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Biomedical subjects

G E Fraser

Publications and source records attributed to G E Fraser.

At least 37 records · Page 2Linked to original sources
PubMed1998

Does high soy milk intake reduce prostate cancer incidence? The Adventist Health Study (United States)

OBJECTIVES: Recent experimental studies have suggested that isoflavones (such as genistein and daidzein) found in some soy products may reduce the risk of cancer. The purpose of this study was to evaluate the relationship between soy milk, a beverage containing isoflavones, and prostate cancer incidence. METHODS: A prospective study with 225 incident cases of prostate cancer in 12,395 California Seventh-Day Adventist men who in 1976 stated how often they drank soy milk. RESULTS: Frequent consumption (more than once a day) of soy milk was associated with 70 per cent reduction of the risk of prostate cancer (relative risk = 0.3, 95 percent confidence interval 0.1-1.0, p-value for linear trend = 0.03). The association was upheld when extensive adjustments were performed. CONCLUSIONS: Our study suggests that men with high consumption of soy milk are at reduced risk of prostate cancer. Possible associations between soy bean products, isoflavones and prostate cancer risk should be further investigated.

Adult↗
PubMed1998

Mortality in vegetarians and non-vegetarians: a collaborative analysis of 8300 deaths among 76,000 men and women in five prospective studies.

OBJECTIVE: To compare the mortality rates of vegetarians and non-vegetarians. DESIGN: Collaborative analysis using original data from five prospective studies. Death rate ratios for vegetarians compared to non-vegetarians were calculated for ischaemic heart disease, cerebrovascular disease, cancers of the stomach, large bowel, lung, breast and prostate, and for all causes of death. All results were adjusted for age, sex and smoking. A random effects model was used to calculate pooled estimates of effect for all studies combined. SETTING: USA, UK and Germany. SUBJECTS: 76,172 men and women aged 16-89 years at recruitment. Vegetarians were those who did not eat any meat or fish (n = 27,808). Non-vegetarians were from a similar background to the vegetarians within each study. RESULTS: After a mean of 10.6 years of follow-up there were 8330 deaths before the age of 90 years, including 2264 deaths from ischaemic heart disease. In comparison with non-vegetarians, vegetarians had a 24% reduction in mortality from ischaemic heart disease (death rate ratio 0.76, 95% CI 0.62-0.94). The reduction in mortality among vegetarians varied significantly with age at death: rate ratios for vegetarians compared to non-vegetarians were 0.55 (95% CI 0.35-0.85), 0.69 (95% CI 0.53-0.90) and 0.92 (95% CI 0.73-1.16) for deaths from ischaemic heart disease at ages <65, 65-79 and 80-89 years, respectively. When the non-vegetarians were divided into regular meat eaters (who ate meat at least once a week) and semi-vegetarians (who ate fish only or ate meat less than once a week), the ischaemic heart disease death rate ratios compared to regular meat eaters were 0.78 (95% CI 0.68-0.89) in semi-vegetarians and 0.66 (95% CI 0.53-0.83) in vegetarians (test for trend P< 0.001). There were no significant differences between vegetarians and non-vegetarians in mortality from the other causes of death examined. CONCLUSION: Vegetarians have a lower risk of dying from ischaemic heart disease than non-vegetarians.

Adolescent↗
PubMed1997

Risk factors for all-cause and coronary heart disease mortality in the oldest-old. The Adventist Health Study.

BACKGROUND: The oldest-old population (> or = 84 years of age) is growing rapidly and consumes a disproportionate amount of health care dollars. Risk factors for disease have not been extensively studied in this group. METHODS: A cohort study of non-Hispanic white Seventh-Day Adventists from California allowed follow-up for mortality from 1976 through 1988. Associations between traditional risk factors, consumption of selected foods, and both coronary heart disease (CHD) and all-cause mortality were evaluated in the oldest-old portion of this population, using proportional hazards regression analyses. RESULTS: We observed 364 cases of CHD and 1387 total deaths during 11,828 person-years of follow-up. Men had higher risk of both all-cause mortality and mortality from CHD. The relative risks (RRs) associated with diabetes mellitus were 1.51 (95% confidence interval [CI], 1.24-1.84; P < .001) for all deaths and 1.95 (95% CI, 1.38-2.76; P < .001) for mortality from CHD. The apparent effects of hypertension were small unless subjects were currently taking antihypertensive medications. Compared with those with no regular vigorous activity, subjects who exercised at least 3 times each week had RRs of death of 0.80 (95% CI, 0.70-0.91; P < .001) and 0.74 (95% CI, 0.56-0.97; P < .05) for mortality from CHD. Subjects who consumed nuts 5 times per week had RRs of death of 0.82 (95% CI, 0.70-0.96; P < .01) and 0.61 (95% CI, 0.45-0.83; P < .001) for death from CHD compared with those consuming nuts less than weekly. In men, regular consumption of donuts appeared hazardous for both all-cause mortality (RR, 1.40; 95% CI, 1.05-1.88) and mortality from CHD (RR, 2.10; 95% CI, 1.15-3.81), and consumption of beef 4 times weekly was associated with a 2-fold RR for CHD compared with vegetarians, but there was no increase in risk for women. CONCLUSIONS: Even in the oldest-old, certain traditional risk factors and dietary habits are associated with mortality.

