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Biomedical subjects

Joann E Manson

Publications and source records attributed to Joann E Manson.

At least 19 recordsLinked to original sources
PubMed2007

Oral contraceptives, reproductive factors, and risk of colorectal cancer among women in a prospective cohort study.

Previous findings on the associations between oral contraceptive (OC) use and reproductive factors and risk of colorectal cancer have been inconclusive. The authors evaluated associations of OC use and reproductive factors (including parity, age at first birth, age at menarche, and age at menopause) with risk of colorectal cancer among women in a large-scale prospective cohort study. The analysis included 39,680 participants in the Women's Health Study who had usable information on ever use of OCs and potential risk factors for colorectal cancer. Relative risks and 95% confidence intervals were estimated from Cox proportional hazards regression models. All p values were two-sided. During an average of 11 years of follow-up (1992-2004), 267 incident cases of colorectal cancer were documented. Ever use of OCs was associated with a lower risk of colorectal cancer (relative risk = 0.67, 95% confidence interval: 0.50, 0.89). Women who had used OCs for 6 months-<3 years had a relative risk of 0.61 (95% confidence interval: 0.40, 0.94) relative to never users, with little additional decreased risk being seen with longer duration of use (p for multivariate trend = 0.09). No significant association was observed between reproductive factors and colorectal cancer risk. These findings provide some support for a potential role of OCs in reducing risk of colorectal cancer.

Age Factors↗
PubMed2006

Impact of cyclooxygenase inhibitors in the Women's Health Initiative hormone trials: secondary analysis of a randomized trial.

OBJECTIVES: We evaluated the hypothesis that cyclooxygenase (COX) inhibitor use might have counteracted a beneficial effect of postmenopausal hormone therapy, and account for the absence of cardioprotection in the Women's Health Initiative hormone trials. Estrogen increases COX expression, and inhibitors of COX such as nonsteroidal anti-inflammatory agents appear to increase coronary risk, raising the possibility of a clinically important interaction in the trials. DESIGN: The hormone trials were randomized, double-blind, and placebo-controlled. Use of nonsteroidal anti-inflammatory drugs was assessed at baseline and at years 1, 3, and 6. SETTING: The Women's Health Initiative hormone trials were conducted at 40 clinical sites in the United States. PARTICIPANTS: The trials enrolled 27,347 postmenopausal women, aged 50-79 y. INTERVENTIONS: We randomized 16,608 women with intact uterus to conjugated estrogens 0.625 mg with medroxyprogesterone acetate 2.5 mg daily or to placebo, and 10,739 women with prior hysterectomy to conjugated estrogens 0.625 mg daily or placebo. OUTCOME MEASURES: Myocardial infarction, coronary death, and coronary revascularization were ascertained during 5.6 y of follow-up in the estrogen plus progestin trial and 6.8 y of follow-up in the estrogen alone trial. RESULTS: Hazard ratios with 95% confidence intervals were calculated from Cox proportional hazard models stratified by COX inhibitor use. The hazard ratio for myocardial infarction/coronary death with estrogen plus progestin was 1.13 (95% confidence interval 0.68-1.89) among non-users of COX inhibitors, and 1.35 (95% confidence interval 0.86-2.10) among continuous users. The hazard ratio with estrogen alone was 0.92 (95% confidence interval 0.57-1.48) among non-users of COX inhibitors, and 1.08 (95% confidence interval 0.69-1.70) among continuous users. In a second analytic approach, hazard ratios were calculated from Cox models that included hormone trial assignment as well as a time-dependent covariate for medication use, and an interaction term. No significant interaction was identified. CONCLUSIONS: Use of COX inhibitors did not significantly affect the Women's Health Initiative hormone trial results.

Journal Article↗
PubMed2006

Plasma lycopene, other carotenoids, and the risk of type 2 diabetes in women.

The authors conducted a nested case-control study from 1992 to 2003 among US women aged 45 years or older and free from cardiovascular disease and cancer to examine the prospective association among plasma lycopene, other carotenoids, and the risk of developing type 2 diabetes. During 10 years of follow-up, 470 cases of incident type 2 diabetes were selected and individually matched on age (+/- 1 year) and follow-up time to 470 nondiabetic controls. Baseline plasma levels of lycopene, alpha-carotene, beta-carotene, beta-cryptoxanthin, and lutein/zeaxanthin were similar in cases and controls (all p > 0.05). A possible crude inverse association between plasma lycopene and risk of type 2 diabetes was attenuated upon multivariate adjustment. After control for plasma total cholesterol and known diabetes risk factors, the multivariate odds ratios of type 2 diabetes in the highest versus the lowest quartile of plasma carotenoids were 1.13 (95% confidence interval (CI): 0.60, 2.13) for lycopene, 1.27 (95% CI: 0.63, 2.57) for alpha-carotene, 1.10 (95% CI: 0.57, 2.13) for beta-carotene, 0.91 (95% CI: 0.46, 1.81) for beta-cryptoxanthin, and 1.35 (95% CI: 0.68, 2.69) for lutein/zeaxanthin. There was no prospective association between baseline plasma carotenoids and the risk of type 2 diabetes in middle-aged and older women.

