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Biomedical subjects

Suzanne P Murphy

Publications and source records attributed to Suzanne P Murphy.

At least 19 recordsLinked to original sources

Body mass index and physical activity as risk factors for pancreatic cancer: the Multiethnic Cohort Study.

OBJECTIVE: To examine body mass index (BMI) and physical activity as risk factors for pancreatic cancer. METHODS: Eight-year prospective data from 77,255 men and 90,175 women including 237 and 235 pancreatic cancer cases, respectively, in the Hawaii-Los Angeles Multiethnic Cohort Study were analyzed. Participants completed a questionnaire that included questions on body weight, height, and physical activity. Cox proportional hazards models were calculated to estimate relative risks (RR) of pancreatic cancer by levels of BMI and total physical activity (as metabolic equivalents (METs)) adjusted for several potential confounders. RESULTS: Obesity (BMI > or = 30 kg/m(2)) was associated with an increased pancreatic cancer risk in men (RR = 1.51 (95% CI: 1.02-2.26)), but a reduced risk in women (RR = 0.65 (95% CI: 0.43-0.99)). In men the risk was higher in never smokers than in current or former smokers, though differences were not statistically significant. Physical activity was not associated with pancreatic cancer risk in either men or women. CONCLUSION: The findings suggest, that a BMI of > or = 30 kg/m(2) may be a risk factor for pancreatic cancer in men. No evidence of an effect of physical activity on risk was found.

Black or African American↗

Calcium and vitamin D intake and risk of colorectal cancer: the Multiethnic Cohort Study.

The associations of intakes of calcium and vitamin D with colorectal cancer risk were examined in the Multiethnic Cohort Study (Hawaii and Los Angeles, California). In 1993-1996, 85,903 men and 105,108 women aged > or =45 years completed a quantitative food frequency questionnaire. A total of 2,110 incident cases of colorectal cancer (1,138 in men and 972 in women) were identified through December 31, 2001. Cox proportional hazards models were used to calculate multivariate-adjusted relative risks and 95% confidence intervals. Total calcium intake (from foods and supplements) was inversely associated with colorectal cancer risk in both men (highest quintile vs. lowest: relative risk (RR) = 0.70, 95% confidence interval (CI): 0.52, 0.93; p for trend = 0.006) and women (RR = 0.64, 95% CI: 0.50, 0.83; p for trend = 0.003). The inverse association was also seen for total vitamin D intake in men (RR = 0.72, 95% CI: 0.51, 1.00; p for trend = 0.03) but not in women. Intake of dairy products was inversely associated with colorectal cancer risk, especially among nonusers of supplemental calcium (men: RR = 0.77, 95% CI: 0.59, 1.01; women: RR = 0.66, 95% CI: 0.49, 0.89). The findings support the hypothesis of protective roles for calcium, vitamin D, and dairy products in the risk of colorectal cancer.

Aged↗

Multivitamin-multimineral supplements' effect on total nutrient intake.

Use of multivitamin-multimineral supplements is widespread and can contribute substantially to total nutrient intakes. In the Hawaii-Los Angeles Multiethnic Cohort (MEC), 48% of men and 56% of women without chronic diseases reported use of multivitamin supplements at least weekly over the past year. We calculated the prevalence of nutrient adequacy for 17 nutrients based on responses to a self-administered quantitative food-frequency questionnaire administered to MEC participants at baseline in 1993-1996. Although the prevalence of nutrient adequacy from food only was higher for multivitamin supplement users (n = 21,056) than for nonusers (n = 69,715), differences averaged only 2 percentage points. For multivitamin users, the prevalence of adequacy improved by an average of 8 percentage points for both men and women when intake from supplements was included. Users were also more likely to have potentially excessive intakes, particularly for iron, zinc, vitamin A, and niacin. The 26,735 MEC participants in Hawaii who answered an open-ended question about multivitamin use in 1999-2001 reported using 1246 different products. The nutrient profile of these products varied widely, and the composition of products at the 90th percentile was 10-fold greater than the composition at the median for some nutrients. We conclude that analyses of nutrient adequacy and excess for supplement users should be extended to national samples and that composition data on actual supplements used are preferable to assuming a default nutrient profile for multivitamin supplements. Multivitamin products could be better formulated to reduce the prevalence of inadequacy and also to reduce the risk of excessive intakes.

Chronic Disease↗

Vegetable intake and pancreatic cancer risk: the multiethnic cohort study.

