No association between fat and fatty acids intake and risk of colorectal cancer.
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Adult↗
Biomedical subjects
A Wolk
Publications and source records attributed to A Wolk.
A prospective study of major dietary patterns and the risk of breast cancer.
Our aim was to study the broader eating patterns that potentially reflect many dietary exposures working together in their association with breast cancer risk. Using data from a prospective study of 61,463 women with an average follow-up of 9.6 years and 1,328 incident cases of breast cancer, we conducted a factor analysis to identify major dietary patterns. Proportional hazards regression was used to estimate hazard ratios. We found no association between the "Western" dietary pattern (characterized by such foods as red and processed meats, refined grains, fat, and sweets) or the "healthy" dietary pattern (fruit and vegetables, fish and poultry, low-fat dairy, and whole grains) and breast cancer risk. However, women who were in the highest category of the "drinker" dietary pattern (wine, beer, and spirits) had a moderately increased risk (rate ratio = 1.27; 95% confidence interval, 1.06-1.52; P for trend, 0.002). The positive association was somewhat weaker among women below 50 years of age, a finding not inconsistent with chance. Our results are in agreement with the majority of previous studies that show alcohol consumption moderately increases the risk of breast cancer, but our results do not support any association between breast cancer risk and the "Western" or "healthy" dietary patterns.
Adult↗
Serum concentrations of organochlorines in men: a search for markers of exposure.
Analysis of single marker substances in serum could provide cost-effective assessment of human exposure to complex mixtures of organochlorines. We studied the serum concentrations of 10 polychlorinated biphenyl (PCB) congeners and 11 chlorinated pesticides and some of their metabolites in samples collected from 120 Swedish men (mean age 63 years, range 40-74 years) from the general Swedish population. The median concentrations of individual PCB congeners increased in the order PCB 52 < PCB 101 < or = PCB28 < PCB 105 < PCB 167 < PCB 156 < PCB 118 < PCB 138 < PCB 180 < PCB 153. The concentrations of o,p'-DDT, o,p'-DDE, p,p'-DDD, alpha-HCH and gamma-HCH were in most cases below the quantification limit (2-4 ng/g lipid). Among the other chlorinated pesticides the median concentration increased in the order oxychlordane (12 ng/g lipid) < p,p'-DDT < trans-nonachlor < beta-HCH < HCB < p,p'-DDE (586 ng/g lipid). The observed concentrations of PCB and chlorinated pesticides were in the same range as those found in similar groups of men from Sweden and Norway, but lower than those found in male populations with recent occupational exposure or high environmental exposure. Strong relationships were found between the concentrations of single mono- and di-ortho PCB congeners and groups of PCB congeners in serum. In our group of men PCB 153 was a good marker substance for the concentration of sigma PCB and sigma di-ortho PCB concentrations in serum. Moreover, among the mono-ortho PCB congeners analyzed, PCB 156 could be used as a marker for the sigma mono-ortho PCB TEQ concentrations in serum in the studied group. No useful marker substances were found among DDT compounds and other chlorinated pesticides and metabolites, except for trans-nonachlor which predicted the concentration of the metabolite oxychlordane fairly well.
Adult↗
Can measurements of IGF-1 and IGFBP-3 improve the sensitivity of prostate-cancer screening?
Further well designed studies are urgently needed to clarify if use of prostate-specific antigen (PSA) as a diagnostic test for prostate cancer can be improved by incorporating measurements of serum insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding-protein 3 (IGFBP-3), and if these measurements might also identify men at higher risk.
Humans↗
Pooled analysis of prospective cohort studies on height, weight, and breast cancer risk.
