Biomedical subjects

Alberto Ascherio

Publications and source records attributed to Alberto Ascherio.

At least 55 records · Page 3Linked to original sources

PubMed2003

Smoking is a risk factor for multiple sclerosis.

The authors determined the relationship between tobacco smoking and the risk of developing multiple sclerosis (MS) in a general population of 22,312 individuals living in Hordaland, Norway in 1997. A total of 87 individuals reported having developed MS. The risk of MS was higher among smokers than among never-smokers (rate ratio 1.81, 95% CI 1.1 to 2.9; p = 0.014). Studies on how smoking interacts with disease onset may contribute to determining the causal agents of this disease.

Adult↗

PubMed2003

Dietary fat intake and risk of stroke in male US healthcare professionals: 14 year prospective cohort study.

OBJECTIVE: To examine the association between intake of total fat, specific types of fat, and cholesterol and risk of stroke in men. Design and setting Health professional follow up study with 14 year follow up. PARTICIPANTS: 43 732 men aged 40-75 years who were free from cardiovascular diseases and diabetes in 1986. MAIN OUTCOME MEASURE: Relative risk of ischaemic and haemorrhagic stroke according to intake of total fat, cholesterol, and specific types of fat. RESULTS: During the 14 year follow up 725 cases of stroke occurred, including 455 ischaemic strokes, 125 haemorrhagic stokes, and 145 strokes of unknown type. After adjustment for age, smoking, and other potential confounders, no evidence was found that the amount or type of dietary fat affects the risk of developing ischaemic or haemorrhagic stroke. Comparing the highest fifth of intake with the lowest fifth, the multivariate relative risk of ischaemic stroke was 0.91 (95% confidence interval 0.65 to 1.28; P for trend = 0.77) for total fat, 1.20 (0.84 to 1.70; P = 0.47) for animal fat, 1.07 (0.77 to 1.47; P = 0.66) for vegetable fat, 1.16 (0.81 to 1.65; P = 0.59) for saturated fat, 0.91 (0.65 to 1.28; P = 0.83) for monounsaturated fat, 0.88 (0.64 to 1.21; P = 0.25) for polyunsaturated fat, 0.87 (0.62 to 1.22; P = 0.42) for trans unsaturated fat, and 1.02 (0.75 to 1.39; P = 0.99) for dietary cholesterol. Intakes of red meats, high fat dairy products, nuts, and eggs were also not appreciably related to risk of stroke. CONCLUSIONS: These findings do not support associations between intake of total fat, cholesterol, or specific types of fat and risk of stroke in men.

Adult↗

PubMed2003

Dietary intakes of fat and risk of Parkinson's disease.

Previous epidemiologic studies have generated inconsistent results regarding the associations between fat intakes and risk of Parkinson's disease. The authors investigated these associations in two large, prospective US cohorts. They documented 191 incident cases of Parkinson's disease in men (1986-1998) and 168 in women (1980-1998) during the follow-up. Overall, intakes of total fat or major types of fat were not significantly associated with the risk. The relative risks comparing the highest quintile of animal fat intake with the lowest were 1.42 for men (95% confidence interval (CI): 0.91, 2.20; p for trend = 0.1) and 0.65 for women (95% CI: 0.36, 1.16; p for trend = 0.3). For men, but not women, replacement of polyunsaturated fat with saturated fat was associated with a significantly increased risk (5% of energy intake, relative risk (RR) = 1.83, 95% CI: 1.10, 3.03). Of the individual polyunsaturated fatty acids, arachidonic acid tended to be inversely associated with the risk (pooled RR between extreme quintiles = 0.65, 95% CI: 0.46, 0.91; p for trend = 0.05). Results do not support an important role of overall fat intake in the pathogenesis of Parkinson's disease, but a possible adverse effect of saturated fat for men could not be excluded.

Adult↗

PubMed2003

Multiple sclerosis and Epstein-Barr virus.