Investigators studying associations between vegetable intake and pancreatic cancer risk have reported inconsistent findings to date. To further explore these associations, the authors analyzed data on 183,522 participants enrolled in the Hawaii-Los Angeles Multiethnic Cohort Study in 1993-1996. Intakes of total vegetables, light green, dark green, yellow-orange, and cruciferous vegetables, tomato products, and legumes were estimated from a quantitative food frequency questionnaire. After an average of 8.3 years of follow-up, 529 pancreatic cancer cases were identified. Multivariate-adjusted Cox proportional hazards models were created. All statistical tests were two-sided. Overall, total vegetable intake was not associated with pancreatic cancer risk, nor was intake of vegetable subgroups. Current smokers, who were at increased risk of pancreatic cancer (relative risk = 1.78, 95% confidence interval: 1.40, 2.27), had a decreased risk with higher intake of dark green vegetables (for comparison of extreme quartiles, relative risk = 0.50, 95% confidence interval: 0.27, 0.92; p-trend = 0.029). The inverse association for dark green vegetables was also seen in African Americans (p-trend = 0.043). In stratified analyses, inverse associations with total vegetables, light green vegetables, and legumes were significant in overweight/obese subjects. In conclusion, the authors found no evidence for an inverse association between vegetable intake and pancreatic cancer overall, but inverse associations in high-risk persons suggest the need for further investigation.

Aged↗

Simple measures of dietary variety are associated with improved dietary quality.

The objective of this study was to identify a measure of dietary variety that was associated with improved dietary quality and easily understood by consumers. Dietary quality was measured by nutrient adequacy and intakes of added sugars, saturated fat, cholesterol, and sodium. We developed four definitions of dietary variety: (a) a count of basic commodities consumed; (b) a count of food codes reported; (c) a count of five Food Guide Pyramid (FGP) food groups consumed; and (d) a count of 22 FGP subgroups consumed. The analysis sample included 4,964 men and 4,797 women aged 19 years and older who participated in the Continuing Survey of Food Intakes by Individuals 1994-96. For each day of dietary data, we examined associations of each type of dietary variety with several measures of dietary quality using Spearman's correlations and multivariate linear regression models. After adjusting for energy intake and the number of FGP food group servings, all types of dietary variety were positively associated with mean nutrient adequacy across 15 nutrients, but associations were strongest for commodity-based variety and for 22 FGP subgroup consumption variety. Likewise, all variety measures were inversely associated with intakes of added sugars and saturated fat, with commodity-based variety and 22 FGP subgroup variety the strongest. We conclude that variety measured using 22 FGP subgroups is preferable because it is a good predictor of dietary quality, is relatively simple to calculate, and is easy to explain to consumers.

Adult↗

A comparison of two methods of measuring food group intake: grams vs servings.

Different measurements can be used to quantify food group intake, such as servings, cups, or grams. Dietary recommendations are given in terms of servings (recently expressed as cup and ounce measurements), but research on disease risks often uses grams as the intake measure. Because serving sizes vary among foods within a food group, the method of expressing food group intake (grams vs servings) may impact disease risk analyses. Daily consumption of eight food groups was calculated as both Food Guide Pyramid servings and grams for 206,721 participants in the Multiethnic Cohort Study who completed a quantitative food frequency questionnaire between 1993 and 1996. Mean grams per serving ranged from 25 g for red meat to 172 g for dairy products. Spearman correlation coefficients between intakes as grams per day and servings per day were 0.85 for grains, 0.97 for vegetables, 0.99 for fruit, 0.95 for dairy products, 0.98 for red meat, 0.93 for processed meat, 1.00 for poultry, and 1.00 for fish. Because there was little effect on the ranking of study participants' intakes due to the method of calculating food group consumption, the two measures are interchangeable in disease risk models.

Aged↗

Alcohol and dietary fibre intakes affect circulating sex hormones among premenopausal women.

BACKGROUND: The association of alcohol and fibre intake with breast cancer may be mediated by circulating sex hormone levels, which are predictors of breast cancer risk. OBJECTIVE: To evaluate the relationship of alcohol and dietary fibre intake with circulating sex hormone levels among premenopausal women. METHODS: A total of 205 premenopausal women completed a validated food-frequency questionnaire at baseline and after 2 years; blood samples taken at the same time were analysed for circulating sex hormone concentrations, including oestrone (E1), oestradiol (E2), free E2, progesterone, androstenedione and sex hormone-binding globulin, by radioimmunoassay. We used mixed models to estimate least-square means of sex hormone concentrations for alcohol intake categories and quartiles of dietary intake. RESULTS: After adjustment for covariates, alcohol consumption was moderately associated with higher circulating oestrogen levels; those who consumed more than one drink per day had 20% higher E2 (Ptrend=0.07) levels than non-drinkers. In contrast, higher dietary fibre intake was associated with lower serum levels of androstenedione (-8% between the lowest and highest quartiles of intake, Ptrend=0.06), but not oestrogens. Similarly, consumption of fruits (-12%, Ptrend=0.03), vegetables (-9%, Ptrend=0.15) and whole grains (-7%, Ptrend=0.07) showed inverse associations with androstenedione levels. CONCLUSIONS: The consistency of the observed differences in sex hormone levels associated with alcohol and fibre-rich foods indicates that these nutritional factors may affect sex hormone concentrations and play a role in breast cancer aetiology and prevention.

