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Biomedical subjects

E Rimm

Publications and source records attributed to E Rimm.

27 records · Page 2Linked to original sources
PubMed1997

Dietary fat intake and the risk of coronary heart disease in women.

BACKGROUND: The relation between dietary intake of specific types of fat, particularly trans unsaturated fat and the risk of coronary disease remains unclear. We therefore studied this relation in women enrolled in the Nurses' Health Study. METHODS: We prospectively studied 80,082 women who were 34 to 59 years of age and had no known coronary disease, stroke, cancer, hypercholesterolemia, or diabetes in 1980. Information on diet was obtained at base line and updated during follow-up by means of validated questionnaires. During 14 years of follow-up, we documented 939 cases of nonfatal myocardial infarction or death from coronary heart disease. Mutivariate analyses included age, smoking status, total energy intake, dietary cholesterol intake, percentages of energy obtained from protein and specific types of fat, and other risk factors. RESULTS: Each increase of 5 percent of energy intake from saturated fat, as compared with equivalent energy intake from carbohydrates, was associated with a 17 percent increase in the risk of coronary disease (relative risk, 1.17; 95 percent confidence interval, 0.97 to 1.41; P=0.10). As compared with equivalent energy from carbohydrates, the relative risk for a 2 percent increment in energy intake from trans unsaturated fat was 1.93 (95 percent confidence interval, 1.43 to 2.61; P<0.001); that for a 5 percent increment in energy from monounsaturated fat was 0.81 (95 percent confidence interval, 0.65 to 1.00; P=0.05); and that for a 5 percent increment in energy from polyunsaturated fat was 0.62 (95 percent confidence interval, 0.46 to 0.85; P= 0.003). Total fat intake was not signficantly related to the risk of coronary disease (for a 5 percent increase in energy from fat, the relative risk was 1.02; 95 percent confidence interval, 0.97 to 1.07; P=0.55). We estimated that the replacement of 5 percent of energy from saturated fat with energy from unsaturated fats would reduce risk by 42 percent (95 percent confidence interval, 23 to 56; P<0.001) and that the replacement of 2 percent of energy from trans fat with energy from unhydrogenated, unsaturated fats would reduce risk by 53 percent (95 percent confidence interval, 34 to 67; P<.001). CONCLUSIONS: Our findings suggest that replacing saturated and trans unsaturated fats with unhydrogenated monounsaturated and polyunsaturated fats is more effective in preventing coronary heart disease in women than reducing overall fat intake.

Adult↗
PubMed1996

Effects of a single bout of ultraendurance exercise on lipid levels and susceptibility of lipids to peroxidation in triathletes.

OBJECTIVE: To determine the effects of a single bout of ultraendurance exercise, as a model for physiologic stress, on lipid and lipoprotein levels, and oxidative susceptibility of lipids in highly trained athletes. DESIGN: Observational trial. POPULATION AND SETTING: Thirty-nine volunteer subjects (26 mean, 13 women; mean age, 38 +/- 10 years) who competed in and completed the 1994 Hawaii Ironman World Championship Triathlon consisting of a consecutive 3.9-km (2.4-mi) swim, 180.2-km (112-mi) bike ride, and a 42.2-km (26.2-mi) run. Subjects answered questionnaires and had blood samples obtained 2 days prior to and within 15 minutes of completion of the triathlon. MAIN OUTCOME MEASURES: Prerace vs postrace changes in lipid and lipoprotein levels, and susceptibility of lipids to peroxidation. RESULTS: The mean duration of exercise was 753 +/- 128 minutes. With exercise, plasma volume-corrected levels of triglycerides decreased 39% from 1.58 +/- 0.83 to 0.97 +/- 0.68 mmol/L (139.6 +/- 73.6 to 85.8 +/- 60.5 mg/dL) (P < .001). Levels of total cholesterol decreased 9% from 4.94 +/- 0.88 to 4.50 +/- 0.79 mmol/L (190.8 +/- 33.8 to 173.8 +/- 30.6 mg/dL) (P < .001), low-density lipoprotein cholesterol decreased 11% from 2.59 +/- 0.77 to 2.30 +/- 0.86 mmol/L (100.1 +/- 29.9 to 88.7 +/- 33.3 mg/dL) (P = .02), and apolipoprotein B decreased 10% from 0.91 +/- 0.20 to 0.82 +/- 0.18 g/L (90.7 +/- 20.0 to 82.0 +/- 17.9 mg/dL) (P < .001). High-density lipoprotein cholesterol and apolipoprotein A-I increased with exercise but not significantly. The susceptibility of lipids to peroxidation decreased significantly (4.51 +/- 1.91 micromol/L, preexercise, vs 2.42 +/- 2.27 micromol/L, postexercise, P < .001), an effect that was not related to antioxidant use or levels of vitamins A, C, or E. Serum iron, a potential pro-oxidant, also decreased by 45% with exercise from 15.75 +/- 5.55 to 8.59 +/- 4.30 micromol/L (88 +/- 31 to 48 +/- 24 micrograms/dL) (P < .001), an effect that was weakly correlated with changes in lipid peroxidation (P = .05). CONCLUSIONS: These data suggest that a single bout of prolonged exercise can reduce lipid and lipoprotein risk factors for developing cardiovascular disease. Moreover, susceptibility of lipids to peroxidation is reduced by exercise, thereby adding to the benefits of physical activity. This effect appears to be independent of antioxidant supplement use and may be mediated by induction of endogenous antioxidants. These observations may explain in part the reduced risk of developing vascular and other diseases in individuals who are physically active.

