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C H Bowles

Publications and source records attributed to C H Bowles.

11 recordsLinked to original sources
PubMed1995

The protective effect of a small amount of fish on coronary heart disease mortality in an elderly population.

BACKGROUND: A protective effect of a small amount of fish on coronary heart disease (CHD) mortality has been established in observational studies in middle-aged people. In the present study this association was investigated in the elderly. METHODS: In 1971 CHD risk factors were measured in 272 people born before 1907. They belonged to a general practice in Rotterdam, the Netherlands and were followed for 17 years. The cross-check dietary history method was used to obtain information on fish consumption. RESULTS: During the follow-up period 58 people died from CHD, 67 from cancer and 187 from all causes. In 1971 about 60% of the elderly ate fish and 40% did not eat fish. Multivariate Cox proportional hazards analyses, taking the confounding effect of major risk factors into account, showed an inverse relation between fish consumption and 17-year CHD mortality. The risk ratio (RR) for fish eaters compared with no-fish eaters was significantly different from unity (RR = 0.51, 95% CI: 0.29-0.89). Cancer and total mortality were not related to fish consumption. CONCLUSION: The results from the present study suggest that the protective effect of a small amount of fish in relation to CHD observed in middle-aged people seems also to be present in the elderly.

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PubMed1995

Body iron stores and mortality due to cancer and ischaemic heart disease: a 17-year follow-up study of elderly men and women.

BACKGROUND: Increased body iron stores have been suggested as a risk factor for cancer and ischaemic heart disease (IHD). However, all studies carried out to date have focused on relatively young populations although the elderly may also be at increased risk. METHODS: We investigated the association between body iron stores and mortality due to cancer and IHD in a 17-year follow-up study of 260 non-institutionalized elderly people aged 64-87 years. Iron status was assessed in 1971 by means of the haemoglobin level, transferrin saturation and total iron binding capacity (TIBC). Information about the vital status and causes of death was obtained in 1988. RESULTS: Among women mortality due to cancer was inversely related to TIBC; the relative risk for the highest tertile of TIBC, adjusted for age, smoking and alcohol intake was 0.05 (95% confidence interval (CI): 0.007-0.39). The risk of mortality due to all-causes was also inversely associated with TIBC. Among men, no association between body iron stores and mortality due to cancer was observed. Mortality due to IHD was not clearly associated with body iron status. Among men, the adjusted relative risk decreased slightly per tertile of transferrin saturation, but this trend was only of borderline significance (P = 0.10). CONCLUSIONS: These results suggest that body iron stores are a risk factor for mortality due to cancer in postmenopausal women. This may be due to accumulation of stored iron among women after menopause. No clear associations with mortality due to IHD were observed in either elderly men or elderly women.

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PubMed1994

Serum total cholesterol and systolic blood pressure as risk factors for mortality from ischemic heart disease among elderly men and women.

Serum total cholesterol (TC) and systolic blood pressure (SBP) were investigated as risk factors for mortality from ischemic heart disease among 272 elderly men and women during 17 years of follow-up. For men, TC was not significantly associated with mortality from ischemic heart disease. Among women, a significant positive association was found (p-trend = 0.03 when adjusted for age, body mass index, SBP, alcohol consumption, smoking, and the prevalence of myocardial infarction, angina pectoris and diabetes mellitus). Among women a significant positive association was also observed for SBP after adjustment for all potential confounders (p-trend = 0.05). Among men, the adjusted association with SBP was not statistically significant. The results suggest that TC and SBP are stronger independent risk factors for mortality from ischemic heart disease among elderly women than among elderly men. These differences between genders may be due to selective mortality among middle-aged men and physiological changes in women during menopause.

Age Factors↗
PubMed1993

Glucose tolerance and mortality from ischemic heart disease in an elderly population. Impact of repeated glucose measurements.

The impact of glucose tolerance, measured repeatedly, on the mortality from ischemic heart disease (IHD) was assessed in a cohort of 202 elderly patients, aged 64 to 84 years in 1971, from a general practice. During the period from 1971 to 1975 the participants were examined annually. The area under the glucose tolerance curve (AUC) was used as a summary index, and for every subject the mean AUC over the 5-year period was calculated. This index was most strongly correlated with the mean 60-minute glucose level (r = 0.96). Between 1975 and 1987, 125 participants died, 28.8% of whom died from IHD. No association between a single measurement of glucose tolerance and IHD mortality was observed. However, using the mean AUC over the 5-year period, a positive association was observed, independent of age, sex, and other potential confounders (P = 0.04). These results indicate that glucose tolerance independently predicts mortality from coronary heart disease in an elderly cohort, provided that information on repeated measurements is taken into account. A continuous risk gradient is suggested.

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PubMed1993

Association between fish intake and coronary heart disease mortality. Differences in normoglycemic and glucose intolerant elderly subjects.