Adolescent↗

Intake of micronutrients high in animal-source foods is associated with better growth in rural Kenyan school children.

Observational studies have shown that children in developing countries consuming diets containing high amounts of bioavailable nutrients, such as those found in animal-source foods, grow better. The present study investigated which specific nutrients from the diet of Kenyan school children predicted their growth. The children (n 544, median age 7 years) participated in a 2-year long food supplementation study with animal-source foods. Height gain during the intervention period was positively predicted by average daily intakes of energy from animal-source foods, haem Fe, preformed vitamin A, Ca and vitamin B12. Weight gain was positively predicted by average daily intakes of energy from animal-source foods, haem Fe, preformed vitamin A, Ca and vitamin B12. Gain in mid-upper-arm muscle area was positively predicted by average daily intakes of energy from animal-source foods and vitamin B12. Gain in mid-upper-arm fat area was positively predicted by average daily intakes of energy from animal-source foods. Gain in subscapular skinfold thickness was not predicted by any of the nutrient intakes. Negative predictors of growth were total energy and nutrients that are contained in high amounts in plant foods. The study shows that growth was positively predicted by energy and nutrients that are provided in high amounts and in a bioavailable form in meat and milk, and their inclusion into the diets of children in developing countries should be part of all food-based programmes in order to improve micronutrient status and growth.

Adipose Tissue↗

Recommended Dietary Allowances should be used to set Daily Values for nutrition labeling.

Guiding principles were recently suggested for revising the Daily Values (DVs) used for nutrition labels on foods and dietary supplements. These principles incorporate the new Dietary Reference Intakes, which are nutrient standards issued between 1997 and 2005 by the Institute of Medicine. Most of the principles are likely to lead to a more accurate basis for the DVs. However, the recommendation to use the Estimated Average Requirement (EAR) rather than the Recommended Dietary Allowance (RDA) should be reconsidered. Traditional public health messages to American and Canadian consumers have focused on nutrient intake levels with a high probability of being adequate. The RDA, with a 98% probability of adequacy, is designed to be the target nutrient intake for individuals; in contrast, the EAR has only a 50% probability of adequacy. Three considerations should lead to a preference for using the RDA rather than the EAR for the DVs: 1) consumers are likely to expect that a product (or a diet) with 100% of the DV has a high probability of nutrient adequacy; 2) use of the RDA for the DV will be consistent with other types of dietary guidance, such as the Dietary Guidelines for Americans 2005 and US food guides; and 3) use of the RDA as a standard for nutrient intake, rather than the EAR, has a potential benefit (a higher prevalence of adequate intakes) that exceeds potential risk (a higher prevalence of excessive intakes).

Food Labeling↗

Allowing for variations in multivitamin supplement composition improves nutrient intake estimates for epidemiologic studies.

Collecting detailed data on dietary supplement use is time-consuming for study participants and investigators, and this is particularly difficult for multivitamin use because of the many different formulations available. Therefore, many studies simply ask about the frequency of multivitamin use and assign default nutrient composition values to obtain nutrient intakes. Multivitamin supplements are important contributors to total nutrient intakes, but it is not known how default values affect the accuracy of intake estimation. In this study, nutrient intakes were calculated from multivitamins consumed by 26,735 multivitamin users who provided detailed information like product name(s) and frequency of use on a mailed questionnaire. We then recalculated the intakes, using 2 different assumptions about the composition of the multivitamin supplements: 1) a single default composition for all products; and 2) four default compositions, 1 for each subtype of multivitamin, i.e., one-a-day with minerals, one-a-day without minerals, B-complex or stress multivitamins, and antioxidant combinations. A total of 1246 different brands of multivitamins were reported and nutrient composition varied widely. Spearman correlation coefficient analyses, using the 4 default nutrient profiles compared with actual nutrient intakes, were >0.5 (P < 0.001) for 12 of 15 nutrients examined. However, correlations using the single default were lower, with only 5 correlations >0.5. Our findings suggest that a questionnaire designed to assess the composition profiles for 4 types of multivitamin products substantially improves the accuracy of nutrient-intake estimates over one that uses a single default nutrient profile for all multivitamin products.