Adult↗
PubMed1996

Analytical performance and clinical utility of a direct LDL-cholesterol assay in a hyperlipidemic pediatric population.

This study compares a new latex immunoseparation method for the direct determination of plasma low-density lipoprotein cholesterol (LDL-C) with the reference procedure for LDL-C (beta-quantification) in a pediatric hyperlipidemic population. The direct LDL-C assay has a mean bias of -98 mg/L in a fasting group (n = 96) of patients (mean triglycerides 1057 +/- 720 mg/L) and a bias of +177 mg/L in a nonfasting group (n = 42, mean triglycerides 4854 +/- 5457 mg/L). The mean total analytical error calculated from our data is 13.8%. The direct LDL-C assay and the commonly used Friedewald calculation respectively classified 81% and 84% of fasting patients correctly, according to the cutoffs of 1100 and 1300 mg/L for LDL-C set by the National Cholesterol Education Program for pediatric patients. Of combined fasting and nonfasting patients, 80% were correctly classified by the direct LDL-C assay. Therefore, despite several analytical shortcomings, the direct LDL-C assay may be useful in managing hyperlipidemic children without the need for a fasting specimen.

Adolescent↗
PubMed1996

Failure of current guidelines for cholesterol screening in urban African-American adolescents.

OBJECTIVE: The National Cholesterol Education Program (NCEP) and the American Academy of Pediatrics recommend selective screening to detect children and adolescents with hypercholesterolemia. We compared the effectiveness of these guidelines with other potential screening strategies in urban African-American adolescents. SUBJECTS AND METHODS: Two hundred sixty African-American adolescents and young adults (192 females and 68 males; age range, 12 to 20 years) who were free from illnesses or medications that disrupt lipid metabolism were included in the study. Participants completed a questionnaire regarding their smoking habits, blood pressure, contraceptive pill use, and family history of early heart disease and high cholesterol and had their blood lipids, lipoproteins, and apolipoproteins measured (152 fasting and 108 nonfasting). RESULTS: Nineteen percent of participants reported family histories of hypercholesterolemia; 26% reported family histories of premature heart disease; and 8% had family histories of both hypercholesterolemia and premature heart disease. Therefore, 37% of these participants would have been targeted for cholesterol screening, compared with the 25% predicted by the NCEP. Less than 50% of the participants with low-density lipoprotein cholesterol (LDL-C) levels greater than 110 or 130 mg/dL would have been detected by selective screening. Total cholesterol was superior as a screening test to apolipoprotein B in predicting LDL-C levels greater than 110 mg/dL (sensitivity, 92% vs 59%). However, total cholesterol minus high-density lipoprotein cholesterol showed better positive predictive value (100%) at LDL-C levels greater than 110 mg/dL than total cholesterol in the fasting (80%) and total groups (90%). CONCLUSIONS: In this population, selective screening with total cholesterol, as recommended by the NCEP, has such poor sensitivity and positive predictive value that other options may be superior. As an alternative, we recommend the measurement of high-density lipoprotein cholesterol together with total cholesterol at the initial screening step in adolescents and universal screening for those older than 16 years to capture a greater proportion of young adults with increased LDL-C. Furthermore, we recommend using the less stringent treatment guidelines established by the Adult Treatment Panel II for premenopausal women and men younger than 35 years for older adolescents and young adults.

Adolescent↗
PubMed1995

Consumption of olive oil and specific food groups in relation to breast cancer risk in Greece.