Age Distribution↗
PubMed1997

Risk factors, lifetime risk, and age at onset of breast cancer.

PURPOSE: We evaluated the relationship between exposure variables and both lifetime risk and mean age at diagnosis of breast cancer in subjects from the Adventist Health Study who developed breast cancer before the age of 91 years. METHODS: Multiple decrement life-table analysis was used. This study provided data from 20,341 women followed for 6 years. RESULTS: In the total population, 30-year-old women with a parental history of any cancer or a maternal history of breast cancer had, respectively, 72% (P < 0.002) and 98% (P < 0.03) higher lifetime risks of breast cancer. Thirty-year-old women who had their first delivery after age 24 years or body mass indices above the 50th percentile had, respectively, 53% (P < 0.007) or 57% (P = 0.01) greater lifetime risk of breast cancer. Women who exercised infrequently had a 27% higher life-time risk (P = 0.09) and an age at diagnosis of breast cancer 6.6 years younger (P < 0.005) than other women. CONCLUSIONS: Standard risk factors account for substantial increases in lifetime risk of breast cancer and may be associated with differences in age at diagnosis.

Adult↗
PubMed1997

Association among health habits, risk factors, and all-cause mortality in a black California population.

We evaluated dietary and other risk factors in a black California cohort. Baseline data were gathered in 1974 and 1976, and mortality follow-up continued through 1985. A study census questionnaire was returned from 3,299 subjects who lived in a household containing at least one Seventh-Day Adventist. Of these, 1,668 subjects also completed a detailed life-style and dietary questionnaire in 1976. Vital status was ascertained using church records and the California State death tapes. Mortality hazard ratios (HR; both sexes combined) across three increasing consumption levels were determined for nuts (1.00, 0.60, 0.56), fruits (1.00, 0.38, 0.57), and green salads (1.00, 0.54, 0.65). Consumption of meats appeared more hazardous for women, although there was no dose-response relation. Education (HR = 1.00, no college; 0.74, some college; 0.42, college graduate), male gender (HR = 1.55), diabetes mellitus (HR = 1.77), and hypertension (HR = 2.52) were independently associated with mortality, as was obesity, which had a curvilinear association in women and a linear association in men. Exercise was not associated with mortality after excluding those with morbidity at baseline. In summary, traditional risk factors operated with similar force in this black population. In addition, the frequent consumption of nuts, fruits, and green salads appears protective.

Adult↗
PubMed1996

Variables associated with cognitive function in elderly California Seventh-day Adventists.

From a cohort of white, non-Hispanic California Seventh-day Adventists, 99 subjects over age 75 years in 1991 were randomly selected. Dietary habits and educational status had been measured in 1976. Subjects completed the Mini-Mental State Examination (MMSE) in 1991, and at that time, they or caregivers also gave information on current medical problems and drug therapy. Those who ate more calories in 1976 had lower MMSE scores in 1991 (p = 0.03), an association strengthened by excluding those with previous stroke or Parkinson's disease by 1991. This raises the possibility that higher consumption of calories in middle age may accelerate the decline in cognitive function seen with aging, as apparently occurs in some animals. Less-educated subjects had lower MMSE scores, especially among the very elderly. The statistical model predicts that the negative association between use of psychotropic drugs and MMSE score (p = 0.004) is particularly potent in those cognitively impaired for other reasons. If causal, this suggests that physicians should use these agents very cautiously in such subjects.

Aged↗
PubMed1996

Cohort studies of fat intake and the risk of breast cancer--a pooled analysis.

