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PubMedDate not supplied

Associations between meat consumption and the prevalence of degenerative arthritis and soft tissue disorders in the adventist health study, California U.S.A.

OBJECTIVE: To examine associations between the prevalence of degenerative arthritis and soft tissue disorders and consumption of meat and other foods among participants in the Adventist Health Study. METHODS: Unconditional logistic regression analysis is used to examine cross-sectional associations, adjusting for the effects of age, smoking, alcohol consumption, body mass index, use of sex hormones and parity. RESULTS: The prevalence of degenerative arthritis and soft tissue disorders was 22.60 percent. Women had a higher prevalence than men and prevalence increased greatly with age. Smoking, higher body mass index, never use of contraceptive pills, and current hormone replacement therapy are associated with a higher prevalence of these disorders on multivariate analysis. Multivariate OR's comparing consumption of meat < 1/week; >or= 1/week; with the reference being no meat, were 1.31(95% CI: 1.21,1.43) and 1.49(1.31, 1.70) in women; and 1.19 (95% CI: 1.05,1.34) and 1.43(1.20, 1.70) in men. Dairy fat and fruit consumption were weakly associated with increased risk. There were protective associations with nut and salad consumption. CONCLUSIONS: Greater meat consumption is associated with a higher prevalence of degenerative arthritis and soft tissue disorders in both male and female subjects of this population, as is hormone replacement therapy in women.

Adult↗

PubMed1992

Chlamydia trachomatis and oral contraceptive use: a quantitative review.

OBJECTIVES: Chlamydia trachomatis is now recognised as a major sexually transmitted disease; oral contraceptive use is rapidly increasing particularly in developing countries. There are thus important public health implications of the many reports that isolation of C trachomatis is more frequent among users of oral contraceptives. The aim of this analysis was to assess the strength and consistency of this association by summarising published studies between 1972 and 1990. DESIGN: Studies identified were grouped according to whether they were prospective or case-control studies. Data were extracted and pooled estimates of the unadjusted odds ratios were made for all studies, as well as for sub-groups defined by an index of study quality, background prevalence of C trachomatis, and the contraceptive comparison being made. LOCATION: Studies in the analysis were mainly conducted in Europe and North America; the meta-analysis was done at the Harvard School of Public Health, Boston, MA, USA. RESULTS: The pooled estimated unadjusted odds ratio for 29 case-control studies examined was 1.93 (95% CI, 1.77-2.11), indicating an almost twofold increased risk of chlamydial infection for oral contraceptive users. Neither study quality nor prevalence of C trachomatis modified this risk. When compared to the use of barrier contraceptives, however, the risk of infection for women using oral contraceptives increased to 2.91 (95% CI, 1.86-4.55). The pooled estimated protective effect of barrier methods in these studies was 0.34 (95% CI, 0.22-0.54). CONCLUSIONS: Cross-study comparisons of the relationship between oral contraceptive use and chlamydial infection are limited by the design and analysis of many component studies which did not control for confounding factors such as sexual behaviour and age. The almost twofold risk of increased chlamydial infection for oral contraceptive users, supported by the findings of two prospective studies, however, points to the importance of considering the risks and benefits of oral contraceptive use in women who are likely to be exposed to C trachomatis and other STDs. The protective effect of barrier methods emphasizes the continued need for promoting barrier methods of contraception.

Case-Control Studies↗

PubMed1990

[Epidemiology of gallbladder calculi in young females].

In a population sample of nearly 900 women aged less than 25 years, prevalence of gallbladder stones (GS) was estimated by ultrasound and some risk factors were analyzed. GS were found in 4.8 percent. The prevalence of GS is significantly higher in females with GS in the family history as compared to persons without known GS in the family (11.8 vs. 2.6 percent); in women who have born as compared to nulliparae (10 vs. 3 percent); in obese women (BMI 26 or higher) as compared to lean women (15.1 vs. 4.2 percent). There was no significant correlation between intake of oral contraceptive and prevalence of GS.