CONTEXT: Infection with Epstein-Barr virus (EBV) has been associated with an increased risk of multiple sclerosis (MS), but the temporal relationship remains unclear. OBJECTIVE: To determine whether antibodies to EBV are elevated before the onset of MS. DESIGN, SETTING, AND POPULATION: Nested case-control study conducted among more than 3 million US military personnel with blood samples collected between 1988 and 2000 and stored in the Department of Defense Serum Repository. Cases were identified as individuals granted temporary or permanent disability because of MS. For each case (n = 83), 2 controls matched by age, sex, race/ethnicity, and dates of blood sample collection were selected. MAIN OUTCOME MEASURES: Antibodies including IgA against EBV viral capsid antigen (VCA) and IgG against VCA, nuclear antigens (EBNA complex, EBNA-1, and EBNA-2), diffuse and restricted early antigens, and cytomegalovirus. RESULTS: The average time between blood collection and MS onset was 4 years. The strongest predictors of MS were serum levels of IgG antibodies to VCA or EBNA complex. The risk of MS increased monotonically with these antibody titers; relative risk (RR) in persons in the highest category of VCA (> or =2560) compared with those in the lowest (< or =160) was 19.7 (95% confidence interval [CI], 2.2-174; P for trend =.004). For EBNA complex titers, the RR for those in the highest category (> or =1280) was 33.9 (95% CI, 4.1-283; P for trend <.001) vs those in the lowest category (< or =40). Similarly strong positive associations between EBV antibodies and risk of MS were already present in samples collected 5 or more years before MS onset. No association was found between cytomegalovirus antibodies and MS. CONCLUSION: These results suggest a relationship between EBV infection and development of MS.

Adolescent↗

PubMed2003

Adipose tissue alpha-linolenic acid and nonfatal acute myocardial infarction in Costa Rica.

BACKGROUND: Alpha-linolenic acid may protect against cardiovascular disease. We examined the association between adipose tissue alpha-linolenic acid and nonfatal acute myocardial infarction (MI) in a population-based case-control study in Costa Rica. METHODS AND RESULTS: The 482 case patients with a first nonfatal acute MI and 482 population control subjects were matched by age, sex, and area of residence. Fatty acids were assessed by gas-liquid chromatography in adipose tissue samples collected from all subjects. ORs and 95% CIs were calculated from multivariate conditional logistic regression models. Subjects in the top quintiles of adipose tissue alpha-linolenic acid had a lower risk of MI than those in the lowest quintile: OR (95% CI), 1.00; 0.80 (0.52 to 1.24); 0.53 (0.34 to 0.82); 0.44 (0.28 to 0.67); and 0.37 (0.24 to 0.59); test for trend, P<0.0001. This association was strengthened after adjustment for established MI risk factors, including smoking, physical activity, income, and adipose tissue linoleic acid and trans fatty acids (OR for the top versus lowest quintile, 0.23; 95% CI, 0.10 to 0.50; test for trend, P<0.0001). Further adjustment for the intake of saturated fat, fiber, alcohol, and vitamin E did not change this association (OR for the top versus lowest quintile, 0.23; 95% CI, 0.10 to 0.55; test for trend, P<0.0001). CONCLUSIONS: The inverse association observed between alpha-linolenic acid and nonfatal acute MI suggests that consumption of vegetable oils rich in alpha-linolenic acid confers important protection against cardiovascular disease.

Adipose Tissue↗

PubMed2003

Oral health and peripheral arterial disease.