Aged↗
PubMed2006

A prospective study of pregravid physical activity and sedentary behaviors in relation to the risk for gestational diabetes mellitus.

BACKGROUND: Although gestational diabetes mellitus (GDM) has been associated with substantial adverse health outcomes for both mothers and offspring, few modifiable risk factors for GDM have been identified. METHODS: We conducted a prospective cohort study among women in the Nurses' Health Study II to assess whether the amount, type, and intensity of pregravid physical activity and sedentary behaviors are associated with GDM risk. The analysis included 21,765 women who reported at least 1 singleton pregnancy between 1990 and 1998. Physical activity and sedentary behaviors were assessed through validated questionnaire. RESULTS: We documented 1428 incident GDM cases. After controlling for body mass index, dietary factors, and other covariates, there was a significant inverse association between vigorous activity and the risk of GDM. The multivariate relative risk (RR) comparing the highest with the lowest quintile of vigorous activity was 0.77 (95% confidence interval [CI], 0.69-0.94) (P = .002 for trend). Among women who did not perform vigorous activity, brisk walking pace was associated with significantly lower GDM risk (RR, 0.66; 95% CI, 0.46-0.95) compared with an easy pace. Women who spent 20 h/wk or more watching television but did not perform vigorous activity had a significantly higher GDM risk than women who spent less than 2 h/wk watching television and were physically active (multivariate RR, 2.30; 95% CI, 1.06-4.97). CONCLUSION: Our prospective study provides strong evidence that regular physical activity before pregnancy is associated with lower GDM risk.

Activities of Daily Living↗
PubMed2006

Conjugated equine estrogens and coronary heart disease: the Women's Health Initiative.

BACKGROUND: In recent randomized trials, conjugated equine estrogens (CEE) with continuous medroxyprogesterone acetate provided no protection against coronary heart disease in postmenopausal women and may have increased cardiac risk. These trials did not address the role of unopposed estrogen for coronary protection. METHODS: A total of 10 739 women aged 50 to 79 years at baseline (mean age, 63.6 years) who had previously undergone hysterectomy were randomized to receive CEE, 0.625 mg/d, or placebo at 40 US clinical centers beginning in 1993. The trial was terminated early after 6.8 years of follow-up (planned duration, 8.5 years). This report includes final, centrally adjudicated results for the primary efficacy outcome (myocardial infarction or coronary death), secondary coronary outcomes, and subgroup analyses. RESULTS: During the active intervention period, 201 coronary events were confirmed among women assigned to receive CEE compared with 217 events among women assigned to receive placebo (hazard ratio, 0.95; nominal 95% confidence interval, 0.79-1.16). Among women aged 50 to 59 years at baseline, the hazard ratio for the primary outcome was 0.63 (nominal 95% confidence interval, 0.36-1.08). In that age group, coronary revascularization was less frequent among women assigned to receive CEE (hazard ratio, 0.55; nominal 95% confidence interval, 0.35-0.86), as were several composite outcomes, which included the primary outcome and coronary revascularization (hazard ratio, 0.66; nominal 95% confidence interval, 0.44-0.97). CONCLUSIONS: Conjugated equine estrogens provided no overall protection against myocardial infarction or coronary death in generally healthy postmenopausal women during a 7-year period of use. There was a suggestion of lower coronary heart disease risk with CEE among women 50 to 59 years of age at baseline.

Age Distribution↗
PubMed2006

Conjugated equine estrogens and peripheral arterial disease risk: the Women's Health Initiative.

