypertension were reported. Older age, smoking, body mass index, waist circumference, waist-hip ratio, weight gain, less physical activity, and sleeping on the back were directly associated with regular snoring. After adjustment for age, body mass index, waist circumference, and other covariates, snoring was associated with a significantly higher prevalence of hypertension at baseline (odds ratio = 1.22, 95% confidence interval (CI): 1.16, 1.27 for occasional snoring and odds ratio = 1.43, 95% CI: 1.33, 1.5 for regular snoring). In prospective analyses using incident cases of hypertension as the outcome, the multivariate relative risks of hypertension were 1.29 (95% CI: 1.22, 1.37) for occasional snoring and 1.55 (95% CI: 1.42, 1.70) for regular snoring. In addition, snoring was associated with significantly higher systolic and diastolic blood pressure levels. These data suggest that snoring may increase risk of hypertension in women, independent of age, body mass index, waist circumference, and other lifestyle factors.

Adult↗
PubMed1999

Fruit and vegetable intake in relation to risk of ischemic stroke.

CONTEXT: Few studies have evaluated the relationship between fruit and vegetable intake and cardiovascular disease. OBJECTIVE: To examine the associations between fruit and vegetable intake and ischemic stroke. DESIGN, SETTING, AND SUBJECTS: Prospective cohort studies, including 75 596 women aged 34 to 59 years in the Nurses' Health Study with 14 years of follow-up (1980-1994), and 38683 men aged 40 to 75 years in the Health Professionals' Follow-up Study with 8 years of follow-up (1986-1994). All individuals were free of cardiovascular disease, cancer, and diabetes at baseline. MAIN OUTCOME MEASURE: Incidence of ischemic stroke by quintile of fruit and vegetable intake. RESULTS: A total of 366 women and 204 men had an ischemic stroke. After controlling for standard cardiovascular risk factors, persons in the highest quintile of fruit and vegetable intake (median of 5.1 servings per day among men and 5.8 servings per day among women) had a relative risk (RR) of 0.69 (95% confidence interval [CI], 0.52-0.92) compared with those in the lowest quintile. An increment of 1 serving per day of fruits or vegetables was associated with a 6% lower risk of ischemic stroke (RR, 0.94; 95 % CI, 0.90-0.99; P =.01, test for trend). Cruciferous vegetables (RR, 0.68 for an increment of 1 serving per day; 95% CI, 0.49-0.94), green leafy vegetables (RR, 0.79; 95% CI, 0.62-0.99), citrus fruit including juice (RR, 0.81; 95% CI, 0.68-0.96), and citrus fruit juice (RR, 0.75; 95% CI, 0.61-0.93) contributed most to the apparent protective effect of total fruits and vegetables. Legumes or potatoes were not associated with lower ischemic stroke risk. The multivariate pooled RR for total stroke was 0.96 (95% CI, 0.93-1.00) for each increment of 2 servings per day. CONCLUSIONS: These data support a protective relationship between consumption of fruit and vegetables-particularly cruciferous and green leafy vegetables and citrus fruit and juice-and ischemic stroke risk.

Adult↗
PubMed1999

Relation of consumption of vitamin E, vitamin C, and carotenoids to risk for stroke among men in the United States.

BACKGROUND: Antioxidants increase the resistance of low-density lipoprotein to oxidation and may thereby reduce risk for atherosclerosis. OBJECTIVE: To determine whether intake of vitamin E, vitamin C, or carotenoids predict risk for total or ischemic stroke. DESIGN: Prospective observational study. SETTING: The Health Professionals Follow-up Study. PARTICIPANTS: 43,738 men 40 to 75 years of age who did not have cardiovascular disease or diabetes. MEASUREMENTS: Repeated and validated dietary assessments were done by using a self-administered 131-item food-frequency questionnaire, which included questions on dose and duration of vitamin supplement use. The follow-up period was 8 years. RESULTS: A total of 328 strokes occurred: 210 ischemic, 70 hemorrhagic, and 48 unclassified. After adjustment for age, smoking, hypertension, hypercholesterolemia, body mass index, physical activity, parental history of myocardial infarction, alcohol consumption, and total energy intake, the relative risk for ischemic stroke in the top quintile of vitamin E intake (median, 411 IU/d) compared with the bottom quintile (5.4 IU/d) was 1.18 (95% CI, 0.77 to 1.82). The relative risk for ischemic stroke in the top quintile of vitamin C intake (1167 mg/d) compared with the bottom quintile (95 mg/d) was 1.03 (CI, 0.66 to 1.59). Results for total stroke were similar. Associations of vitamin intake with hemorrhagic stroke were also nonsignificant, but the CIs were wide. Neither dose nor duration of vitamin E or vitamin C supplement use was related to risk for total or ischemic stroke. The relative risk for ischemic stroke was 1.16 (CI, 0.81 to 1.67) in men using 250 IU or more of vitamin E supplementation per day compared with men who used no vitamin E supplements and was 0.93 (CI, 0.60 to 1.45) in men using 700 mg or more of vitamin C supplementation per day compared with men who used no vitamin C supplements. A significant inverse relation between lutein intake and risk for ischemic stroke was seen but was not independent of other dietary factors. CONCLUSIONS: Vitamin E and vitamin C supplements and specific carotenoids did not seem to substantially reduce risk for stroke in this cohort. Modest effects, however, cannot be excluded.