BACKGROUND: Many studies have reported the association between poor oral health and coronary heart disease or stroke, but few of them evaluated peripheral arterial disease (PAD). Hence, in this study we examined the associations between oral health and PAD. METHODS AND RESULTS: In the prospective study of 45,136 eligible male health professionals free of cardiovascular diseases at baseline, we identified 342 cases of PAD during a 12-year follow-up period. We evaluated the association between different measures of oral diseases and the occurrence of PAD. Baseline number of teeth was not related to the risk of PAD, but cumulative incident tooth loss was significantly associated with elevated risk of subsequent occurrence of PAD. The relative risk for history of periodontal disease was 1.41 (95% CI, 1.12 to 1.77) and for any tooth loss during the follow-up period was 1.39 (95% CI, 1.07 to 1.82), controlling for traditional risk factors of cardiovascular disease. Among men with a history of periodontal diseases, the relative risk of tooth loss increased to 1.88 (95% CI, 1.27 to 2.77), whereas no association was found between tooth loss and PAD among those without periodontal diseases (RR, 0.92; 95% CI, 0.61 to 1.38). We further explored the potential induction period of tooth loss and found that tooth loss in the previous 2 to 6 years was most strongly associated with PAD. CONCLUSIONS: We found that incident tooth loss was significantly associated with PAD, especially among men with periodontal diseases. The results support a potential oral infection-inflammation pathway.

Adult↗

PubMed2003

Nonsteroidal anti-inflammatory drugs and the risk of Parkinson disease.

BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce dopaminergic neuron degeneration in animal models of Parkinson disease (PD). However, no epidemiological data have been available on NSAID use and the risk of PD. OBJECTIVE: To investigate prospectively whether the use of nonaspirin NSAIDs or aspirin is associated with decreased PD risk. DESIGN, SETTINGS, AND PARTICIPANTS: Prospective cohorts of 44 057 men and 98 845 women free of PD, stroke, or cancer (Health Professionals Follow-up Study, 1986-2000, and Nurses' Health Study, 1980-1998). Main Outcome Measure Newly diagnosed PD. RESULTS: We documented 415 incident PD cases (236 men and 179 women). Participants who reported regular use of nonaspirin NSAIDs at the beginning of the study had a lower risk of PD than nonregular users during the follow-up; the pooled multivariate relative risk was 0.55 (95% confidence interval, 0.32-0.96, P =.04). Compared with nonusers, a nonsignificantly lower risk of PD was also observed among men and women who took 2 or more tablets of aspirin per day (relative risk, 0.56; 95% confidence interval, 0.26-1.21). CONCLUSION: These findings are consistent with the hypothesis that use of NSAIDs may delay or prevent the onset of PD.

Acetaminophen↗

PubMed2003

Weight loss in Parkinson's disease.

We prospectively examined the changes of body weight among 468 individuals with Parkinson's disease (PD) before and after the diagnosis. The average weight of PD patients was stable until shortly before the diagnosis (p for trend = 0.2) and then declined (p for trend < 0.0001). Interestingly, PD patients tended to increase their energy intakes as their weights decreased (p for trend < 0.002). In conclusion, weight loss in PD patients appears to be a continuous process that starts several years before the diagnosis and is not caused by reduced energy intake.

Adult↗

PubMed2003

Alcohol consumption and the incidence of Parkinson's disease.

Cigarette smoking and caffeine consumption are associated with a decreased incidence of Parkinson's disease (PD). This inverse association may result from neuroprotective effects of cigarette smoke and caffeine, or from a disinclination of future PD patients to engage in habituating behaviors. We investigated the association between consumption of alcoholic beverages, another potentially habituating behavior, and risk of PD in two large prospective cohorts Nurses' Health Study, and Health Professionals' Follow-up Study. We detected 415 new cases of PD during follow-up. Compared with nondrinkers at baseline, the relative rate (95% confidence interval) was 1.0 (0.8-1.3) for drinkers of less than 5 gm/day, 1.0 (0.8-1.4) for 5 to less than 15 gm/day, 1.1 (0.8-1.6) for 15 to less than 30 gm/day, and 0.7 (0.5-1.2) for 30 gm/day or more (p for trend = 0.45). Consumption of wine or liquor was not associated with the incidence of PD. Compared with those who consumed beer less than once per month, the relative rate (95% confidence interval) was 0.7 (0.5-0.9) for one to three drinks of beer per month, and 0.7 (0.5, 0.9) for one or more drinks of beer per week. The risk of PD was similar in individuals who usually consume moderate amounts of alcohol and in abstainers.