Antioxidants↗

Dietary energy density is associated with overweight status among 5 ethnic groups in the multiethnic cohort study.

Differences in BMI among ethnic groups may be partially explained by the consumption of energy-dense foods, which influences energy intake in controlled laboratory studies. However, the role of dietary energy density (ED, kJ/g) in free-living persons is less understood. Our objective was to determine whether ED is related to current BMI and the risk for overweight and obesity and whether these relations are consistent among ethnic groups. We calculated ED from responses to a quantitative food frequency questionnaire and validated the measures against multiple 24-h recalls. Subjects consisted of 191,023 participants in the Hawaii-Los Angeles Multiethnic Cohort who were African American, Native Hawaiian, Japanese American, Latino, or Caucasian. Mean ED varied from a low of 4.62 kJ/g in Japanese American men to a high of 5.08 kJ/g in African American men. Mean BMI was lowest in Japanese Americans of both sexes and highest in Native Hawaiian men and African American women. After adjusting for the amount of food consumed per day, age, current smoking status, physical activity, chronic disease, and education, a 1 kJ/g increase in ED was associated with an increase in BMI of approximately 1 kg/m2 in each ethnic sex group. This same increase in ED was associated with a significantly increased risk of being overweight in all ethnic sex groups, varying from 4% in African American men to 34% in Japanese American women. Our findings suggest that consumption of an energy dense diet is a risk factor for higher BMI in both men and women across ethnic groups.

Aged↗

Meat and fat intake as risk factors for pancreatic cancer: the multiethnic cohort study.

BACKGROUND: Meat intake has been associated with risk of exocrine pancreatic cancer, but previous findings have been inconsistent. This association has been attributed to both the fat and cholesterol content of meats and to food preparation methods. We analyzed data from the prospective Multiethnic Cohort Study to investigate associations between intake of meat, other animal products, fat, and cholesterol and pancreatic cancer risk. METHODS: During 7 years of follow-up, 482 incident pancreatic cancers occurred in 190,545 cohort members. Dietary intake was assessed using a quantitative food frequency questionnaire. Associations for foods and nutrients relative to total energy intake were determined by Cox proportional hazards models stratified by gender and time on study and adjusted for age, smoking status, history of diabetes mellitus and familial pancreatic cancer, ethnicity, and energy intake. Statistical tests were two-sided. RESULTS: The strongest association was with processed meat; those in the fifth quintile of daily intake (g/1000 kcal) had a 68% increased risk compared with those in the lowest quintile (relative risk = 1.68, 95% confidence interval = 1.35 to 2.07; Ptrend < .01). The age-adjusted yearly incidence rates per 100,000 persons for the respective quintiles were 41.3 and 20.2. Intakes of pork and of total red meat were both associated with 50% increases in risk, comparing the highest with the lowest quintiles (both Ptrend < .01). There were no associations of pancreatic cancer risk with intake of poultry, fish, dairy products, eggs, total fat, saturated fat, or cholesterol. Intake of total and saturated fat from meat was associated with statistically significant increases in pancreatic cancer risk but that from dairy products was not. CONCLUSION: Red and processed meat intakes were associated with an increased risk of pancreatic cancer. Fat and saturated fat are not likely to contribute to the underlying carcinogenic mechanism because the findings for fat from meat and dairy products differed. Carcinogenic substances related to meat preparation methods might be responsible for the positive association.

Adult↗

Insulin-like growth factor-1 and binding protein-3 in a 2-year soya intervention among premenopausal women.

Soya foods may protect against the development of breast cancer. Insulin-like growth factor (IGF)-1 is under investigation as a possible link between nutrition and cancer. We examined the effect of soya foods on circulating IGF-1 and IGF binding protein (BP)-3 levels among 196 healthy premenopausal women in a 2-year randomised nutritional trial. The intervention group consumed two daily servings of soya foods including tofu, soya milk, soya nuts and soya protein powder (equivalent to 50 mg isoflavones and 5-22 g soya protein per serving); the controls maintained their regular diet. Five serum samples at baseline, 3, 6, 12, and 24 months were collected in the morning during the luteal phase and analysed for IGF-1 and IGFBP-3 by double-antibody ELISA. We applied mixed models to investigate the intervention effect and predictors of serum levels while considering the repeated measurement design. Adherence with the study regimen was high and dropout rates were acceptable. Randomisation resulted in similar mean IGF-1 and IGFBP-3 levels by group. We did not observe a significant intervention effect on IGF-1, IGFBP-3, and their molar ratio during the entire study period. However, urinary isoflavone excretion during the study period was positively associated with IGF-1 (P=0.04) and the IGF-1:IGFBP-3 ratio (P=0.06). The effect was consistent over time. Adding soya foods to the diet of premenopausal women does not appear to lower serum levels of IGF-1 and IGFBP-3; if anything, the greater protein intake from soya may lead to a small increase in IGF-1 serum levels.