Adult↗

PubMed1988

Prevalence of dysmenorrhoea in Wellington women.

A survey of 1826 women in the Wellington region was carried out. Participants were asked about their general and gynaecological health and their menstrual, contraceptive and obstetric history. Detailed questions were asked about the menstruating women's last menstrual cycle. Half the women reported some dysmenorrhoea, and 520 had 'significant period pain.' Severity, duration and timing of pain were indexed. There was maximum prevalence at 20 to 24 years and positive associations with smoking, short cycles, and moderate to severe premenstrual symptoms. There was association with method of contraception but no association with sedentary occupation or body mass index. The apparent negative relationship with parity was not significant when age, smoking and premenstrual symptomatology were taken into account.

Adolescent↗

PubMed2003

Effects of oral contraceptive use on body mass index and blood pressure among female villagers in north-east Thailand.

The use of contraceptives has become prevalent among females in Thailand in the past 20 years, and oral contraceptive use has been suggested to trigger changes in fat intake, energy expenditure, fat metabolism and blood pressure. Based on field investigations of 391 married women aged 20 years or over in Yasothon Province, North-east Thailand, this study aims to elucidate the effects of oral contraceptive use on body mass index (BMI: kg/m2) and blood pressure, taking into account reproductive histories and socioeconomic conditions. The proportion of obese (BMI > or = 25) subjects was high in the age groups 30-39, 40-49 and 50-59, accounting for, respectively, 39.4%, 51.1% and 48.5% of these populations. The proportion of women with hypertension (90/140 mmHg) was 23.7%, 18.5% and 26.2% in the 40-49, 50-59 and 60-69 age groups. Current contraceptive practices in the studied population included sterilization by operation, oral contraception and injection. These methods accounted for 43.0%, 12.8% and 8.2% of the population, respectively. Sociodemographic factors such as reproductive history, years of education and household income were not significantly related to BMI or to blood pressure (ANOVA with age adjustment). In contrast, oral contraceptive users had significantly higher BMIs and diastolic blood pressures (p<0.01, ANOVA with age adjustment). Multiple regression analysis also revealed that oral contraceptive use was a weak but significant contributing factor to both high BMI and blood pressure when sociodemographic factors were taken into account and controlled for statistically. It can thus be concluded that the use of contraceptive pills, which contain oestrogen and progestin and are provided free of charge to Thai women, tend to increase BMI and to elevate blood pressure.

Adult↗

PubMed1991

Risk profiles of women with cervical neoplasia.

Risk-factor profiles were compared in M.D. Anderson Cancer Center patients with various uterine cervix histologic diagnoses. Intraepithelial neoplasia (n = 171) and condyloma (n = 82) were associated with significantly lower patient age (mean 23.6 and 25.8 years, respectively). In addition, these two groups were lowest in annual income, age at beginning intercourse and at first pregnancy, and highest in percentages of black and Hispanic patients, number of sexual partners, and history of gonorrhea. Women with squamous carcinoma in situ (n = 47), who were about a decade older, exhibited a similar socioeconomic distribution and sexual history. All three groups also reported high prevalences of current smokers, were most likely to use oral contraceptives, and were least likely to use diaphragms or condoms. Patients with invasive squamous cell carcinoma (n = 77) had a mean age of 46.3 years, a large lowest-income constituency, and the highest mean number of pregnancies; they were least likely to have used oral contraceptives. Adenocarcinoma (n = 21) was epidemiologically distinct: a predominance of white woman characterized by high socioeconomic status, elevated body mass index, and non of the liberal sexual practices of the other groups. Primary and secondary prevention strategies must be tailored to the unique needs and socioeconomic status of the young at-risk populations.

Adult↗

PubMed2002

Anaemia in women of reproductive age in Dar-es-Salaam, Tanzania.