BACKGROUND: Experiments in animals, international correlation comparisons, and case-control studies support an association between dietary fat intake and the incidence of breast cancer. Most cohort studies do not corroborate the association, but they have been criticized for involving small numbers of cases, homogeneous fat intake, and measurement errors in estimates of fat intake. METHODS: We identified seven prospective studies in four countries that met specific criteria and analyzed the primary data in a standardized manner. Pooled estimates of the relation of fat intake to the risk of breast cancer were calculated, and data from study-specific validation studies were used to adjust the results for measurement error. RESULTS: Information about 4980 cases from studies including 337,819 women was available. When women in the highest quintile of energy-adjusted total fat intake were compared with women in the lowest quintile, the multivariate pooled relative risk of breast cancer was 1.05 (95 percent confidence interval, 0.94 to 1.16). Relative risks for saturated, monounsaturated, and polyunsaturated fat and for cholesterol, considered individually, were also close to unity. There was little overall association between the percentage of energy intake from fat and the risk of breast cancer, even among women whose energy intake from fat was less than 20 percent. Correcting for error in the measurement of nutrient intake did not materially alter these findings. CONCLUSIONS: We found no evidence of a positive association between total dietary fat intake and the risk of breast cancer. There was no reduction in risk even among women whose energy intake from fat was less than 20 percent of total energy intake. In the context of the Western lifestyle, lowering the total intake of fat in midlife is unlikely to reduce the risk of breast cancer substantially.

Adult↗
PubMed1996

Healthy volunteer effect in a cohort study: temporal resolution in the Adventist Health Study.

The healthy volunteer effect was studied by comparing 6 years of mortality data for 31,124 participants from the Adventist Health Study (AHS) who responded to both a relatively brief census questionnaire (CQ) in 1974 and a detailed life-style questionnaire (LQ) in 1976 (responders), to mortality data for 8,762 individuals who did not respond to the second questionnaire. The rate ratio (RR) comparing LQ nonresponders to responders for all cause mortality decreased from 2.5 (2.2-2.9) in 1977 to 1.4 (1.2-1.7) in 1982 (p for trend = 0.02); for ischemic heart disease mortality from 2.3 (1.8-3.0) to 1.3 (1.0-1.7); and for all sites cancer mortality from 1.8 (1.3-2.5) to 1.5 (1.1-2.0). The death rate decreased markedly among nonresponders and increased slightly among responders during the study. Similar results were seen for age and gender subgroups. Multivariate analysis controlling for confounding variables confirms these results, except that the apparent effect of education is probably due to effect modification by age. The RR decreased to about one after 3 years of follow-up in young subjects but remained elevated (> 2) in older subjects. Available sociodemographic information reveals that a higher proportion of responders are married, have college education, are SDA church members, and use medical services less than nonresponders during the previous year. Because the risk remains elevated at the end of the study in some but not all subgroups, it seems reasonable that the elevated risk in nonresponders may be due in part to a less healthy life style and in part to exclusion of individuals who did not feel well during enrollment. The results suggest that for internal comparisons no bias is likely to occur; but descriptive statistics for certain subgroup comparisons, and external comparisons, may be biased by the healthy volunteer effect.

Adult↗
PubMed1996

Validity of selected physical activity questions in white Seventh-day Adventists and non-Adventists.

The validity and reliability of selected physical activity questions were assessed in both Seventh-day Adventist (N = 131) and non-Adventist (N = 101) study groups. Vigorous activity questions similar to those used by others and new questions that measured moderate and light activities were included. Validation was external, comparing questionnaire data with treadmill exercise time, resting heart rate, and body mass index (kg.m-2), and internal, comparing data with other similar questions. Both Adventist and non-Adventist males showed significant age-adjusted correlations between treadmill time and a "Run-Walk-Jog Index" (R = 0.28, R = 0.48, respectively). These correlations increased substantially when restricting analysis to exercise speeds exceeding 3 mph (R = 0.39, R = 0.71, respectively). Frequency of sweating and a vigorous physical activity index also correlated significantly with treadmill time in males. Correlations were generally weaker in females. Moderate- and light-intensity questions were not correlated with physical fitness. Internal correlations R = 0.50-0.78) between the above three vigorous activity questions were significant in all groups, and correlations (R = 0.14-0.60) for light and moderate activity questions were also documented. Test-retest reliability coefficients were high for vigorous activity questions (R = 0.48-0.85) and for one set of moderate activity questions (R = 0.43-0.75). No important differences in validity and reliability were found between Adventist and non-Adventists, but the validity of vigorous activity measures was generally weaker in females.

Adult↗
PubMed1995

Effect of risk factor values on lifetime risk of and age at first coronary event. The Adventist Health Study.