The association between anthropometric indices and the risk of breast cancer was analyzed using pooled data from seven prospective cohort studies. Together, these cohorts comprise 337,819 women and 4,385 incident invasive breast cancer cases. In multivariate analyses controlling for reproductive, dietary, and other risk factors, the pooled relative risk (RR) of breast cancer per height increment of 5 cm was 1.02 (95% confidence interval (CI): 0.96, 1.10) in premenopausal women and 1.07 (95% CI: 1.03, 1.12) in postmenopausal women. Body mass index (BMI) showed significant inverse and positive associations with breast cancer among pre- and postmenopausal women, respectively; these associations were nonlinear. Compared with premenopausal women with a BMI of less than 21 kg/m2, women with a BMI exceeding 31 kg/m2 had an RR of 0.54 (95% CI: 0.34, 0.85). In postmenopausal women, the RRs did not increase further when BMI exceeded 28 kg/m2; the RR for these women was 1.26 (95% CI: 1.09, 1.46). The authors found little evidence for interaction with other breast cancer risk factors. Their data indicate that height is an independent risk factor for postmenopausal breast cancer; in premenopausal women, this relation is less clear. The association between BMI and breast cancer varies by menopausal status. Weight control may reduce the risk among postmenopausal women.
Adult↗
Antioxidants and cancers of the esophagus and gastric cardia.
Antioxidant vitamins have attracted considerable attention in previous studies of esophageal squamous-cell carcinoma, but dietary studies of adenocarcinoma of the esophagus and gastric cardia remain sparse. Treating these tumors as distinct diseases, we studied intakes of vitamin C, beta-carotene and alpha-tocopherol in a nationwide population-based case-control study in Sweden, with 185, 165, and 258 cases of esophageal adenocarcinoma, esophageal squamous-cell carcinoma, and gastric cardia adenocarcinoma, respectively, and 815 controls. Subjects with a high parallel intake of vitamin C, beta-carotene, and alpha-tocopherol showed a 40-50% decreased risk of both histological types of esophageal cancer compared with subjects with a low parallel intake. Antioxidant intake was not associated with the risk of gastric cardia adenocarcinoma. Separately, vitamin C and beta-carotene reduced the risk of esophageal cancers more than alpha-tocopherol. We found that antioxidant intake is associated with similar risk reductions for both main histological types of esophageal cancer. Our findings indicate that antioxidants do not explain the diverging incidence rates of the 2 histological types of esophageal cancer. Moreover, our data suggest that inverse associations with esophageal squamous-cell carcinoma and adenocarcinoma may be stronger among subjects under presumed higher oxidative stress due to smoking or gastroesophageal reflux, respectively. Our results may be relevant for the implementation of focused, cost-effective preventive measures.
Adenocarcinoma↗
Dietary antioxidant intake and the risk of cardia cancer and noncardia cancer of the intestinal and diffuse types: a population-based case-control study in Sweden.
In spite of diverging incidence trends, subsite, and subtype-specific gastric cancer data on the association with dietary antioxidants are sparse. We aimed to test whether the apparent protective effect of antioxidants is mainly confined to noncardia (distal) cancer of the intestinal subtype, to which most of the incidence decline in gastric cancer has been ascribed. In a Swedish study base (total population 1.3 million), we interviewed 567 cases uniformly classified to subsite (cardia vs. noncardia) and subtype (intestinal vs. diffuse), and 1165 population-based controls, frequency matched for age and sex. Serologic data on H. pylori status was available for a subset of 542 individuals. Ascorbic acid (vitamin C) was inversely associated with all subsites and subtypes of gastric cancer in a significant dose-response manner (all p<0.05), with risk reductions between 40% and 60%. beta-carotene was also strongly and negatively associated with risk, particularly with the intestinal type. The associations with alpha-tocopherol (vitamin E) were less clear. The highest parallel intake of all three antioxidants (quartiles 4), compared to those with the lowest parallel intakes (quartiles 1), was associated with a 70% lower risk of developing noncardia cancer (OR 0.3, 95% CI 0.1-0.9). Our results suggest that antioxidants might be especially beneficial among subjects at increased risk for gastric cancer such as smokers and those infected by H. pylori. We conclude that a high intake of antioxidants, as a consequence of high consumption of fruit and vegetables, may lower the risk not only for gastric cancer of the intestinal type, but also for diffuse type adenocarcinoma and cardia cancer.