Adult↗

Dietary intakes and health-related behaviours of Korean American women born in the USA and Korea: the Multiethnic Cohort Study.

OBJECTIVE: This study assessed and compared heath-related behaviours and nutrient and food group intakes between US-born and Korea-born Korean American women. DESIGN AND SUBJECTS: Cross-sectional analyses were performed for ethnic Koreans who participated in the Multiethnic Cohort Study in Hawaii and Los Angeles in 1993-1996. The sample included 492 Korean American women aged 45-75 years who were born in the USA (n = 274) or Korea (n = 218). Participants were recruited using driver's license files as a primary sampling source and completed a self-administered questionnaire, including a quantitative food frequency section. RESULTS: The proportion overweight or obese was 31.4% in US-born and 9.4% in Korea-born women. US-born women had higher intakes of total fat and fat as a percentage of energy, and lower intakes of sodium, vitamin C, beta-carotene and carbohydrate as a percentage of energy, than Korea-born women. Comparing intakes of food group servings from the Food Guide Pyramid, US-born women reported more whole grains, red meat and nuts, and less soy products, than did Korea-born women. US-born women also consumed fewer vegetables and fruit than those born in Korea. Few women in either group reported intakes that met the recommendations for dairy foods. Intake of discretionary fat from the Pyramid tip was higher in US-born than in Korea-born women. CONCLUSIONS: These findings indicate that the acculturation of Korean immigrants affects dietary intakes in ways that may alter risks of several chronic diseases. Further studies will be necessary to examine the effects of dietary acculturation on disease patterns.

Acculturation↗

Dietary patterns using the Food Guide Pyramid groups are associated with sociodemographic and lifestyle factors: the multiethnic cohort study.

Dietary patterns have been used to identify typical combinations of foods that may be associated with disease risks. We defined dietary patterns among 195,298 participants of the Multiethnic Cohort Study in Hawaii and Los Angeles in 1993-1996. Intakes of Food Guide Pyramid groups were calculated from a quantitative FFQ for subjects of 5 ethnic groups (African Americans, Hawaiians, Japanese Americans, Latinos, and whites). Three distinct dietary patterns, "Fat and Meat," "Vegetables," and "Fruit and Milk," were identified by exploratory factor analysis with a varimax rotation and validated by confirmatory factor analysis. Similar factor loadings were found for each of 10 ethnic-gender groups in stratified analyses. The odds ratios (OR) for being above the median scores for each factor were calculated. Age, gender, and ethnicity had relatively strong associations with dietary patterns whereas education showed only weak associations. BMI > or = 30 was strongly positively associated with the Fat and Meat pattern (OR = 2.14, 95% CI: 2.08-2.20, vs. BMI < 25). Current smokers showed a positive association with the Fat and Meat pattern (OR = 1.67, CI: 1.62-1.72, vs. nonsmokers) and inverse associations with the Vegetables (OR = 0.66, CI: 0.64-0.68) and Fruit and Milk patterns (OR = 0.53, CI: 0.52-0.55). Physical activity was positively associated with the Vegetables and Fruit and Milk patterns but not with the Fat and Meat pattern. These findings support the hypothesis that dietary patterns are influenced by interrelated sociocultural, demographic, and other lifestyle factors and may be useful in investigations of diet-disease relations.

Aged↗

Challenges in using the dietary reference intakes to plan diets for groups.

A recent report describes a new paradigm for planning the dietary intakes of groups, the goals of which are to achieve low prevalences of both inadequate and excessive intakes. However, there are many challenges involved in properly implementing these methods, and pilot studies are urgently needed. For individuals, the target for nutrient intakes is usually the Recommended Dietary Allowance (RDA); for nutrients without an RDA, the Adequate Intake (AI) can be used. Intakes should be planned so they do not exceed the Tolerable Upper Intake Level (UL). Several applications illustrating how to use the DRIs for planning the diets of individuals have been published, so this review will focus primarily on the methods that are recommended for planning the diets of groups.

Adolescent↗