BACKGROUND: Estradiol reduced progression of ultrasonographic carotid disease in a randomized trial. No trials of unopposed estrogen for prevention of lower extremity arterial disease or aortic aneurysm have been conducted. METHODS: The Estrogen Alone trial randomized 10739 postmenopausal women with prior hysterectomy, mean age 63.6 +/- 7.3 years, to conjugated equine estrogens (CEE 0.625 mg/d) or placebo and documented health outcomes over an average of 7.1 +/- 1.6 years. RESULTS: A trend toward increased risk of peripheral arterial events with CEE was observed (hazard ratio [HR] 1.32, 95% CI 0.99-1.77). Carotid arterial events (HR 1.19, 95% CI 0.82-1.74), lower extremity arterial events (HR 1.41, 95% CI 0.86-2.32), and abdominal aortic aneurysm (HR 2.40, 95% CI 0.92-6.23) were more frequent, but not individually significant, in the CEE group. However, the composite of lower extremity arterial disease/abdominal aortic aneurysm was significantly more frequent among women assigned to CEE (HR 1.63, 95 % CI 1.05-2.51). In subgroup analyses, no clear pattern of risk with CEE was apparent by age or by time since menopause. CONCLUSIONS: Unopposed CEE conferred no protection against peripheral arterial disease among generally healthy postmenopausal women; in fact, there was a suggestion of increased risk.

Aged↗
PubMed2006

Dietary patterns and changes in body weight in women.

OBJECTIVE: Our objective was to examine the association between adherence to dietary patterns and weight change in women. RESEARCH METHODS AND PROCEDURES: Women (51,670, 26 to 46 years old) in the Nurses' Health Study II were followed from 1991 to 1999. Dietary intake and body weight were ascertained in 1991, 1995, and 1999. A Western pattern, characterized by high intakes of red and processed meats, refined grains, sweets and desserts, and potatoes, and a prudent pattern, characterized by high intakes of fruits, vegetables, whole grains, fish, poultry, and salad dressing, were identified with principal component analysis, and associations between patterns and change in body weight were estimated. RESULTS: Women who increased their Western pattern score had greater weight gain (multivariate adjusted means, 4.55 kg for 1991 to 1995 and 2.86 kg for 1995 to 1999) than women who decreased their Western pattern score (2.70 and 1.37 kg for the two time periods), adjusting for baseline lifestyle and dietary confounders and changes in confounders over time (p < 0.001 for both time periods). Furthermore, among women who increased their prudent pattern score, weight gain was smaller (multivariate-adjusted means, 1.93 kg for 1991 to 1995 and 0.66 kg for 1995 to 1999) than among women who decreased their prudent pattern score (4.83 and 3.35 kg for the two time periods) (p < 0.001). The largest weight gain between 1991 and 1995 and between 1995 and 1999 was observed among women who decreased their prudent pattern score while increasing their Western pattern score (multivariate adjusted means, 6.80 and 4.99 kg), whereas it was smallest for the opposite change in patterns (0.87 and -0.64 kg) (p < 0.001). DISCUSSION: Adoption of a Western dietary pattern is associated with larger weight gain in women, whereas a prudent dietary pattern may facilitate weight maintenance.

Adult↗
PubMed2006

Changes in caffeine intake and long-term weight change in men and women.

BACKGROUND: The long-term effects of caffeine intake on weight have not been examined prospectively. OBJECTIVE: The objective was to assess the relation between caffeine intake and 12-y weight change. DESIGN: We conducted a prospective study of 18 417 men and 39 740 women, with no chronic diseases at baseline, who were followed from 1986 to 1998. Caffeine intake was assessed repeatedly every 2-4 y. Weight change was calculated as the difference between the self-reported weight in 1986 and in 1998. RESULTS: The participants reported a change in caffeine intake that varied across quintiles, from decreases of 296 and 342 mg/d to increases of 213 and 143 mg/d in men and women, respectively. Age-adjusted models showed a lower mean weight gain in participants who increased their caffeine consumption than in those who decreased their consumption, but the differences between extreme quintiles were small: -0.43 kg (95% CI: -0.17, -0.69) in men and -0.41 kg (95% CI: -0.20, -0.62) in women. After adjustment for potential confounders and baseline and change in total energy intake and other nutrients and foods, the differences remained similar for men and diminished slightly for women (men: -0.43 kg; 95% CI: -0.17, -0.68; women: -0.35; 95% CI: -0.14, -0.56). An increase in coffee and tea consumption was also associated with less weight gain. In men, the association between caffeine intake and weight was stronger in younger participants (P for interaction < 0.001); in women, the association was stronger in those who had a body mass index (in kg/m2) > or = 25, who were less physically active, or who were current smokers (P for interaction < 0.001). CONCLUSION: Increases in caffeine intake may lead to a small reduction in long-term weight gain.