Adenocarcinoma↗
Organochlorines and bone mineral density in Swedish men from the general population.
Persistent organochlorines (POCs), such as polychlorinated biphenyls (PCBs) and DDT, are present at relatively high concentrations in food and show estrogenic, anti-estrogenic or anti-androgenic activity in biological test systems. Because bone mineral density (BMD) in men is influenced by sex hormones, we looked for associations between BMD and serum concentrations of POCs in 115 men (mean age 63 years, range 40-75 years) from the general Swedish population. Ten PCB congeners, five DDT isomers, hexachlorobenzene, three hexachlorocyclohexane isomers, trans-nonachlor and oxychlordane were analyzed by gas chromatography. Quantitative bone measurements were performed by dual-energy X-ray absorptiometry at three sites: whole body, the L2-L4 region of the lumbar spine, and the neck region of the proximal femur, as well as by quantitative ultrasound on the left os calcis (broadband ultrasound attenuation (BUA) and speed of sound (SOS)). After adjustment for confounding factors in linear regression analyses we found no strong association between serum concentrations of single POCs and the five BMD and ultrasound variables. When POCs were grouped according to hormonal activity (estrogenic, anti-estrogenic, anti-androgenic) and the study subjects were divided into organochlorine concentration quartiles, a weak association was indicated between increased serum concentrations of p,p'-DDE (antiandrogenic) and decreased BMD, BUA and SOS. This may suggest that p,p'-DDE could cause negative effects on bone density, but the findings might also be due to chance since multiple comparisons were made in the statistical analysis. Overall our results do not suggest that the studied POCs caused major effects on bone density in our study group.
Adult↗
Social mapping of the obesity epidemic in Sweden.
OBJECTIVE: The aim of the present study is to describe the evolution of the obesity epidemic in Sweden, with specific attention to the socioeconomic gradient. DESIGN: Data from the Swedish Surveys of Living Conditions were used. Three such surveys were undertaken in 1980/81, 1988/89, and 1996/97, each of which was based on a simple random sample from the national population registry. SUBJECTS: A total of 38,284 observations are used in this analysis, including males and females aged 16-84. The sample is approximately equally divided among the 3 survey periods and by gender. MEASUREMENTS: The following body weight categories are used to describe changing prevalences: overweight (BMI>/=25), obesity (BMI>/=30) and underweight (BMI<18.5). Because body weight and heights were self-reported, recorded values were adjusted for estimating gender-specific obesity prevalences. Education was used as a proxy for socioeconomic status. RESULTS AND CONCLUSIONS: The prevalence of BMI>/=30 increased significantly over the 16-year observation period. At the time of the 1980/81 survey, the adjusted estimates were 8.8% in women and 6.6% in men, compared to 11.9% and 10.0% respectively, in 1996/97. The prevalence of BMI>/=25 was also analyzed for time trends, with specific attention to populations at risk. The largest proportionate changes occurred in women aged 16-44, among whom the prevalence of overweight doubled. The inverse educational gradient with respect to obesity is still present in both sexes, but there is no indication that it has increased in magnitude between 1980/81-1996/97.
Adolescent↗
Reflux-inducing dietary factors and risk of adenocarcinoma of the esophagus and gastric cardia.