Adult↗

PubMed2003

Prospective study of phobic anxiety and risk of Parkinson's disease.

Anxiety disorders are common in Parkinson's disease (PD). However, the risk of PD among people with anxiety has not been examined in a prospective cohort study. We examined this relation prospectively within the Health Professionals Follow-Up Study, a cohort of US male health professionals. In 1988, anxiety was assessed using the Crown-Crisp phobic anxiety index in 35,815 men without PD, stroke, or cancer at baseline. There were 189 incident cases of PD during 12 years of follow-up. After adjusting for age, smoking, and caffeine intake, the relative risk of PD among men with the highest level of anxiety (Crown-Crisp index scores of 4 and above) was 1.5 (95% CI = 1.0-2.1; P-trend = 0.01) compared to men with the lowest level of anxiety. This positive association persisted after excluding cases of PD with onset in the first 2 years of follow-up. Use of anxiolytic medication was also associated with an elevated risk of PD (RR= 1.6; 95% CI = 0.9-3.1), but adjusting for this potential confounder did not materially affect the association between anxiety and risk of PD. Our results suggest that anxiety is a risk factor for PD. Whether this association is causal or the result of shared underlying biology remains a question.

Adult↗

PubMed2003

Dietary fiber reduces peripheral arterial disease risk in men.

We prospectively evaluated the relationship between dietary fiber and peripheral arterial disease risk (PAD) among 46,032 men, aged 40 to 75 y, in 1986. Subjects answered a vascular disease questionnaire and completed a validated 131-item food frequency questionnaire, and were free of PAD, cardiovascular disease and diabetes. During 12 y of follow-up 308 incident PAD cases were documented. After adjusting for age, smoking, hypertension, hypercholesterolemia, family history of early coronary heart disease, alcohol consumption, BMI, physical activity and energy intake, PAD risk in each quintile of cereal fiber intake compared with the lowest quintile was 0.69, 95% CI 0.49-0.97 for quintile 2; 0.65, 95% CI 0.45-0.94 for quintile 3; 0.68, 95% CI 0.47-0.98 for quintile 4; and 0.67, 95% CI 0.47-0.97 for quintile 5. In a nonlinear model the overall inverse association (P = 0.02) and nonlinear components (P = 0.03) were significant. Fruit, vegetable and total fiber intakes were not associated with PAD risk. These results suggest an inverse association between cereal fiber intake and PAD risk in men. Increasing cereal fiber intake may prevent PAD.

Adult↗

PubMed2003

High 18:2 trans-fatty acids in adipose tissue are associated with increased risk of nonfatal acute myocardial infarction in costa rican adults.

Trans-fatty acid intake is associated with coronary heart disease (CHD), but the atherogenic potential of individual trans-fatty acids (FA) from partially hydrogenated oils (18:1 and 18:2) or meat and dairy products (16:1 and 18:1) is unclear. Incident cases (n = 482) of a first nonfatal myocardial infarction (MI) were matched with population controls (n = 482) for age, gender and area of residence, all living in Costa Rica. Trans-FA in adipose tissue samples were assessed by gas chromatography. Odds ratios (OR) and 95% confidence intervals were calculated from conditional logistic regression models. Total adipose tissue trans-fat was positively associated with risk of MI. After adjusting for established risk factors and other confounders, the OR by quintiles of total trans-fat were 1.00, 1.34, 2.05, 2.22 and 2.94 (P-test for trend < 0.01). This association was attributed mainly to 18:2 trans-FA that were abundant in both adipose tissue and in partially hydrogenated soybean oil, margarines and baked products used by this population; OR = 1.00, 0.96, 2.09, 3.51 and 5.05 (P-test for trend < 0.001). Adipose tissue 16:1 trans-FA were also associated with MI; OR = 1.00, 1.57, 1.39, 1.34 and 2.58 (P-test for trend < 0.05). An association with 18:1 trans-FA was not detected. High 18:2 trans-FA in adipose tissue are associated with increased risk of MI. Because the use of hydrogenated oils is increasing worldwide, consumers should be aware of the harmful effects of products containing partially hydrogenated oils.