BACKGROUND: Anaemia is among the greatest health problems in reproductive age women in developing countries. OBJECTIVES: To estimate the prevalence of anaemia among non-pregnant parous women, and to investigate the main underlying cause for the anaemia. SETTING: A sub-urban Maternal and Child Health Clinic (MCH) in Dar es Salaam. DESIGN: Cross-sectional. METHODS: Consecutive parous non-pregnant women who had brought their children for vaccination and/or had come for family planning to Mbagala MCH clinic were invited to participate in the study. Obstetric and social history was recorded, and their height and weight were checked. Haemoglobin was measured using HemoCue hemoglobinometer. Anaemic women were further investigated to determine the cause of anaemia by haematological and biochemical tests. RESULTS: Five hundred and four parous non-pregnant women were screened, 49% were anaemic (Hb <12 g/dl) and 1.6% severely anaemic (Hb <7 g/dl). Anaemia was not related to socio-demographic and obstetric history characteristics, but decreased significantly with increasing Body Mass Index (BMI) (p=0.042). The prevalence of anaemia was significantly lower in women using hormonal contraceptives, compared to non-users (36% vs 54%) (p=0.04). Eighty-seven percent of the anaemic women were iron deficient and 8.7% had elevated serum C-reactive protein indicating undiagnosed infections. CONCLUSION: Nutritional deficiencies in women have to be corrected before and between pregnancies and all contacts women have with the health system should be utilised for anaemia control interventions, in addition to long-term community approaches. To improve maternal health calls for a broader agenda and a change of approach in the MCH-clinics.

Adolescent↗

PubMed1999

Prevalence of cholelithiasis: results of an epidemiologic investigation in Vidauban, southeast France. General Practitioner's Group of Vidauban.

Cholelithiasis leads to 80,000 cholecystectomies being performed every year in France, but its prevalence is still unknown. The aim of this study was to assess the prevalence and risk factors of cholelithiasis in a random population of 1027 women and 727 men over the age of 30 in a small town in the southeast of France. Detailed clinical history, dietary investigation, and gallbladder ultrasound were collected for each subject and assessed by univariate analysis. A regression model was used in the multivariate analysis to detect the relative risk of cholelithiasis. Cholelithiasis was found in 130 individuals (global prevalence 13.9%). The relative risk for lithiasis was higher in women compared to men (1.89). Age (P<0.0001) and body mass index (BMI) >25 (P = 0.013) were also significant risk factors. Neither pregnancy nor oral contraceptive use proved to be risk factors. Typical biliary colic pain was the only symptom significantly associated with cholelithiasis (P<0.0001). These results show that the prevalence of gallstones in France is similar to that in Denmark and Italy.

Adult↗

PubMed1996

[Prevalence of porphyria cutanea tarda in Madrid and relationship between urine porphyrin and ethanol intake in a multiple linear regression model].

BACKGROUND: The application of a simple fluorometric analytical method enabled us to quantify the urinary porphyrin excretion and to establish the prevalence of porphyria cutanea tarda (PCT) in the town of Madrid, Spain, in a cross-sectional study. PATIENTS AND METHODS: The study assessed 1,613 subjects from three districts in Madrid, in whom further variables potentially related to porphyrinuria such as ethanol intake or -in women-oral contraceptive use were measured and recorded. RESULTS: The estimated prevalence of the disease was 1.24 cases per 1,000 inhabitants (95% confidence interval 0.15-4.47 per thousand). After excluding from the study sample all cases with existent disease, an analysis was performed to ascertain an unilateral tolerance interval for urinary porphyrin concentration in the adult population; this level was established at 181.2 micrograms/l. The effect of ethanol intake on porphyrinuria was considered significant using a multiple linear regression model adjusted for the control variables gender, age and body mass index. In fertile women, contraceptive use did not attain statistical significance when that variable was included in a multiple regression model. CONCLUSIONS: A high prevalence has been estimated for PCT in the Madrid population. A significant association was further found between alcohol intake and porphyrinuria in non-porphyric adults.

Adolescent↗

PubMed1987

Contrasting diet and body mass among users and nonusers of oral contraceptives and exogenous estrogens: the Lipid Research Clinics Program Prevalence Study.