Gastroesophageal reflux (GER) is the strongest known risk factor for esophageal adenocarcinoma. For long-term sufferers with severe symptoms, the excess risk may exceed 40-fold. GER has also been shown to increase the risk of cancers of the gastric cardia more than fourfold. Several foods, including dietary fat, chocolate, mints, coffee, onions, citrus fruit, and tomatoes, have been associated with temporary symptoms of reflux, most likely through a relaxation of the lower esophageal sphincter (LES). Our aim was to determine whether these foods are associated with risk of adenocarcinoma of the esophagus or gastric cardia. We studied intakes of LES-relaxing foods and other dietary habits potentially associated with reflux in a nationwide population-based case-control study in Sweden, with 185 and 258 cases of esophageal adenocarcinoma and gastric cardia adenocarcinoma, respectively, and 815 controls. We found no association between LES-relaxing foods and symptoms of chronic reflux, although this might be due to avoidance of these foods among sufferers. In addition, we found no association between dietary factors known to cause LES relaxation and the risk of adenocarcinoma of the esophagus or gastric cardia. Our findings indicate that dietary factors associated with LES relaxation and transient GER (but perhaps not severe chronic reflux) are not associated with any important risk of esophageal malignancy.
Adenocarcinoma↗
Insulin-like growth factor-binding protein-1 and prostate cancer.
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Case-Control Studies↗
Occupational physical activity and renal cell cancer: a nationwide cohort study in Sweden.
The causes of renal cell cancer remain incompletely understood. In one previous retrospective case-control study, high occupational physical activity has been associated with a decreased risk among men, but not among women. Our aim was to investigate the association between occupational physical activity and renal cell cancer in a large cohort in Sweden. A cohort of Swedish men and women was identified in the nationwide censuses in 1960 and 1970, and the reported occupations were classified into 4 levels of physical demands. Follow-up from 1971 through 1989 was accomplished through record linkages to the Swedish Cancer Registry. Multivariate Poisson regression models were used to estimate relative risk (RR) and 95% confidence intervals (CI). We found a monotonic increase in risk of renal cell cancer with decreasing level of occupational physical activity among men (p for trend <0.001). After adjustment for socio-economic status, place of residence, and calendar year of follow-up, men with long-term sedentary jobs had a 25% (RR = 1.25, 95% CI 1.02-1.53) increased risk compared to men with physically demanding occupations. Among women there was no association, the dose-risk trend was not significant (p for trend >0.50). Occupational physical activity was inversely associated with renal cell cancer among men. The absence of association among women might be due to smaller range of exposure, confounding by household work or reproductive factors, or to a difference in biological response to physical activity in men and women.
Adult↗
Long-term intake of dietary fiber and decreased risk of coronary heart disease among women.
CONTEXT: Epidemiological studies of men suggest that dietary fiber intake protects against coronary heart disease (CHD), but data on this association in women are sparse. OBJECTIVE: To examine the association between long-term intake of total dietary fiber as well as fiber from different sources and risk of CHD in women. DESIGN AND SETTING: The Nurses' Health Study, a large, prospective cohort study of US women followed up for 10 years from 1984. Dietary data were collected in 1984, 1986, and 1990, using a validated semiquantitative food frequency questionnaire. PARTICIPANTS: A total of 68782 women aged 37 to 64 years without previously diagnosed angina, myocardial infarction (MI), stroke, cancer, hypercholesterolemia, or diabetes at baseline. MAIN OUTCOME MEASURE: Incidence of acute MI or death due to CHD by amount of fiber intake. RESULTS: Response rate averaged 80% to 90% during the 10-year follow-up. We documented 591 major CHD events (429 nonfatal MIs and 162 CHD deaths). The age-adjusted relative risk (RR) for major CHD events was 0.53 (95% confidence interval [CI], 0.40-0.69) for women in the highest quintile of total dietary fiber intake (median, 22.9 g/d) compared with women in the lowest quintile (median, 11.5 g/d). After controlling for age, cardiovascular risk factors, dietary factors, and multivitamin supplement use, the RR was 0.77 (95% CI, 0.57-1.04). For a 10-g/d increase in total fiber intake (the difference between the lowest and highest quintiles), the multivariate RR of total CHD events was 0.81 (95% CI, 0.66-0.99). Among different sources of dietary fiber (eg, cereal, vegetables, fruit), only cereal fiber was strongly associated with a reduced risk of CHD (multivariate RR, 0.63; 95% CI, 0.49-0.81 for each 5-g/d increase in cereal fiber). CONCLUSIONS: Our findings in women support the hypothesis that higher fiber intake, particularly from cereal sources, reduces the risk of CHD.