Adipose Tissue↗

PubMed2003

The use of B vitamin supplements and peripheral arterial disease risk in men are inversely related.

Peripheral arterial disease (PAD) causes morbidity and is associated with mortality. B vitamin intake has been inversely associated with coronary heart disease, but their effects on PAD are not known. We examined prospectively the relationships between dietary folate, vitamin B-6 and B-12 and PAD risk in 51529 male U.S. health professionals, aged 40 to 75 y, who answered a detailed 131-item questionnaire to assess diet and vitamin supplement use. The study population consisted of 46036 men free of PAD, cardiovascular disease and diabetes at baseline followed for 12 y during which we documented 308 incident PAD cases. For every 400 microg/d increment of folate intake, the multivariate adjusted PAD risk decreased by 21% [relative risk (RR) = 0.79, 95% CI 0.64-0.96]. Men in the top category of folate intake (median = 840 micro g) were at 33% lower risk of PAD than men in the bottom category (median = 244 microg) (RR = 0.67, 95% CI 0.45-0.96, P-value, test for trend = 0.03) after multivariate adjustment. There were weak inverse associations between intake of vitamin B-6 and PAD risk (RR = 0.70, 95% CI 0.48-1.02, P-value, test for trend = 0.06) and B-12 (RR = 0.77, 95% CI 0.54-1.11, P-value, test for trend = 0.12). These results suggest that higher consumption of folate may contribute to the prevention of PAD.

Adult↗

PubMed2003

Infection with Chlamydia pneumoniae and risk of multiple sclerosis.

BACKGROUND: Chlamydia pneumoniae (Cpn) has been proposed as a possible etiologic agent for multiple sclerosis (MS), but results of previous studies are conflicting. METHODS: Using a nested case-control design, we examined the association between Cpn infection and MS in the Nurses' Health Study (NHS) and Nurses' Health Study II (NHS II) cohorts. Among 32,826 women in the NHS and 29,722 women in the NHS II with blood samples, 141 incident cases of definite or probable MS were documented. Each case was matched to two healthy controls on year of birth and NHS cohort. Serum samples were tested for the presence of Cpn-specific immunoglobin G antibodies using microimmunofluorescence. RESULTS: Cpn immunoglobin G seropositivity was positively associated with risk of MS (odds ratio [OR] = 1.7; 95% confidence interval [CI] = 1.1-2.7). This association did not change after adjusting for age at blood collection, ancestry, latitude of residence at birth, and smoking (OR = 1.9; CI = 1.1-3.1). Seropositivity for Cpn was only moderately associated with risk of relapsing-remitting MS (OR = 1.7; CI = 0.9-3.2), but it was strongly associated with risk of progressive MS (OR = 7.3; CI = 1.4-37.2). Geometric mean titers of Cpn-specific immunoglobin G antibody were similar in women with relapsing-remitting MS as compared with matched controls (44 vs 39), but they were elevated in women with progressive MS (99 vs 40). CONCLUSIONS: These results support a positive association between Cpn infection and progressive MS.

Adult↗

PubMed2003

The association between fruit and vegetable consumption and peripheral arterial disease.