Mean dietary constituent levels using the 24-hour recall method and body mass measures were examined among oral contraceptive and exogenous estrogen users and nonusers in the Lipid Research Clinics Program Prevalence Study. Among women aged 20-44 years, oral contraceptive users had a significantly lower mean Quetelet index of body mass and triceps skinfold thickness and a significantly higher total caloric intake. Among women aged 45-69 years, those taking exogenous estrogens had a significantly lower mean Quetelet index. No significant differences between hormone users and nonusers were seen for per cent of calories from fat (saturated or unsaturated), protein, carbohydrates, starch, sucrose, or alcohol. The higher total caloric intake in oral contraceptive users in contrast to nonusers and the lower body mass in both groups of gonadal hormone users may in part be indicative of other differences in life-style and behavior between the study groups. Further documentation of specific eating patterns, nutrient intake, and energy metabolism in women consuming gonadal hormones and in suitable control subjects seems to be indicated.

Adult↗

PubMed1994

Effort and achievement in national family planning programmes.

New data show that national family planning programmes have made impressive progress in the last 25 years. Fertility rates have been reduced dramatically, but during the current decade even greater achievements will be called for.

Family Planning Services↗

PubMed2002

Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third National Health and Nutrition Examination Survey, 1988-1994.

BACKGROUND: Recent reports of rickets among African American children drew attention to the vitamin D status of these infants and their mothers. African American women are at higher risk of vitamin D deficiency than are white women, but few studies have examined determinants of hypovitaminosis D in this population. OBJECTIVE: We examined the prevalence and determinants of hypovitaminosis D among African American and white women of reproductive age. DESIGN: We examined 1546 African American women and 1426 white women aged 15-49 y who were not pregnant and who participated in the third National Health and Nutrition Examination Survey (1988-1994). Hypovitaminosis D was defined as a serum 25-hydroxyvitamin D concentration < or =37.5 nmol/L. Multiple logistic regression was used to examine the independent association of dietary, demographic, and behavioral determinants of hypovitaminosis D. RESULTS: The prevalence of hypovitaminosis D was 42.4 +/- 3.1% ( +/- SE) among African Americans and 4.2 +/- 0.7% among whites. Among African Americans, hypovitaminosis D was independently associated with consumption of milk or breakfast cereal <3 times/wk, no use of vitamin D supplements, season, urban residence, low body mass index, and no use of oral contraceptives. Even among 243 African Americans who consumed the adequate intake of vitamin D from supplements (200 IU/d), 28.2 +/- 2.7% had hypovitaminosis D. CONCLUSIONS: The high prevalence of hypovitaminosis D among African American women warrants further examination of vitamin D recommendations for these women. The determinants of hypovitaminosis D among women should be considered when these women are advised on dietary intake and supplement use.

Adult↗

PubMed2004

Awareness, prevalence, medication use, and risk factors of acute mountain sickness in tourists trekking around the Annapurnas in Nepal: a 12-year follow-up.

Acute altitude exposure may lead to acute mountain sickness (AMS). Increased awareness of altitude-related health hazards in trekkers may accompany a decrease in AMS prevalence. We compared awareness and AMS prevalence in trekkers in two cohorts on an altitude trek up to 5400 m and assessed risk factors for AMS by repeating an observational cohort study 12 yr after an initial study. Questionnaires in English were distributed to two cohorts of 500 trekkers in 1986 and 1998. All trekkers over a several day period were asked to participate. Average participation rate was 62% (71% in 1986 and 53% in 1998). We found an increase in AMS awareness in trekkers from 80% to 95%, a decrease in AMS prevalence from 43% to 29%, and significant slower climbing profiles. We found no relationship between AMS and smoking habits, body mass index, oral contraception intake, or training status. By contrast, age was a strong independent risk factor inversely related to AMS. Subjects over 55 yr were 2.6 times less likely to suffer from AMS than subjects under 25 yr. Self-medication, including acetazolamide and analgesics, had increased importantly from 17% to 56%, and contraception intake in women had increased from 19% to 32%. In conclusion, in 1998 as compared to 1986, trekkers were older, climbed more slowly, had better awareness of altitude illness, used more medication, and suffered less from AMS.