Adult↗
PubMed1999

A prospective study of egg consumption and risk of cardiovascular disease in men and women.

CONTEXT: Reduction in egg consumption has been widely recommended to lower blood cholesterol levels and prevent coronary heart disease (CHD). Epidemiologic studies on egg consumption and risk of CHD are sparse. OBJECTIVE: To examine the association between egg consumption and risk of CHD and stroke in men and women. DESIGN AND SETTING: Two prospective cohort studies, the Health Professionals Follow-up Study (1986-1994) and the Nurses' Health Study (1980-1994). PARTICIPANTS: A total of 37851 men aged 40 to 75 years at study outset and 80082 women aged 34 to 59 years at study outset, free of cardiovascular disease, diabetes, hypercholesterolemia, or cancer. MAIN OUTCOME MEASURES: Incident nonfatal myocardial infarction, fatal CHD, and stroke corresponding to daily egg consumption as determined by a food-frequency questionnaire. RESULTS: We documented 866 incident cases of CHD and 258 incident cases of stroke in men during 8 years of follow-up and 939 incident cases of CHD and 563 incident cases of stroke in women during 14 years of follow-up. After adjustment for age, smoking, and other potential CHD risk factors, we found no evidence of an overall significant association between egg consumption and risk of CHD or stroke in either men or women. The relative risks (RRs) of CHD across categories of intake were less than 1 per week (1.0), 1 per week (1.06), 2 to 4 per week (1.12), 5 to 6 per week (0.90), and > or =1 per day (1.08) (P for trend = .75) for men; and less than 1 per week (1.0), 1 per week (0.82), 2 to 4 per week (0.99), 5 to 6 per week (0.95), and > or =1 per day (0.82) (P for trend = .95) for women. In subgroup analyses, higher egg consumption appeared to be associated with increased risk of CHD only among diabetic subjects (RR of CHD comparing more than 1 egg per day with less than 1 egg per week among diabetic men, 2.02 [95% confidence interval, 1.05-3.87; P for trend = .04], and among diabetic women, 1.49 [0.88-2.52; P for trend = .008]). CONCLUSIONS: These findings suggest that consumption of up to 1 egg per day is unlikely to have substantial overall impact on the risk of CHD or stroke among healthy men and women. The apparent increased risk of CHD associated with higher egg consumption among diabetic participants warrants further research.

Adult↗
PubMed1999

Dietary fat and coronary heart disease: a comparison of approaches for adjusting for total energy intake and modeling repeated dietary measurements.

Previous cohort studies of fat intake and risk of coronary heart disease (CHD) have been inconsistent, probably due in part to methodological differences and various limitations, including inadequate dietary assessment and incomplete adjustment for total energy intake. The authors analyzed repeated assessment of diet from the Nurses' Health Study to examine the associations between intakes of four major types of fat (saturated, monounsaturated, polyunsaturated, and trans fats) and risk of CHD during 14 years of follow-up (1980-1994) by using alternative methods for energy adjustment. In particular, the authors compared four risk models for energy adjustment: the standard multivariate model, the energy-partition model, the nutrient residual model, and the multivariate nutrient density model. Within each model, the authors compared four different approaches for analyzing repeated dietary measurements: baseline diet only, the most recent diet, and two different algorithms for calculating cumulative average diets. The substantive results were consistent across all models; that is, higher intakes of saturated and trans fats were associated with increased risk of CHD, while higher intakes of monounsaturated and polyunsaturated fats were associated with reduced risk. When nutrients were considered as continuous variables, the four energy-adjustment methods yielded similar associationS. However, the interpretation of the relative risks differed across models. In addition, within each model, the methods using the cumulative averages in general yielded stronger associations than did those using either only baseline diet or the most recent diet. When the nutrients were categorized according to quintiles, the residual and the nutrient density models, which gave similar results, yielded statistically more significant tests for linear trend than did the standard and the partition models.