Adult↗
PubMed2006

Potato and french fry consumption and risk of type 2 diabetes in women.

BACKGROUND: Potatoes, a high glycemic form of carbohydrate, are hypothesized to increase insulin resistance and risk of type 2 diabetes. OBJECTIVE: The objective was to examine prospectively the relation between potato consumption and the risk of type 2 diabetes. DESIGN: We conducted a prospective study of 84,555 women in the Nurses' Health Study. At baseline, the women were aged 34-59 y, had no history of chronic disease, and completed a validated food-frequency questionnaire. The participants were followed for 20 y with repeated assessment of diet. RESULTS: We documented 4496 new cases of type 2 diabetes. Potato and french fry consumption were both positively associated with risk of type 2 diabetes after adjustment for age and dietary and nondietary factors. The multivariate relative risk (RR) in a comparison between the highest and the lowest quintile of potato intake was 1.14 (95% CI: 1.02, 1.26; P for trend = 0.009). The multivariate RR in a comparison between the highest and the lowest quintile of french fry intake was 1.21 (95% CI: 1.09, 1.33; P for trend < 0.0001). The RR of type 2 diabetes was 1.18 (95% CI: 1.03, 1.35) for 1 daily serving of potatoes and 1.16 (95% CI: 1.05, 1.29) for 2 weekly servings of french fries. The RR of type 2 diabetes for substituting 1 serving potatoes/d for 1 serving whole grains/d was 1.30 (95% CI: 1.08, 1.57). The association between potato consumption and risk of type 2 diabetes was more pronounced in obese women. CONCLUSIONS: Our findings suggest a modest positive association between the consumption of potatoes and the risk of type 2 diabetes in women. This association was more pronounced when potatoes were substituted for whole grains.

Adult↗
PubMed2006

Adherence to the Mediterranean dietary pattern is positively associated with plasma adiponectin concentrations in diabetic women.

BACKGROUND: Although the typical diet of the Mediterranean region has received much recognition over the past several years for its association with substantial health benefits, it remains unknown whether its favorable effects are mediated through changes in adiponectin concentrations. OBJECTIVE: The objective was to determine whether adherence to a Mediterranean-type diet is associated with higher plasma adiponectin concentrations. DESIGN: This study was a prospective and cross-sectional evaluation of plasma adiponectin concentrations and dietary data from 987 diabetic women from the Nurses' Health Study who had no history of cardiovascular disease at the time blood was drawn in 1990. RESULTS: Women who scored highest on a 9-point scale that measures adherence to a Mediterranean-type dietary pattern tended to be older, were less likely to be current smokers, had lower body mass indexes and waist circumferences, and had higher total energy intakes, physical activities, and plasma adiponectin concentrations than did women with the lowest scores. Median plasma adiponectin concentrations were 23% higher in women who most closely followed a Mediterranean-type diet than in low adherers after adjustment for age and energy intake (P < 0.01). Body composition, lifestyle, and medical history explained some, but not all, of the observed association between diet and adiponectin concentrations because high adherers tended to have greater adiponectin concentrations than did moderate or low adherers, even after adjustment for these variables. CONCLUSIONS: Our data suggest that, of the several components of the Mediterranean dietary pattern score, alcohol, nuts, and whole grains show the strongest association with adiponectin concentrations. Close adherence to a Mediterranean-type diet is associated with higher adiponectin concentrations.

Adiponectin↗
PubMed2006

The consumption of lycopene and tomato-based food products is not associated with the risk of type 2 diabetes in women.

Lycopene is a major carotenoid with potent antioxidant properties that may provide protection against the development of type 2 diabetes mellitus (DM). In this study we examined the association between baseline dietary intakes of lycopene, lycopene-containing foods, and the subsequent development of type 2 DM in a large prospective cohort study. We analyzed a total of 35,783 women from the United States, aged > or =45 y and free from self-reported cardiovascular disease, cancer, and DM at baseline. Intakes of lycopene and total and individual tomato-based food products were assessed by a 131-item-validated semiquantitative food-frequency questionnaire. During a median follow-up of 10.2 y, 1544 cases of incident type 2 DM were documented. After adjusting for age, total energy intake, randomized treatment assignment, body mass index, and other known DM risk factors, the multivariate-adjusted relative risks and 95% CI of type 2 DM across increasing quintiles of dietary lycopene, were 1.00 (baseline), 1.10 (0.94-1.29), 1.10 (0.94-1.29), and 1.07 (0.91-1.26) (P linear trend = 0.56). Compared with women who consumed <1.5 servings/wk total tomato-based food products, women who consumed 1.5 to <4, 4 to <7, 7 to <10, and > or =10 servings/wk had multivariate relative risks (95% CI) of 1.03 (0.88-1.20), 1.02 (0.87-1.20), 1.09 (0.89-1.33), and 1.04 (0.80-1.36), respectively (P linear trend = 0.54). The associations for individual tomato-based food products were similar to the results for the combination of all tomato products. Our study found little evidence for an association between dietary intake of lycopene or lycopene-containing foods and the risk of type 2 DM.