Adult↗
The role of diabetes mellitus in the aetiology of renal cell cancer.
To investigate the relation between diabetes mellitus and the risk of renal cell cancer we carried out a population-based retrospective cohort study. Patients identified in the Swedish Inpatient Register who were discharged from hospitals with a diagnosis of diabetes mellitus between 1965 and 1983 formed a cohort of 153852 patients (80005 women and 73847 men). The cohort members were followed up to 1989 by record linkage to three nation-wide registries. Standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) were computed using age-specific sex-specific and period-specific incidence and mortality rates derived from the entire Swedish population. After exclusion of the first year of observation, a total of 267 incidences of renal cell cancer (ICD-7:180.0) occurred in diabetic patients compared with the 182.4 that had been expected. Increased risks were observed in both women (SIR = 1.7, 95% confidence interval, CI = 1.4-2.0) and men (SIR = 1.3; 95 % CI = 1.1-1.6) throughout the duration of follow-up (1-25 years). A higher risk was seen for kidney cancer (ICD-7:180) mortality (SMR = 1.9; 95% CI = 1.7-2.2, women; SMR 1.7, 95% CI = 1.4-1.9, men). In comparison with the general population, patients with diabetes mellitus have an increased risk of renal cell cancer.
Age Factors↗
Occupational physical activity and risk for breast cancer in a nationwide cohort study in Sweden.
OBJECTIVE: Our purpose was to investigate effects of physical activity on risk for breast cancer. METHODS: From the Swedish nationwide censuses in 1960 and 1970 we defined three partly overlapping cohorts of women whose occupational titles allowed reproducible classification of physical demands at work in 1960 (n = 704,904), in 1970 (n = 982,270), or with the same demands in both 1960 and 1970 (n = 253,336). The incidence of breast cancer during 1971-89 was ascertained through record linkage to the Swedish Cancer Register. We used Poisson regression to estimate relative risks (RR). RESULTS: A total of 20,419, 22,840, and 8261 breast cancers, respectively, were detected in the three cohorts. In all three cohorts the risk for breast cancer increased monotonically with decreasing level of occupational physical activity and with increasing socioeconomic status. Among women with the same estimated physical activity level in 1960 and 1970 the RR was 1.3 for sedentary as compared with high/very high activity level (95% CI 1.2-1.4; p for trend < 0.001). Adjustment for socioeconomic status virtually eliminated this association (RR 1.1; 95% CI 0.9-1.2; p for trend 0.12) leaving a statistically significant 30% gradient only among women aged 50-59 years at follow-up. The association between socioeconomic status and breast cancer risk was largely unchanged after adjustment for occupational physical activity. CONCLUSION: The protective effect of occupational physical activity on breast cancer risk, if any, appears to be confined to certain age groups.
Activities of Daily Living↗
Higher relative, but lower absolute risks of myocardial infarction in women than in men: analysis of some major risk factors in the SHEEP study. The SHEEP Study Group.