Adult↗
PubMed1999

Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire.

BACKGROUND: Recently, the analysis of dietary patterns has emerged as a possible approach to examining diet-disease relations. OBJECTIVE: We examined the reproducibility and validity of dietary patterns defined by factor analysis using dietary data collected with a food-frequency questionnaire (FFQ). DESIGN: We enrolled a subsample of men (n = 127) from the Health Professionals Follow-up Study in a diet-validation study in 1986. A 131-item FFQ was administered twice, 1 y apart, and two 1-wk diet records and blood samples were collected during this 1-y interval. RESULTS: Using factor analysis, we identified 2 major eating patterns, which were qualitatively similar across the 2 FFQs and the diet records. The first factor, the prudent dietary pattern, was characterized by a high intake of vegetables, fruit, legumes, whole grains, and fish and other seafood, whereas the second factor, the Western pattern, was characterized by a high intake of processed meat, red meat, butter, high-fat dairy products, eggs, and refined grains. The reliability correlations for the factor scores between the 2 FFQs were 0.70 for the prudent pattern and 0.67 for the Western pattern. The correlations (corrected for week-to-week variation in diet records) between the 2 FFQs and diet records ranged from 0.45 to 0.74 for the 2 patterns. In addition, the correlations between the factor scores and nutrient intakes and plasma concentrations of biomarkers were in the expected direction. CONCLUSIONS: These data indicate reasonable reproducibility and validity of the major dietary patterns defined by factor analysis with data from an FFQ.

Adult↗
PubMed1999

Dietary saturated fats and their food sources in relation to the risk of coronary heart disease in women.

BACKGROUND: Metabolic studies suggest that saturated fatty acids differ in their effects on blood lipids. OBJECTIVE: The objective was to examine the associations between intakes of individual saturated fatty acids and their food sources in relation to the risk of coronary heart disease (CHD). DESIGN: This was a prospective cohort study of 80082 women in the Nurses' Health Study aged 34-59 y. Subjects had no known cardiovascular disease, cancer, hypercholesterolemia, or diabetes, and completed validated food-frequency questionnaires in 1980. RESULTS: During 14 y of follow-up, we documented 939 incident cases of major CHD events. In multivariate analyses in which age, smoking, and other covariates were controlled for, intakes of short- to medium-chain saturated fatty acids (4:0-10:0) were not significantly associated with the risk of CHD. In contrast, intakes of longer-chain saturated fatty acids (12:0-18:0) were each separately associated with a small increase in risk. The multivariate RR for a 1% energy increase from stearic acid was 1.19 (95% CI: 1.02, 1.37). The ratio of polyunsaturated to saturated fat was strongly and inversely associated with CHD risk (multivariate RR for a comparison of the highest with the lowest deciles: 0.58; 95% CI: 0.41, 0.83; P for trend < 0.0001). Conversely, higher ratios of red meat to poultry and fish consumption and of high-fat to low-fat dairy consumption were associated with significantly greater risk. CONCLUSION: A distinction between stearic acid and other saturated fats does not appear to be important in dietary advice to reduce CHD risk, in part because of the high correlation between stearic acid and other saturated fatty acids in typical diets.

Adult↗
PubMed1999

Variations in infant mortality rates among municipalities in the state of Ceará, Northeast Brazil: an ecological analysis.

