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Biomedical subjects

J E Enstrom

Publications and source records attributed to J E Enstrom.

17 recordsLinked to original sources
PubMed1992

Vitamin C intake and mortality among a sample of the United States population.

We examined the relation between vitamin C intake and mortality in the First National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study cohort. This cohort is based on a representative sample of 11,348 noninstitutionalized U.S. adults age 25-74 years who were nutritionally examined during 1971-1974 and followed up for mortality (1,809 deaths) through 1984, a median of 10 years. An index of vitamin C intake has been formed from detailed dietary measurements and use of vitamin supplements. The relation of the standardized mortality ratio (SMR) for all causes of death to increasing vitamin C intake is strongly inverse for males and weakly inverse for females. Among those with the highest vitamin C intake, males have an SMR (95% confidence interval) of 0.65 (0.52-0.80) for all causes, 0.78 (0.50-1.17) for all cancers, and 0.58 (0.41-0.78) for all cardiovascular diseases; females have an SMR of 0.90 (0.74-1.09) for all causes, 0.86 (0.55-1.27) for all cancers, and 0.75 (0.55-0.99) for all cardiovascular diseases. Comparisons are made relative to all U.S. whites, for whom the SMR is defined to be 1.00. There is no clear relation for individual cancer sites, except possibly an inverse relation for esophagus and stomach cancer among males. The relation with all causes of death among males remains after adjustment for age, sex, and 10 potentially confounding variables (including cigarette smoking, education, race, and disease history).

Adult↗
PubMed1989

Health practices and cancer mortality among active California Mormons.

Religiously active Mormons in California are a nonsmoking population with unusually low risk for cancer. This finding is based on the results of our 1979 questionnaire survey of life-style and the 8-year (1980-1987) follow-up of mortality among 5,231 Mormon high priests and 4,613 wives 25-99 years of age. Our study, which is the first prospective cohort study of Mormons, shows low standardized mortality ratios (SMRs) for this population, relative to those for whites in the general population in the United States, which are defined as 100. The SMRs for males are 47 for all cancers, 52 for cardiovascular diseases, and 47 for all causes; the SMRs for females are 72 for all cancers, 64 for cardiovascular diseases, and 66 for all causes. For middle-aged high priests adhering to three health practices (never smoking cigarettes, engaging in regular physical activity, and getting proper sleep), the SMRs are 34 for all cancers, 14 for cardiovascular diseases, and 22 for all causes. These results have been largely replicated in an active Mormon-like subgroup (white nonsmokers attending church weekly) from a representative sample of residents of Alameda County, CA. Our findings confirm and expand on previous descriptive studies of Mormons and demonstrate how these results can be generalized.

Adult↗
PubMed1989

Contralateral breast cancers following treatment for initial breast cancers in women.

The risk of a second primary cancer arising in the contralateral breast following treatment of an initial breast cancer was evaluated for 1,630 women whose first breast cancers were diagnosed and treated at University of California at Los Angeles between 1955 and 1979. Based on follow-up data ranging from 5 to 30 years, the rate of development of nonsimultaneous contralateral breast cancers was slightly in excess of 2.5 per 1,000 person-years at risk. There was no detectably significant difference in the frequency of second primary cancers related to the type of treatment of the first cancers, whether that was surgery, radiation therapy, or surgery plus radiation therapy.

Breast Neoplasms↗
PubMed1988

Second primary cancers of the head and neck following treatment of initial primary head and neck cancers.

The risk of a second primary cancer arising in the head and neck, following surgical or radiation treatment of an initial primary cancer in the head and neck, was evaluated for 2,151 patients whose first cancers were diagnosed and treated at UCLA between 1955 and 1979. Based on follow-up data ranging from 5 to 30 years, the rate of development of second cancers of the head and neck was in excess of 2.5 per 1000 person-years at risk. There was no statistically significant difference in the frequency or post-treatment interval of second primary cancers related to the type of treatment of the first cancer, whether that was surgery, radiation therapy, or surgery plus radiation therapy.

Adult↗
PubMed1986

The relationship between vitamin C intake, general health practices, and mortality in Alameda County, California.

To evaluate the relation between vitamin C intake and mortality, a prospective follow-up study was carried out among 3,119 noninstitutionalized adult residents of Alameda County, California who had completed a detailed lifestyle questionnaire around the beginning of 1974. During 10 years of follow-up, 276 deaths have been identified. The questionnaire information and mortality data indicate that this sample is fairly representative of the county population and similar to the United States population. There is no important relation between the estimated 1974 vitamin C intake at levels above and below 250 mg per day and subsequent mortality from cancer, circulatory disease, all other causes, or all causes combined. However, there is an inverse relation between combinations of several health habits and total mortality. The health habits include never smoking cigarettes, regular physical activity, moderate or no use of alcohol, 7-8 hours of sleep per day, and maintaining proper weight. The conclusions with regard to vitamin C are limited by the crudeness with which the dietary intake has been estimated and changes in intake over time. Nevertheless, these results are not consistent with any substantial relation between vitamin C intake and subsequent mortality.