BACKGROUND: Experimental animal studies suggest that olive oil consumption, as contrasted to consumption of other fat types, does not enhance the occurrence of chemically induced mammary tumors, but human data are sparse. Furthermore, evidence is inconclusive concerning the role of food groups, as distinct from that of major nutrients, in the etiology of breast cancer in women. PURPOSE: This analysis was conducted to evaluate and quantify the effect of consumption of olive oil, margarine, and a range of food groups on the risk of breast cancer. METHODS: Data from a comprehensive, semiquantitative food-frequency questionnaire administered to 820 women with breast cancer and 1548 control women from the study base were used to calculate odds ratios (ORs) and X statistics of linear trend for the consumption of olive oil, margarine, and a series of food groups classified in quintiles. Adjustment for the effects of reproductive risk factors, energy intake, and mutual confounding influences was implemented through unconditional logistic regression modeling. RESULTS: Vegetable consumption and fruit consumption were independently associated with statistically significant reductions of breast cancer risk by 12% and 8%, respectively, per quintile increase; no significant associations were evident for the other food groups examined. Increased olive oil consumption was associated with significantly reduced breast cancer risk (OR = 0.75 [95% confidence interval = 0.57-0.98] for more than once a day versus once a day), whereas increased margarine consumption was associated with significantly increased risk (OR = 1.05 [95% confidence interval = 1.00-1.10] for an increment of four times a month). The olive oil association was apparently concentrated among postmenopausal women, but the relevant interaction term was not statistically significant; there was no suggestion of interaction with menopausal status for consumption of either vegetables, fruits, or margarine. CONCLUSIONS: Although major categories of macronutrients do not show significant associations with breast cancer risk in most studies, including the present one, vegetables and fruits are inversely, significantly, and strongly associated with this risk. There also is evidence that olive oil consumption may reduce the risk of breast cancer, whereas margarine intake appears to be associated with an elevated risk for the disease.

Breast Neoplasms↗
PubMed1994

Calcium, vitamin D, dairy foods, and the occurrence of colorectal adenomas among men and women in two prospective studies.

A high intake of calcium, vitamin D, or specific dairy products is thought to reduce the incidence of colorectal cancer. The association of these nutrients and foods with the occurrence of colorectal adenomas, precursors of cancer, was studied in two large US cohort studies. Cases were patients with a diagnosis of adenomatous polyps of the left colon or rectum (331 men, 1986-1990; 350 women, 1980-1988), and controls were persons with endoscopic findings negative for adenoma (9,159 men and 8,585 women). After adjustment for age, total energy, family history of colorectal cancer, body mass index, alcohol consumption, folate, intake of saturated fat and fiber, indications for endoscopy, and previous endoscopy, total calcium intake was not associated with the risk for adenoma (relative risk (RR), highest vs. lowest quintile of intake: men, 1.13, 95% confidence interval (CI) 0.76-1.66; women, 1.17, 95% CI 0.81-1.69). Total vitamin D intake was unrelated to the risk for adenoma in men (RR = 1.29, 95% CI 0.87-1.93). An inverse nonsignificant association was observed in women in the 1980-1988 analyses (RR = 0.68, 95% CI 0.41-1.13, trend p = 0.09), mainly attributable to the intake of multivitamin supplements, but an analysis of 4-year data (1984-1988) using a more detailed dietary assessment showed no association with vitamin D (RR = 1.04, 95% CI 0.65-1.67). Milk consumption and intake of total fermented dairy products were not related to adenoma risk. In conclusion, the occurrence of colorectal adenoma was neither related to calcium intake nor to milk consumption, whereas vitamin D from supplements but not diet was slightly, but not significantly, inversely associated with risk among women only.

Adenoma↗
PubMed1993

Smoking, alcohol, and plasma levels of carotenes and vitamin E.

Taken together, the results from these studies clearly indicate that alcohol and cigarette smoking may both decrease serum or plasma beta-carotene levels after controlling for dietary intake and lipid profile. The variation among studies in the magnitude of the association and statistical significance may reflect, in part, the joint distribution of smoking and alcohol intake in the populations. For example, in the supplementation study reported by Costantino, 89% consumed alcohol, considerably higher than population averages. Further, one-third of the men in that study consumed more than 65 ml (52 gm) of pure alcohol per day. This contrasts with the data from the Health Professionals Follow-up Study, where the mean intake of alcohol was 12.3 gm/day with a standard deviation of 15.8. Even lower alcohol intakes are reported in women, further attenuating the relation and the statistical power to detect a relation between alcohol and beta-carotene levels. Measurement error in assessing dietary intake of beta-carotene could explain some of the association between smoking, alcohol and serum beta-carotene levels because of incomplete control (residual confounding) of dietary intake. Methods for statistically adjusting for error in measurement have not yet been implemented in analyses of this nature.

Adolescent↗