BACKGROUND: Infant mortality rates vary substantially among municipalities in the State of Ceará, from 14 to 193 per 1000 live births. Identification of the determinants of these differences can be of particular importance to infant health policy and programmes in Brazil where local governments play a pivotal role in providing primary health care. METHODS: Ecological study across 140 municipalities in the State of Ceará, Brazil. RESULTS: To determine the interrelationships between potential predictors of infant mortality, we classified 11 variables into proximate determinants (adequate weight gain and exclusively breastfeeding), health services variables (prenatal care up-to-date, participation in growth monitoring, immunization up-to-date, and decentralization of health services), and socioeconomic factors (female literacy rate, household income, adequate water supply, adequate sanitation, and per capita gross municipality product), and included the variables in each group simultaneously in linear regression models. In these analyses, only one of the proximate determinants (exclusively breastfeeding (inversely), R2 = 9.3) and one of the health services variables (prenatal care up-to-date (inversely), R2 = 22.8) remained significantly associated with infant mortality. In contrast, female literacy rate (inversely), household income (directly) and per capita GMP (inversely) were independently associated with the infant mortality rate (for the model including the three variables R2 = 25.2). Finally, we considered simultaneously the variables from each group, and selected a model that explained 41% of the variation in infant mortality rates between municipalities. The paradoxical direct association between household income and infant mortality was present only in models including female illiteracy rate, and suggests that among these municipalities, increases in income unaccompanied by improvements in female education may not substantially reduce infant mortality. The lack of independent associations between inadequate sanitation and infant mortality rates may be due to the uniformly poor level of this indicator across municipalities and provides no evidence against its critical role in child survival. CONCLUSIONS: These results suggest that promotion of exclusive breastfeeding and increased prenatal care utilization, as well as investments in female education would have substantial positive effects in further reducing infant mortality rates in the State of Ceará.

Brazil↗
PubMed1999

Smoking and risk of total and fatal prostate cancer in United States health professionals.

Studies that have examined the relationship between cigarette use and prostate cancer incidence have yielded inconsistent results, although most studies have suggested that smoking is related to the occurrence of fatal prostate cancer. We evaluated prospectively the relationship between cigarette smoking and total, distant metastatic, and fatal prostate cancer in 47,781 male health professionals throughout the United States followed with questionnaires. From 1986 to 1994, we documented 1369 men with prostate cancer (excluding stage A1). One hundred fifty-two of the men had distant metastatic disease at diagnosis, and 103 fatal cases occurred from 1986 to 1994. Early (before age 30), late (within recent 10 years), and lifetime cumulative smoking history were unrelated to risk of total prostate cancer. However, men who had smoked 15 or more pack-years of cigarettes within the preceding 10 years were at higher risk of distant metastatic prostate cancer [multivariate relative risk (RR), 1.81; 95% confidence interval (CI), 1.05-3.11; P (trend), 0.03] and fatal prostate cancer [RR, 2.06; CI, 1.08-3.90; P (trend), 0.02] relative to nonsmokers. Within 10 years after quitting, the excess risk among smokers is eliminated. The higher rate of fatal prostate cancer among smokers did not appear to result from confounding by diet or other lifestyle factors, different screening behavior between smokers and nonsmokers, or from other smoking-related comorbidities. Our results indicate that although smoking was unrelated to prostate cancer incidence, recent tobacco use had a substantial impact on the occurrence of fatal prostate cancer.

Adult↗
PubMed1999

Relationship between health services, socioeconomic variables and inadequate weight gain among Brazilian children.

This ecological analysis assessed the relative contribution of behavioural, health services and socioeconomic variables to inadequate weight gain in infants (0-11 months) and children (12-23 months) in 140 municipalities in the State of Ceara, north-east Brazil. To assess the total effect of selected variables, we fitted three unique sets of multivariate linear regression models to the prevalence of inadequate weight gain in infants and in children. The final predictive models included variables from the three sets. Findings showed that participation in growth monitoring and urbanization were inversely and significantly associated with the prevalence of inadequate weight gain in infants, accounting for 38.3% of the variation. Female illiteracy rate, participation in growth monitoring and degree of urbanization were all positively associated with prevalence of inadequate weight gain in children. Together, these factors explained 25.6% of the variation. Our results suggest that efforts to reduce the average municipality-specific female illiteracy rate, in combination with participation in growth monitoring, may be effective in reducing municipality-level prevalence of inadequate weight gain in infants and children in Ceara.

Adolescent↗
PubMed1998

Intake of potassium, magnesium, calcium, and fiber and risk of stroke among US men.