The effect of traditional coronary heart disease risk factors on lifetime risk, age at onset, and survival free of coronary disease has not been extensively studied. The authors have used the cohort data from 27,321 California Seventh-day Adventists who had no known heart disease in 1976 to investigate these questions. Multiple decrement life tables incorporating non-parametric estimates of conditional probabilities for both coronary disease and all other competing endpoints were used to estimate these survival outcomes. Variance estimators are provided in an appendix. Persons characterized by being either past smokers, diabetic, hypertensive, physically, non-vegetarian, or infrequent consumers of nuts often showed substantial differences in these survival outcomes. Statistically significant results include earlier age at onset of coronary disease at between 4 and 10 years, reduced life expectancy free of the disease between 5 and 9 years, and increased lifetime risk between 8% and 16%, when comparing groups with and without adverse values for different risk factors. The presence of adverse levels of two risk factors predicted even greater differences in these endpoints. These important effects are easily understood by the layman or non-epidemiologist professional, which is often not true of a relative risk. This should increase the effectiveness of such results when promoting behavioral change.

Adult↗
PubMed1995

Comparison of echocardiographic variables between type I diabetics and normal controls.

This report compares echocardiographic estimates of systolic and diastolic function and ventricular dimensions in type I diabetics and normal controls. A random sample of 60 diabetics selected from a central hospital diabetic clinic was compared with a sample of 40 nondiabetic controls, and matched to the diabetics by age, gender, and blood pressure. Simple comparisons showed that diabetics had a higher mean resting heart rate (HR) (p < 0.001) and a slower diastolic early filling phase (maximal rate of increase in left ventricular dimension in early diastole [v/dtmax], p = 0.08; time from end-systole until dv/dtmax [ES-dv/dtmax], p = 0.03), which were explained by differences in HR and other factors. Resting HR was significantly associated with several echocardiographic variables, but the slope relating resting HR to ventricular dimension was more negative in diabetics than in controls (end-diastolic diameter, p < 0.008; end-systolic diameter, p < 0.005), and the ratio of systolic to diastolic duration was significantly (p < 0.01) less positive in diabetics. The association of resting HR to duration of isovolumic diastole was positive in diabetics and negative in controls (p < 0.02). Among diabetics, those with higher resting HR had more retinopathy (p < 0.05), microalbuminuria (p < 0.05), smaller ventricles (p < 0.01), and longer isovolumic diastole (p < 0.05). Poorer diabetic control was associated with poorer systolic (fractional shortening, p < 0.05) and diastolic (dv/dtmax, p < 0.05; ES-dv/dtmax, p < 0.05) function.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Diet and coronary heart disease: beyond dietary fats and low-density-lipoprotein cholesterol.

Traditionally, the effects of diet on coronary heart disease have been attributed to the effects of medium-chain fatty acids, soluble fiber, and dietary cholesterol on serum low-density-lipoprotein (LDL) cholesterol concentrations. We review evidence here that many other dietary substances may affect risk, often via mechanisms not involving LDL-cholesterol concentrations directly. Such substances include phytosterols, tocotrienols, arginine, and antioxidant vitamins. The effects of diet on high-density-lipoprotein-cholesterol concentrations, triglycerides (fasting and postprandial), oxidized LDL particles, prostaglandins, and endothelium-derived relaxing factor are described. Finally, an illustration of some epidemiologic associations between diet and coronary disease events is made from the Adventist Health Study data.

Adult↗
PubMed1994

Cancer incidence among California Seventh-Day Adventists, 1976-1982.

Cancer incidence was monitored in a population of 34,000 Seventh-day Adventists in California. By religious belief, Adventists do not consume tobacco, alcohol, or pork and approximately one-half adhere to a lacto-ovovegetarian lifestyle. Only a small percentage are pure vegetarians. Comparisons of cancer-incidence rates in this population with an external reference population were completed by calculating standardized morbidity ratios (SMRs) for all cancer sites. Also, within the population, relative risks were calculated by using data obtained from a detailed lifestyle questionnaire that members of the study population completed. For all cancer sites combined in males, the SMR was lower in the Adventists (SMR = 0.73). The SMR was also lower in males for most individual cancer sites. However, prostate cancer risk was higher. For females, the all-cancer SMR was lower but not significantly so (SMR = 92). Most site-specific SMRs were lower, although not as much as the male SMRs. The SMR for endometrial cancer was significantly higher in female Adventists.

Adult↗
PubMed1994

Nuts: a new protective food against coronary heart disease.

Recent epidemiological findings indicate that frequent nut consumption offers protection from fatal and non-fatal coronary heart disease events. Although human nutrition studies seem to indicate that nut consumption lowers total and LDL cholesterol, the unique nutrient composition of nuts invites speculation on other mechanisms of protection.