Antioxidants↗
PubMed2006

Disclosure of sexual orientation and behavior in the Nurses' Health Study II: results from a pilot study.

OBJECTIVE: To examine disclosure of sexual orientation and response rates in a pilot study of questions on sexual orientation and gender of sexual partners in the Nurses' Health Study II. METHODS: A pilot questionnaire was mailed to random samples of 350 women from each of three marital status strata: never married, previously married, and currently married. We estimated prevalence of each category of sexual orientation in the pilot study. Response rates to the sexual orientation question for the pilot questionnaire and the 1995 cohort questionnaire were compared. RESULTS: The overall response rate to the pilot study was 78%. In the pilot study, 98% of women reported a sexual orientation of heterosexual, 0.1% bisexual, and 0.9% lesbian, with 0.7% either declining to answer, leaving the question blank, or categorizing themselves as none of the above, weighted for stratified sampling by marital status. The distribution of sexual orientation in the cohort study (N = 91,654) was similar. Asking women to participate in the pilot study of sexual orientation questions did not appear to cause participants to drop out of the cohort. Concordance between reported sexual orientation on the pilot study and the cohort study was high. CONCLUSIONS: Based on our experience, researchers may be encouraged to add questions on sexual orientation to large studies of women.

Bisexuality↗
PubMed2006

Ethnicity, obesity, and risk of type 2 diabetes in women: a 20-year follow-up study.

OBJECTIVE: To examine ethnic differences in risk of type 2 diabetes, taking dietary and lifestyle risk factors into account. RESEARCH DESIGN AND METHODS: A prospective (1980-2000) cohort (from The Nurses' Health Study) including 78,419 apparently healthy women (75,584 whites, 801 Asians, 613 Hispanics, and 1,421 blacks) was studied. Detailed dietary and lifestyle information for each participant was repeatedly collected every 4 years. RESULTS: During 1,294,799 person-years of follow-up, we documented 3,844 incident cases of diabetes. Compared with whites, the age-adjusted relative risks (RRs) were 1.43 (95% CI 1.08-1.90) for Asians, 1.76 (1.32-2.34) for Hispanics, and 2.18 (1.82-2.61) for blacks. After adjustment for BMI, the RRs changed to 2.26 (1.70-2.99) for Asians, 1.86 (1.40-2.47) for Hispanics, and 1.34 (1.12-1.61) for blacks. For each 5-unit increment in BMI, the multivariate RR of diabetes was 2.36 (1.83-3.04) for Asians, 2.21 (1.75-2.79) for Hispanics, 1.96 (1.93-2.00) for whites, and 1.55 (1.36-1.77) for blacks (P for interaction <0.001). For each 5-kg weight gain between age 18 and the year 1980, the risk of diabetes was increased by 84% (95% CI 58-114) for Asians, 44% (26-63) for Hispanics, 38% (28-49) for blacks, and 37% (35-38%) for whites. A healthy diet high in cereal fiber and polyunsaturated fat and low in trans fat and glycemic load was more strongly associated with a lower risk of diabetes among minorities (RR 0.54 [95% CI 0.39-0.73]) than among whites (0.77 [0.72-0.84]). CONCLUSIONS: The risk of diabetes is significantly higher among Asians, Hispanics, and blacks than among whites before and after taking into account differences in BMI. Weight gain is particularly detrimental for Asians. Our data suggest that the inverse association of a healthy diet with diabetes is stronger for minorities than for whites.

Adult↗
PubMed2006

Dietary fibers and glycemic load, obesity, and plasma adiponectin levels in women with type 2 diabetes.