BACKGROUND: Animal experiments and epidemiological studies have suggested that high potassium intake may reduce the risk of stroke, but the evidence is inconclusive, and the role of other nutrients in potassium-rich foods remains unknown. METHODS AND RESULTS: We examined the association of potassium and related nutrients with risk of stroke among 43 738 US men, 40 to 75 years old, without diagnosed cardiovascular diseases or diabetes, who completed a semiquantitative food frequency questionnaire in 1986. During 8 years of follow-up, 328 strokes (210 ischemic, 70 hemorrhagic, 48 unspecified) were documented. The multivariate relative risk of stroke of any type for men in the top fifth of potassium intake (median intake, 4.3 g/d) versus those in the bottom (median, 2.4 g/d) was 0.62 (95% CI, 0.43, 0.88; P for trend=0.007). Results for ischemic stroke alone were similar. Intakes of cereal fiber and magnesium, but not of calcium, were also inversely associated with risk of total stroke. These inverse associations were all stronger in hypertensive than normotensive men and were not materially altered by adjustment for blood pressure levels. Use of potassium supplements was also inversely related to risk of stroke, particularly among men taking diuretics (relative risk, 0.36; 95% CI, 0.18, 0.72). CONCLUSIONS: Although these data do not prove a causal relationship, they are consistent with the hypothesis that diets rich in potassium, magnesium, and cereal fiber reduce the risk of stroke, particularly among hypertensive men. Potassium supplements may also be beneficial, but because of potential risks, use should be carefully monitored and restricted to men taking potassium-losing diuretics.

Adult↗
PubMed1998

Calcium and fructose intake in relation to risk of prostate cancer.

Laboratory and clinical data indicate an antitumor effect of 1,25(OH)2 vitamin D (1,25(OH)2D) on prostate cancer. High calcium intake suppresses formation of 1,25(OH)2D from 25(OH)D, thereby decreasing the 1,25(OH)2D level. Ingestion of fructose reduces plasma phosphate transiently, and hypophosphatemia stimulates 1,25(OH)2D production. We thus conducted a prospective study among 47,781 men of the Health Professionals Follow-Up Study free of cancer in 1986 to examine whether calcium and fructose intake influenced risk of prostate cancer. Between 1986 and 1994, 1369 non-stage A1 and 423 advanced (extraprostatic) cases of prostate cancer were diagnosed. Higher consumption of calcium was related to advanced prostate cancer [multivariate relative risk (RR), 2.97; 95% confidence interval (CI), 1.61-5.50 for intakes > or = 2000 mg/day versus < 500 mg/day; P, trend, 0.002] and metastatic prostate cancer (RR, 4.57; CI, 1.88-11.1; P, trend, <0.001). Calcium from food sources and from supplements independently increased risk. High fructose intake was related to a lower risk of advanced prostate cancer (multivariate RR, 0.51; CI, 0.33-0.80, for intakes > 70 versus < or = 40 g/day; P, trend, 0.007). Fruit intake was inversely associated with risk of advanced prostate cancer (RR, 0.63; 95% CI, 0.43-0.93; for > 5 versus < or = 1 serving per day), and this association was accounted for by fructose intake. Non-fruit sources of fructose similarly predicted lower risk of advanced prostate cancer. A moderate positive association between energy-adjusted fat intake and advanced prostate cancer was attenuated and no longer statistically significant when controlled for calcium and fructose. Our findings provide indirect evidence for a protective influence of high 1,25(OH)2D levels on prostate cancer and support increased fruit consumption and avoidance of high calcium intake to reduce the risk of advanced prostate cancer.

Adult↗
PubMed1998

Body anthropometry and the risk of hip and wrist fractures in men: results from a prospective study.

Available epidemiological information on the associations between body anthropometry and the incidence of fractures in men is limited. We therefore prospectively investigated the association between body anthropometry and the incidence of hip and wrist fractures from low and moderate trauma among 43,053 men who were 40 years to 75 years of age in 1986 when they first enrolled in the Health Professionals Follow-Up Study. After 8 years of follow-up, 201 wrist fracture cases and 56 hip fracture cases were reported. Greater height was associated with significant elevations in both hip and wrist fractures, whereas nonsignificant inverse associations were observed with weight and body mass index. Men in the highest quintile of waist circumference had a relative risk (RR) of 2.57 (95% confidence interval [CI] 0.64 to 10.3) for hip fracture and 2.05 (95% CI 1.06 to 3.96) for wrist fracture when compared with men in the lowest quintile. Waist-to-hip ratio was also positively related to fracture incidence; comparing highest with lowest quintile, the RRs were 3.92 (95% CI 1.07 to 14.3) for hip fracture and 1.50 (95% CI 0.85 to 2.66) for wrist fracture. These anthropometric indicators, in particular waist-to-hip ratio, may be useful for the prediction of hip fracture in adult men.