OBJECTIVES: Middle-aged men have often been the subjects of multifactorial studies of myocardial infarction (MI) risk factors. One major objective of the SHEEP study was to compare the effects of different MI risk factors in women and men. DESIGN: SHEEP (Stockholm Heart Epidemiology Program) is a population-based case-referent study of causes of MI (first event) in Swedish women and men aged 45-70 years. During the period 1992-94, 2246 cases of MI were identified; 34% of the cases were women and 27% of the cases were fatal. One referent per case was chosen randomly from the Stockholm County population after stratification for the case's sex and age. Logistic regression was used to estimate the relative risks associated with risk factors of primary interest (diabetes, hypercholesterolaemia, hypertriglyceridaemia, hypertension, overweight, physical inactivity, smoking and job strain). RESULTS: The relative risk estimates ranged from 1.5 to 4.4 in women and from 1.3 to 2.9 in men (results for nonfatal cases and their referents). None of the 95% confidence intervals included 1.0. The relative risks were higher in the women than in the men (101-180%). The absolute risks, however, were all lower in the women than in the men. Estimates of Rothman's synergy index for gender ranged from 1.0 (hypertension) to 1.8 (current smoking). CONCLUSIONS: The indications of some effect modification due to sex (stronger risks in men for certain exposures) invoke the question of possible mechanisms.
Aged↗
Dietary intake of alpha-linolenic acid and risk of fatal ischemic heart disease among women.
BACKGROUND: Experimental studies in laboratory animals and humans suggest that alpha-linolenic acid (18:3n-3) may reduce the risk of arrhythmia. OBJECTIVE: The objective was to examine the association between dietary intake of alpha-linolenic acid and risk of fatal ischemic heart disease (IHD). DESIGN: This was a prospective cohort study. The intake of alpha-linolenic acid was derived from a 116-item food-frequency questionnaire completed in 1984 by 76283 women without previously diagnosed cancer or cardiovascular disease. RESULTS: During 10 y of follow-up, we documented 232 cases of fatal IHD and 597 cases of nonfatal myocardial infarction. After adjustment for age, standard coronary risk factors, and dietary intake of linoleic acid and other nutrients, a higher intake of alpha-linolenic acid was associated with a lower relative risk (RR) of fatal IHD; the RRs from the lowest to highest quintiles were 1.0, 0.99, 0.90, 0.67, and 0.55 (95% CI: 0.32, 0.94; P for trend = 0.01). For nonfatal myocardial infarction there was only a modest, nonsignificant trend toward a reduced risk when extreme quintiles were compared (RR: 0.85; 95% CI: 0.61, 1.19; P for trend = 0.50). A higher intake of oil and vinegar salad dressing, an important source of alpha-linolenic acid, was associated with reduced risk of fatal IHD when women who consumed this food > or =5-6 times/wk were compared with those who rarely consumed this food (RR: 0.46; 95% CI: 0.27, 0.76; P for trend = 0.001). CONCLUSIONS: This study supports the hypothesis that a higher intake of alpha-linolenic acid is protective against fatal IHD. Higher consumption of foods such as oil-based salad dressing that provide polyunsaturated fats, including alpha-linolenic acid, may reduce the risk of fatal IHD.
Adult↗
Relation between the intake of milk fat and the occurrence of conjugated linoleic acid in human adipose tissue.
BACKGROUND: Conjugated linoleic acid (CLA) is a group of naturally occurring fatty acids mainly present in fats from ruminants. CLA has been shown to be a potential anticarcinogen. OBJECTIVE: In this study, the relation between bovine milk fat intake and the occurrence of CLA in human adipose tissue was investigated. DESIGN: One hundred twenty-three men weighed and recorded the foods they consumed for 1 wk. Afterward, recall interviews were conducted by telephone monthly for 7 consecutive months to inquire about food consumption during the previous 24 h. The entire dietary recording procedure was repeated once. The fatty acid composition of adipose tissue and serum was analyzed. RESULTS: The average amount of one isomer of CLA--9-cis,11-trans-octadecadienoic acid (9c,11t-18:2)--as a percentage of total fatty acids was found to be 0.50% in adipose tissue and 0.25% in serum. The amount of 9c,11t-18:2 in adipose tissue was significantly correlated with milk fat intake (r = 0.42). The percentage of 9c,11t-18:2 in both adipose tissue and in serum was strongly correlated with myristoleic acid (14:1). CONCLUSION: The amount of 9c,11t-18:2 in human adipose tissue was significantly related to milk fat intake.
Adipose Tissue↗