Coronary Disease↗
PubMed1993

Effects of walnuts on serum lipid levels and blood pressure in normal men.

BACKGROUND: In a recent six-year follow-up study, we found that frequent consumption of nuts was associated with a reduced risk of ischemic heart disease. To explore possible explanations for this finding, we studied the effects of nut consumption on serum lipids and blood pressure. METHODS: We randomly placed 18 healthy men on two mixed natural diets, each diet to be followed for four weeks. Both diets conformed to the National Cholesterol Education Program Step 1 diet and contained identical foods and macronutrients, except that 20 percent of the calories of one diet (the walnut diet) were derived from walnuts (offset by lesser amounts of fatty foods, meat, and visible fat [oils, margarine, and butter]). RESULTS: With the reference diet, the mean (+/- SD) serum values for total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol were, respectively, 182 +/- 23, 112 +/- 16, and 47 +/- 11 mg per deciliter (4.71 +/- 0.59, 2.90 +/- 0.41, and 1.22 +/- 0.28 mmol per liter). With the walnut diet, the mean total cholesterol level was 22.4 mg per deciliter (0.58 mmol per liter) lower than the mean level with the reference diet (95 percent confidence interval, 28 to 17 mg per deciliter [0.72 to 0.44 mmol per liter]); the LDL and HDL cholesterol levels were, respectively, 18.2 mg per deciliter (0.47 mmol per liter) (P < 0.001) and 2.3 mg per deciliter (0.06 mmol per liter) (P = 0.01) lower. These lower values represented reductions of 12.4, 16.3, and 4.9 percent in the levels of total, LDL, and HDL cholesterol, respectively. The ratio of LDL cholesterol to HDL cholesterol was also lowered (P < 0.001) by the walnut diet. Mean blood-pressure values did not change during either dietary period. CONCLUSIONS: Incorporating moderate quantities of walnuts into the recommended cholesterol-lowering diet while maintaining the intake of total dietary fat and calories decreases serum levels of total cholesterol and favorably modifies the lipoprotein profile in normal men. The long-term effects of walnut consumption and the extension of this finding to other population groups deserve further study.

Adult↗
PubMed1993

The incidence of dementia and intake of animal products: preliminary findings from the Adventist Health Study.

We investigated the relationship between animal product consumption and evidence of dementia in two cohort substudies. The first enrolled 272 California residents matched for age, sex, and zip code (1 vegan, 1 lacto-ovo-vegetarian, and 2 'heavy' meat eaters in each of 68 quartets). This design ensured a wide range of dietary exposure. The second included 2,984 unmatched subjects who resided within the Loma Linda, California area. All subjects were enrolled in the Adventist Health Study. The matched subjects who ate meat (including poultry and fish) were more than twice as likely to become demented as their vegetarian counterparts (relative risk 2.18, p = 0.065) and the discrepancy was further widened (relative risk 2.99, p = 0.048) when past meat consumption was taken into account. There was no significant difference in the incidence of dementia in the vegetarian versus meat-eating unmatched subjects. There was no obvious explanation for the difference between the two substudies, although the power of the unmatched sub-study to detect an effect of 'heavy' meat consumption was unexpectedly limited. There was a trend towards delayed onset of dementia in vegetarians in both substudies.

Aged↗
PubMed1992

Allergy and cancer: organ site-specific results from the Adventist Health Study.

The relation between allergy and risk of cancer was evaluated in a cohort study of 34,198 Seventh-day Adventists in California. Information on prevalence of asthma, hay fever, and reactions to chemicals, medications, bee stings, and poison oak (or ivy) was obtained by questionnaire in 1976. The reported allergies must have been serious enough to require treatment by a physician. The cohort was then followed for 6 years (1977-1982). Both stratified analysis and Cox proportional hazards regression analyses were utilized to evaluate the relation of allergy to cancer after taking into account several potentially confounding variables. For all cancer sites combined in males, there was a 33% increased risk associated with reaction to medications. In contrast, among females, reaction to medications was associated with a 21% decrease in risk. Both results were statistically significant. Prostate and breast cancer risk were elevated in persons who reported any type of allergic history, as was risk of lymphatic or hematopoietic cancers and sarcoma. For each of these types of cancer, risk increased with increasing numbers of allergies. However, ovarian cancer risk was decreased in persons with any allergic history and increasing numbers of allergies was associated with decreasing risk of this form of cancer. These results suggest that the association between allergy and cancer is complex and depends on the specific allergy and the specific organ site under consideration.

California↗