Acclimatization↗

PubMed2000

Oral contraception and cardiovascular risk factors during adolescence.

The objective of the present study was to analyze the pattern of oral contraceptive (OC) use in teenagers and to examine the relationship between OC use and other cardiovascular risk factors. The study was conducted in 24 Belgian secondary schools. Most students (1526 adolescents aged 12-17 years) agreed to participate (participation rate: 83.6%). Smoking, physical activity habits, menarche, and OC use were assessed by a self-administered questionnaire. Total cholesterol level, blood pressure and anthropometric measurements were also measured. Fourteen per cent of mature girls (14%, n = 92) were OC users. Two-thirds of them (66.3%, n = 61) were taking OC which contained either gestodene or desogestrel. Blood pressure and BMI were similar for OC users and non-users. Total cholesterol level was significantly higher in OC users than in non-users (191 mg/dL versus 172 mg/dL). Logistic regression model confirmed the significant influence of OC use on total cholesterol level (OR = 3.08). OC users were also often smokers (39% versus 20% for non-users). In conclusion, the present study has found significant relationships between OC use and cardiovascular risk factors i.e., high total cholesterol and smoking. The first implication is a need for further research on lipoprotein profile in young OC users. Secondly, the combined use of OC and smoking in teenagers calls for preventive actions.

Adolescent↗

PubMed1992

How common are polycystic ovaries in normal women and what is their significance for the fertility of the population?

OBJECTIVE: We wished to determine the prevalence of polycystic ovaries (PCO) and relate morphological appearance to fertility. DESIGN: We sent postal invitations to a random sample of women born in the years 1952-1969 from a list of a single Group Practice to attend for reproductive history questionnaire, examination, ultrasound scan of the ovaries and hormone measurements within 5 days of the onset of menstruation. SUBJECTS: Of 1065 women potentially available for study, 571 (54%) replied of whom 353 (62%) agreed to participate. One hundred and ninety (18%) completed the study, 163 were deferred (57 because of current or very recent pregnancy, 106 because of inconvenience at time approached), and 18 additional women volunteered. MEASUREMENTS: Prevalence of polycystic ovaries, ovarian size and morphology, menstrual history, features of androgen excess, fertility status, serum hormone levels. RESULTS: The prevalence of PCO was 22% (41/190). PCO and non-PCO women were similar with respect to age, body mass index, oral contraceptive pill (OCP) usage, acne, and menstrual pattern but hirsutism (Ferriman and Gallwey score > 7) was significantly (P = 0.006) more frequent among PCO women. Proven prior fertility was the same in PCO (56%) and non-PCO (64%) women and an equal proportion in each group had not yet tested their fertility. Of those women with previously proven fertility, self-perceived difficulty in conception occurred in similar proportions of women with and without PCO. Unresolved primary or secondary infertility (2.5-4%) was similar in both groups. Ovarian volume (each ovary separately) was larger in women with PCO irrespective of current OCP usage. Serum levels of oestradiol and FSH were similar in PCO and non-PCO women, but LH was distributed around a higher median in PCO women. Median testosterone and androstenedione levels were the same in PCO and non-PCO women. CONCLUSIONS: The prevalence of polycystic ovarian morphology is high but, in this sample of women, was accompanied by minimal clinical manifestations and apparently no deleterious effects on earlier fertility. An isolated finding of polycystic ovaries may be a normal variation and should not necessarily imply altered fertility potential.

Adult↗

PubMed2004

Risk factors for osteoporosis in postmenopausal African-American women.