Adult↗
PubMed1998

Associations of plasma carotenoid concentrations and dietary intake of specific carotenoids in samples of two prospective cohort studies using a new carotenoid database.

Diet-plasma carotenoid associations were examined in samples of women and men from each cohort in the Nurses' Health Study and the Health Professionals Follow-Up Study. In each sample, participants completed two self-administered food frequency questionnaires with at least a 1-year interval and provided a blood specimen preceding the second food frequency questionnaire. Carotenoid intakes were estimated from values for the five major carotenoids found in human plasma, specifically, alpha- and beta-carotene, beta-cryptoxanthin, lutein, and lycopene, using the United States Department of Agriculture-National Cancer Institute Carotenoid Database, as well as updated values for tomato products. Pearson correlation coefficients were calculated to compare diet-plasma correlations over time by sex after adjustment for recognized covariates. Among nonsmoking women (n = 162), the adjusted diet-plasma carotenoid associations were 0.48 for alpha-carotene, 0.27 for beta-carotene and lutein, 0.32 for beta-cryptoxanthin, and 0.21 for lycopene. Among nonsmoking men (n = 110), diet-plasma correlations were 0.47 for alpha-carotene and lycopene, 0.35 for beta-carotene, 0.43 for beta-cryptoxanthin, and 0.40 for lutein. Correlations between total fruit or vegetable intake and each plasma carotenoid level were not as high as any of the calculated carotenoid intake using the new database values. The correlations observed in this study indicate that the new carotenoid database provides valuable information on specific carotenoid intake and may be useful in epidemiological studies that attempt to account for associations between fruit or vegetable intake and disease.

Aged↗
PubMed1998

Use of toenail fluoride levels as an indicator for the risk of hip and forearm fractures in women.

The relation between fluoride intake and risk of osteoporotic fractures remains unclear. The lack of individual measures of long-term fluoride intake has limited epidemiologic studies. We used toenail fluoride in this study as a measure of long-term intake to evaluate the relation between fluoride intake and subsequent risk of hip and distal forearm fractures. Between 1982 and 1984, we collected toenail clippings from 62,641 women in the Nurses' Health Study who were free from cancer, heart disease, stroke, and previous hip or forearm fracture. We identified fracture cases (53 proximal femur and 188 distal forearm) through subsequent biennial mailed questionnaires and matched controls to cases on year of birth. The odds ratio of hip fracture among women in the highest quartile of toenail fluoride [ > 5.50 parts per million (ppm)], compared with those in the lowest quartile (> 2.00 ppm), was 0.8 (95% confidence interval = 0.2-4.0), with adjustment for menopausal status, postmenopausal hormone use, caffeine intake, and alcohol consumption. The corresponding adjusted odds ratio for forearm fracture was 1.6 (95% confidence interval = 0.8-3.1). Further adjustment for body mass index, smoking status, and calcium and vitamin D intake did not alter these results.

Adult↗
PubMed1997

Intake of fatty acids and risk of coronary heart disease in a cohort of Finnish men. The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study.

The relation of intakes of specific fatty acids and the risk of coronary heart disease was examined in a cohort of 21,930 smoking men aged 50-69 years who were initially free of diagnosed cardiovascular disease. All men participated in the Finnish Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study and completed a detailed and validated dietary questionnaire at baseline. After 6.1 years of follow-up from 1985-1988, the authors documented 1,399 major coronary events and 635 coronary deaths. After controlling for age, supplement group, several coronary risk factors, total energy, and fiber intake, the authors observed a significant positive association between the intake of trans-fatty acids and the risk of coronary death. For men in the top quintile of trans-fatty acid intake (median = 6.2 g/day), the multivariate relative risk of coronary death was 1.39 (95% confidence interval (CI) 1.09-1.78) (p for trend = 0.004) as compared with men in the lowest quintile of intake (median = 1.3 g/day). The intake of omega-3 fatty acids from fish was also directly related to the risk of coronary death in the multivariate model adjusting also for trans-saturated and cis-monounsaturated fatty acids (relative risk (RR) = 1.30, 95% CI 1.01-1.67) (p for trend = 0.06 for men in the highest quintile of intake compared with the lowest). There was no association between intakes of saturated or cis-monounsaturated fatty acids, linoleic or linolenic acid, or dietary cholesterol and the risk of coronary deaths. All the associations were similar but somewhat weaker for all major coronary events.

Aged↗