Adolescent↗
PubMed1979

Rising lung cancer mortality among nonsmokers.

On the basis of data available from two representative samples of lung cancer deaths in the United States as well as national mortality statistics and other epidemiologic studies, the lung cancer mortality rate has risen substantially between 1914 and 1968 among persons who never smoked cigarettes. For white males the relative increase for ages 35--84 years has been about 15-fold; the relative increase for ages 65--84 years has been about 30-fold. For white females the relative increase for ages 35--84 years has been about sevenfold. Most of the relative increase occurred before 1935 and was probably due to changes in diagnostic criteria. However, increases have continued up to the present for male nonsmokers, who now apparently have an annual age-adjusted lung cancer death rate of about 25 per 100,000 persons between the ages 35--84 years. The rising lung cancer rate among nonsmokers indicates that factors in addition to personal cigarette smoking have had a significant effect on the mortality rate from this disease. In spite of the limited quality of these data, they suggest that a more complete understanding of lung cancer etiology is needed.

Adult↗
PubMed1978

Cancer and total mortality among active Mormons.

Based on Church records for 15,500 California Mormons during 1968 to 1975 and for 55,000 Utah Mormons during 1970 and 1975, the ratio of age-adjusted death rates for religiously active Mormon males compared with U.S. white males is 38% for ages 35 to 64 years and 50% for ages 35 years and above. The remaining life expectancy for active Mormon men at age 35 is about 44 years, over 7 years greater than for U.S. white males. Their standardized mortality ratio is 50% for all cancer, being 23% for smoking-related cancer sites and 68% for all other sites. Active Mormons, defined here to be High Priests and Seventies, abstain almost completely from the use of tobacco, alcohol, coffee, and tea, but appear to be fairly similar to other white males with regard to socioeconomic status, urbanization, and diet. Active Mormons are healthier than Mormons as a whole and rank among the lowest in mortality when compared with other groups of healthy males.

Adult↗
PubMed1978

Multiple sclerosis among Spanish-surnamed Californians.

The 2,500,000 Spanish-surnamed white Californians have an age-adjusted multiple sclerosis death rate of 0.27 per 100,000 based on 48 MS deaths from 1966 through 1975. This compares with a rate of 0.83 for other white Californians and 0.75 for all Californians, suggesting that the MS death rate in California is due to genetic or local environmental causes. However, the 620,000 foreign-born Spanish-surnamed white Califorians have the extremely low MS death rate of 0.07, which is one-sixth the rate of 0.42 for the 1.330,000 Spanish-surnamed whites born in California. These data, by contrast with the first set, seem to indicate that environmental factors associated with place of birth are of primary importance. These findings suggest that Spanish-Americans as a whole have an MS death rate that is among the lowest of all subpopulation in the United States and that they offer additional opportunities for studying the etiology of multiple sclerosis.

California↗
PubMed1977

Colorectal cancer and beer drinking.

Evidence is presented of a significant statistical association between beer drinking and colorectal cancer, particularly rectal cancer. This finding is based on correlations between consumption and cancer mortality and between changes in consumption and changes in cancer mortality for 47 states in the United States of America. Also various secular trends, an urban-rural gradient, socioeconomic gradients and sex ratios in the United States are shown to be generally consistent with a relationship between beer consumption and colorectal cancer, particularly rectal cancer. The limitations on drawing sound aetiological inferences from such data are acknowledged. In particular, several other variables are shown to be associated with both beer drinking and colorectal cancer. Also, a discussion of previous epidemiological studies is given, and it appears there is only a limited amount of direct evidence in humans to support the statistical demographic relationships.

Alcohol Drinking↗
PubMed1975

Cancer mortality among Mormons.

Preliminary results show that the 1970-72 cancer mortality rate among California Mormon adults is about one-half to three-fourths that of the general California population for most cancer sites, including many sites with an unclear etiology. Furthermore, the cancer death rate in the predominately Mormon state of Utah is about two-thirds to three-fourths of the United States rate, and the lowest in the entire country. Mormons are a large, health-conscious religious group whose Church doctrine forbids the use of tobacco, alcohol, coffee, and tea, and recommends a nutritious diet. Initial indications are that Mormons as a whole smoke and drink about half as much as the general population, and that active Mormons abstain almost completely from tobacco and alcohol. However, they appear to be fairly similar to the general white population in other respects, such as socioeconomic status and urbanization. The significance of these findings is discussed.

Adolescent↗
PubMed1975

Colorectal cancer and consumption of beef and fat.

Secular, socioeconomic and urban-rural gradients and geographical differences in beef and fat consumption within the United States of America are compared with corresponding data on colorectal cancer incidence and mortality rates. These results, together with the results of most previous epidemiological studies, appear to contradict the hypothesis that beef and fat consumption are involved in the aetiology of colorectal cancer.

Colonic Neoplasms↗