OBJECTIVE: To compare the association of habitual fish intake with 17-yr mortality of coronary heart disease between normoglycemic and glucose intolerant elderly subjects. RESEARCH DESIGN AND METHODS: In 1971, 272 men and women, 64-87 yr of age, were examined in a general practice in the town of Rotterdam, The Netherlands. Glucose intolerance (impaired glucose tolerance or diabetes mellitus) was observed in 83 subjects, and 189 subjects were found to be normoglycemic and free of clinically diagnosed diabetes mellitus. Information on usual dietary intake was obtained using the cross-check dietary history method. RESULTS: Fish consumption was found in 58.7% of the normoglycemic population and in 62.4% of the glucose intolerant population. Among normoglycemic subjects, the age- and sex-adjusted 17-yr mortality for coronary heart disease was 10.9/1000 person-yr for those who ate fish and 25.1/1000 person-yr for those who did not. For the glucose intolerant population, the rates were 20.6/1000 and 31.2/1000 person-yr, respectively. Adjusted for age, sex, body mass index, smoking, alcohol use, intake of energy, polyunsaturated fat, and carbohydrates, the risk ratio for normoglycemic population was 0.34 (95% confidence interval: 0.16-0.72). For glucose intolerant subjects, an adjusted risk ratio of 0.80 (95% confidence interval: 0.31-2.05) was observed. CONCLUSIONS: These results suggest that in a glucose intolerant population the possible protective effect of fish intake on coronary heart disease may be smaller than in normoglycemic subjects.

Age Factors↗
PubMed1992

A longitudinal study on glucose tolerance and other cardiovascular risk factors: associations within an elderly population.

From 1971 until 1975, 204 patients from a general practice, aged 64-87 at entry, were examined annually. At every examination body weight, serum lipids, and systolic blood pressure were measured, and a complete glucose tolerance test was carried out. Clinically diagnosed diabetics were excluded. Adjusted for age and sex, the annual change in the area under the glucose curve (AUC) was significantly associated with body weight change. Changes in serum total cholesterol, serum triglycerides, and systolic blood pressure were also associated with body weight change. The results were independent of potential confounders such as alcohol use, smoking habits, presence of cardiovascular disease, and baseline levels of the different risk factors. The change in AUC was also associated with changes in serum total cholesterol, independent of confounders such as body weight. Changes in AUC were not related to changes in systolic blood pressure and serum triglycerides. The results of this study suggest that changes in glucose tolerance are not only related to changes in body weight, but also to changes in serum cholesterol.

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PubMed1991

Intra- and interindividual variability of glucose tolerance in an elderly population.

The intra- and interindividual variability of the oral glucose tolerance test (OGTT) and other risk factors was investigated in 237 subjects, aged 64-87, examined annually in the period 1971-1975. Coefficients of intraindividual variation (CVa) were calculated from individual regressions on time. The lowest CVa was found for the summary index including fasting glucose (area under the curve, AUC): 10.0 +/- 4.9%. For fasting and 30, 60, and 120 min glucose the values ranged from 12 to 18%. The CVa's were not associated with age, gender, drug use, and disease prevalence, and may also be applied to other populations. The reliability coefficient depended on the prevalence of diabetes in the population and was higher than observed in younger populations. The highest reliability coefficient was observed for AUC: 0.81. For the combined information of OGTT, reflected by AUC or by classification according to WHO criteria, the variability was comparable to that of other cardiovascular risk factors such as serum total cholesterol.

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PubMed1991

Carbohydrate intake and body mass index in relation to the risk of glucose intolerance in an elderly population.

The association between the intake of carbohydrates, body mass index (BMI), and the 4-y incidence of impaired glucose tolerance and diabetes mellitus (glucose intolerance) was investigated in elderly men and women aged 64-87 y. In 1971 the baseline population consisted of 175 normoglycemic subjects. During the follow-up period (1972-1975) an oral glucose-tolerance test (OGTT) was carried out annually. In univariate analyses, baseline BMI and the habitual intake of carbohydrates and pastries, as determined from a cross-check dietary history, were positively associated with the incidence of glucose intolerance. The habitual intake of legumes was inversely related to the incidence of glucose intolerance. These results could not be explained by potential confounding factors such as age, gender, alcohol use, energy intake, prescribed diet, medication use, and comorbidity. These results suggest that energy balance and the use of carbohydrate-rich foods are related to the development of glucose intolerance in an elderly population.

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PubMed1991

Inverse association between fish intake and risk of glucose intolerance in normoglycemic elderly men and women.

OBJECTIVE: To examine the association of fish intake with the subsequent risk of impaired glucose tolerance and diabetes mellitus (glucose intolerance). RESEARCH DESIGN AND METHODS: In 1971, information about food intake was obtained by the cross-check dietary history method on 175 men and women aged 64-87 yr who were normoglycemic and free of clinical diabetes. During the follow-up period from 1972 to 1975, an oral glucose tolerance test was performed annually, and in 59 of 175 elderly people a diagnosis of glucose intolerance was made at least once. RESULTS: In 1971, approximately 60% of the subjects usually ate fish, with a mean daily intake of 24.2 g. In fish eaters, the incidence of glucose intolerance was significantly lower compared with nonfish eaters (odds ratio [OR] 0.40, 95% confidence interval [CI] 0.21-0.77). With logistic regression analysis, this inverse association could not be explained by taking into account age and sex or possible confounding baseline characteristics, such as the prevalence of myocardial infarction, body mass index, energy intake per kilogram body weight, or intake of carbohydrates (OR 0.47, 95% CI 0.23-0.93). Baseline characteristics of the oral glucose tolerance test and serum triglyceride levels could also not account for this result. CONCLUSIONS: These results suggest that, in an elderly population, the habitual consumption of a small amount of fish may protect against the development of impaired glucose tolerance and diabetes mellitus.

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