BACKGROUND: Although postmenopausal African-American women are at lower risk for osteoporosis-related fractures compared with white women, fractures in African-American women are associated with significantly higher morbidity and mortality. Therefore, early diagnosis and treatment of osteoporosis in this population is just as important as it is for other ethnic groups and worthy of the attention of physicians and healthcare organizations. OBJECTIVE: The purpose of this study was to evaluate risk factors for osteoporosis in postmenopausal African-American women. DESIGN: This was a retrospective, case-control study in 201 postmenopausal African-American women at a community-based osteoporosis center. Spine and hip bone mineral density measurements were obtained by dual-energy x-ray absorptiometry. Patient and family medical history, past and present pharmaceutical use, and dietary and exercise habits were collected using a patient self-administered questionnaire. RESULTS: Using the manufacturer's African-American referent database, 56 women had osteoporosis, 99 had osteopenia, and 46 had normal bone mineral density. Risk factors more common in the osteoporotic group compared with the normal group included sedentary lifestyle (P < 0.03), family history of osteoporosis (P < 0.03), low body mass index (P < 0.05), and history of bilateral oophorectomy (P < 0.03). Polyarthritis was more prevalent in the normal versus the osteoporotic group (P < 0.001). In addition, premenopausal use of oral contraceptives (P < 0.005) and postmenopausal use of estrogen therapy (P < 0.05) were more common in the normal compared with the osteoporotic group. CONCLUSIONS: Many risk factors for osteoporosis in African-American women are similar to those in white women and can aid in the selection of patients in need of bone density testing.

Black or African American↗

PubMed2003

Prevalence and risk factors of non-fatal venous thromboembolism in the active population of the VITA Project.

Cost-effective strategies for the identification of subjects at risk of venous thromboembolism (VTE) in the active population are still lacking. Our objectives were to identify risk factors for venous thromboembolism in active subjects. We analyzed data from a population-based sample of 15055 Caucasians aged 18-65 years randomly selected from the census list of the township of Vicenza, Italy. A validated methodology was used to retrospectively identify subjects with previous VTE. Body mass index (BMI), smoking, oral contraceptive use, previous superficial vein thrombophlebitis (SVT) and familial history of VTE, all at the age of first thrombosis, were ascertained by direct interview and by review of available medical records. Ninety-two deep vein thromboses [prevalence: 61.1/10000, 95% confidence interval (CI) 49.2-74.9], three upper deep vein thrombosis (prevalence: 1.9/10000, 95% CI 0.4-5.8) and 21 pulmonary embolism (prevalence: 13.9/10000, 95% CI 8.6-21.3) were identified. After age and sex adjustment, clinically identifiable risk factors were: history of SVT [odds ratio (OR) = 6.8], oral contraceptive use (OR = 4.7), family history of VTE (OR = 4.5), smoking (OR = 1.7) and BMI above the third tertile (OR vs. mid-tertile 2.9). While previous SVT and BMI were associated with VTE in all circumstantial situations (surgery/trauma, pregnancy or idiopathic VTE), for oral contraceptive use, positive family history and smoking the degree of association varied significantly depending on the situation. Non-fatal VTE affects 0.7% of the subjects belonging to an active population, 56% of cases being potentially preventable. In 30% of VTE cases, at least two easily recognizable risk factors are present. Clinical assessment of risk factors remains the mainstay of VTE prevention.

Adolescent↗

PubMed2003

Local side effects observed among long-term users of norplant contraceptive implants.

The prevalence of local signs and symptoms related to the site of insertion of implants, and the association of these signs and symptoms with time of use, skin color and body mass index (BMI) was evaluated among users of the Norplant implant system. Three hundred and three Norplant users attending at the reproductive health clinic of PROFAMILIA in Santo Domingo, Dominican Republic, were asked if they had ever had any discomfort at the site/arm of implant insertion and the implant insertion area was examined and hyperpigmentation and hollowing of the surface was recorded. Half of the subjects reported either pain or paresthesia or both, in almost equal numbers, some time since insertion. Hyperpigmentation was observed in 35.6% and hollowing in 22.4% of the subjects. Report of pain and paresthesia was inversely associated to time of use and to BMI. Hyperpigmentation was directly associated to time of use and darker skin, and hollowing of the arm surface in the implants area with time of use and BMI. Local signs and symptoms were more frequent than previously reported, although they were of mild nature and appeared not to worry most of the users.

Adult↗