BACKGROUND: High fruit and vegetable consumption has been associated with a lower risk of cardiovascular diseases, but few studies have focused on peripheral arterial disease. In this study, we evaluated the association of consumption of fruits and vegetables with peripheral arterial disease. METHODS: In a cohort of 44,059 men initially free of cardiovascular disease and diabetes, we documented 295 cases of peripheral arterial disease during a 12-year follow-up. Fruit and vegetable consumption was assessed by food frequency questionnaire. RESULTS: In the age-adjusted model, men in the highest quintile had a relative risk of 0.55 (95% confidence interval = 0.38-0.80) for overall fruit and vegetable intake, 0.52 (0.36-0.77) for fruit intake, and 0.54 (0.36-0.81) for vegetable intake, compared with those in the lowest quintile of intake. However, the associations were greatly weakened after adjustment for smoking and other traditional cardiovascular disease risk factors. Comparing men in the highest quintile versus the lowest quintile, relative risks and 95% confidence intervals were 0.95 (0.62-1.44) for overall fruit and vegetable intake, 0.97 (0.64-1.48) for fruit intake, and 0.76 (0.50-1.17) for vegetable intake. CONCLUSIONS: We did not find evidence that fruit and vegetable consumption protects against peripheral arterial disease, although a modest benefit cannot be excluded.

Arteriosclerosis↗

PubMed2003

Periodontal disease, tooth loss, and incidence of ischemic stroke.

BACKGROUND AND PURPOSE: Periodontal and other infections have been suggested as potential risk factors for stroke. This study evaluates periodontal disease and tooth loss as risk factors for ischemic stroke. METHODS: The study population consisted of 41 380 men who were free of cardiovascular disease and diabetes at baseline. Periodontal disease history was assessed by mailed validated questionnaires. During 12 years of follow-up, stroke incidence was assessed and subclassified by use of medical history, medical records, and imaging reports. Hazard ratios (HRs) were adjusted for age, amount smoked, obesity, alcohol, exercise, family history of cardiovascular disease, multivitamin use, vitamin E use, profession, baseline reported hypertension, and hypercholesterolemia. Sex and socioeconomic status were inherently controlled for by restriction. Confounding variables were updated in the analyses for each 2-year follow-up interval. RESULTS: We documented 349 ischemic stroke cases during the follow-up period. Men who had < or =24 teeth at baseline were at a higher risk of stroke compared to men with > or =25 teeth (HR=1.57; 95% CI, 1.24 to 1.98). There was little evidence of an increased risk with recent tooth loss during follow-up. A modest association was seen between baseline periodontal disease history and ischemic stroke (HR=1.33; 95% CI, 1.03 to 1.70). Addition of dietary factors to the model changed the HR only slightly. CONCLUSIONS: Our results suggest that periodontal disease and fewer teeth may be associated with increased risk of ischemic stroke.

Adult↗

PubMed2003

Tooth loss and dietary intake.

BACKGROUND: Several studies have reported that impaired dentition status is associated with poor nutritional intake. However, most of these studies are cross-sectional and thus are unable to clarify the temporal sequence. METHODS: We assessed the longitudinal relation between tooth loss and changes in consumption of fruits and vegetables and of nutrients important for general health among 31,813 eligible male health professionals. RESULTS: Subjects who lost five or more teeth had a significantly smaller reduction in consumption of dietary cholesterol and vitamin B12, greater reduction in consumption of polyunsaturated fat and smaller increase in consumption of dietary fiber and whole fruit than did subjects who had lost no teeth. Men who had lost teeth also were more likely to stop eating apples, pears and raw carrots. CONCLUSIONS: The results support the temporal association between tooth loss and detrimental changes in dietary intakes, which could contribute to increased risk of developing chronic diseases. PRACTICE IMPLICATIONS: Dietary evaluation and recommendations can be incorporated into dental visits to provide a greater benefit to patients.

Adult↗

PubMed2002

Epidemiologic studies on dietary fats and coronary heart disease.

The results of large prospective epidemiologic investigations support the hypothesis that coronary disease risk depends on the quality rather than quantity of dietary fat. Whereas saturated fat and cholesterol appear to increase the risk of coronary heart disease (CHD) as predicted by their effects on blood lipids, strong evidence has emerged that the deleterious effects of trans unsaturated fatty acids (trans fatty acids) extend beyond those predicted by their well-known adverse influence on the ratio of low-density lipoprotein to high-density lipoprotein cholesterol. On the other hand, increased consumption of the polyunsaturated fats, linoleic acid and linolenic acid, appears to reduce the risk of CHD.

Coronary Disease↗