OBJECTIVE: The purpose of this study was to examine the associations of dietary fibers and glycemic load with plasma adiponectin in diabetic women and investigate the modification effect of obesity. RESEARCH DESIGN AND METHODS: We conducted a cross-sectional analysis in 902 women with type 2 diabetes from the Nurses' Health Study. Dietary information was obtained using semiquantitative food frequency questionnaires. RESULTS: After adjustment for age, smoking, alcohol consumption, physical activity, aspirin use, HbA(1c), history of hypertension and hypercholesterolemia, and postmenopausal hormone use, intakes of cereal fiber and fruit fiber (P for trend = 0.002 and 0.036, respectively) were significantly associated with an increasing trend of plasma adiponectin concentrations. Further adjustment for BMI did not appreciably change the associations for cereal fiber but attenuated the associations for fruit fiber. Adiponectin concentrations were 24% higher in the highest compared with the lowest quintile of cereal fiber. Dietary glycemic load and glycemic index were significantly associated with lower plasma adiponectin levels, after adjustment for BMI and other covariates (P for trend = 0.01 and 0.03, respectively). The percent differences in adiponectin concentration between the highest and the lowest quintiles of dietary glycemic load and glycemic index were 17 and 18%, respectively. The associations between dietary factors and plasma adiponectin were consistent across lean (BMI <25 kg/m(2)), overweight (25 or=30 kg/m(2)). CONCLUSIONS: Our data indicate that dietary cereal fiber and glycemic load/index are associated with the circulating adiponectin concentration. Such associations were not modified by obesity status.

Adiponectin↗
PubMed2006

A prospective study of dairy intake and the risk of type 2 diabetes in women.

OBJECTIVE: Although studies have indicated that increased dairy intake may reduce risk of overweight and insulin resistance syndrome, data directly relating dairy intake to type 2 diabetes remain sparse. RESEARCH DESIGN AND METHODS: We prospectively examined the associations between intake of dairy foods and calcium and incident type 2 diabetes in 37,183 women without a history of diabetes, cardiovascular disease, and/or cancer at baseline. RESULTS: During an average of 10 years of follow-up, we documented 1,603 incident cases. After adjusting for potential confounders including BMI, smoking status, physical activity, family history of diabetes, alcohol consumption, history of hypertension, use of hormones, and high cholesterol, the relative risk for type 2 diabetes among women in the highest quintile of dairy intake was 0.79 (95% CI 0.67-0.94; P for trend = 0.007) compared with those in the lowest quintile. Each serving-per-day increase in dairy intake was associated with a 4% lower risk (0.96 [0.93-1.01]). The inverse association with type 2 diabetes appeared to be mainly attributed to low-fat dairy intake; the multivariate relative risks comparing the highest to the lowest quintiles was 0.79 (0.67-0.93; P for trend = 0.002) for low-fat dairy. The inverse relation between dairy intake and incident type 2 diabetes remained unchanged after further adjustment for dietary calcium, vitamin D, glycemic load, fat, fiber, and magnesium intake. These associations also did not vary significantly according to BMI. CONCLUSIONS: A dietary pattern that incorporates higher low-fat dairy products may lower the risk of type 2 diabetes in middle-aged or older women.

Calcium, Dietary↗
PubMed2006

Coffee, caffeine, and risk of type 2 diabetes: a prospective cohort study in younger and middle-aged U.S. women.

OBJECTIVE: High habitual coffee consumption has been associated with a lower risk of type 2 diabetes, but data on lower levels of consumption and on different types of coffee are sparse. RESEARCH DESIGN AND METHODS: This is a prospective cohort study including 88,259 U.S. women of the Nurses' Health Study II aged 26-46 years without history of diabetes at baseline. Consumption of coffee and other caffeine-containing foods and drinks was assessed in 1991, 1995, and 1999. We documented 1,263 incident cases of confirmed type 2 diabetes between 1991 and 2001. RESULTS: After adjustment for potential confounders, the relative risk of type 2 diabetes was 0.87 (95% CI 0.73-1.03) for one cup per day, 0.58 (0.49-0.68) for two to three cups per day, and 0.53 (0.41-0.68) for four or more cups per day compared with nondrinkers (P for trend <0.0001). Associations were similar for caffeinated (0.87 [0.83-0.91] for a one-cup increment per day) and decaffeinated (0.81 [0.73-0.90]) coffee and for filtered (0.86 [0.82-0.90]) and instant (0.83 [0.74-0.93]) coffee. Tea consumption was not substantially associated with risk of type 2 diabetes (0.88 [0.64-1.23] for four or more versus no cups per day; P for trend = 0.81). CONCLUSIONS: These results suggest that moderate consumption of both caffeinated and decaffeinated coffee may lower risk of type 2 diabetes in younger and middle-aged women. Coffee constituents other than caffeine may affect the development of type 2 diabetes.

Adult↗