Significant Inverse Trend Research Articles

Community level predictors of physical activity among women in the preconception period.

Although physical activity is a key behavior targeted during the preconception period given its significant impact on pregnancy/birth outcomes and psychological well-being, few women meet national guidelines. While intrapersonal factors influencing physical activity among this population have been studied, community factors remain unexplored. The objective of this study was to examine community level predictors of physical activity among preconception women. Data from Add Health were limited to women (Wave III; age 18-28; n = 7,596) and excluded respondents who were pregnant, physically disabled, and missing data. The outcome variable was ≥5 instances of moderate-vigorous physical activity (MVPA) in 1 week. Community predictor variables included neighborhood-level structural and social determinants (e.g., socio-demographic composition; landscape diversity; urbanization; access to resources; crime; vehicle availability). Multilevel logistic regression modeling was used to estimate the odds of engaging in ≥5 instances of MVPA. Few women (26 %) reported ≥5 instances of MVPA in 1 week. Adjusted multilevel analysis revealed women in the preconception period were more likely to report high MVPA when living in communities with larger population densities (OR 1.34, 95 % CI 1.02-1.77) and median household income greater than $50,000 (OR 1.33, 95 % CI 1.06-1.66). Additionally, a significant inverse trend was found between high MVPA and proportion of the community without a high school diploma. Findings suggest that neighborhood composition may have an impact on preconception physical activity status. Implications include increased efforts targeting community conditions for facilitating physical activity; ultimately, improving health among women and subsequent offspring.

Factors influencing ovulation and the risk of ovarian cancer in BRCA1 and BRCA2 mutation carriers.

The role of the lifetime number of ovulatory cycles has not been evaluated in the context of BRCA-associated ovarian cancer. Thus, we conducted a matched case-control study to evaluate the relationship between the cumulative number of ovulatory cycles (and contributing components) and risk of developing ovarian cancer in BRCA mutation carriers (1,329 cases and 5,267 controls). Information regarding reproductive and hormonal factors was collected from a routinely administered questionnaire. Conditional logistic regression was used to evaluate all associations. We observed a 45% reduction in the risk of developing ovarian cancer among women in the lowest vs. highest quartile of ovulatory cycles (OR = 0.55; 95% CI 0.41-0.75, p = 0.0001). Breastfeeding for more than 12 months was associated with a 38% (95% CI 0.48-0.79) and 50% (95% CI 0.29-0.84) reduction in risk among BRCA1 and BRCA2 mutation carriers, respectively. For oral contraceptive use, maximum benefit was seen with five or more years of use among BRCA1 mutation carriers (OR = 0.50; 95% CI 0.40-0.63) and three or more years for BRCA2 mutation carriers (OR = 0.42; 95% CI 0.22-0.83). Increasing parity was associated with a significant inverse trend among BRCA1 (OR = 0.87; 95% CI 0.79-0.96; p-trend = 0.005) but not BRCA2 mutation carriers (OR 0.98; 95% CI 0.81-1.19; p-trend = 0.85). A later age at menopause was associated with an increased risk in women with a BRCA1 mutation (OR trend = 1.18; 95% CI 1.03-1.35; p = 0.02). These findings support an important role of breastfeeding and oral contraceptive use for the primary prevention of ovarian cancer among women carrying BRCA mutations.

Systematic review of prostate cancer risk and association with consumption of fish and fish-oils: analysis of 495,321 participants.

Fish-oils have a potential role in inflammation, carcinogenesis inhibition and favourable cancer outcomes. There has been increasing interest in the relationship of diet with cancer incidence and mortality, especially for eicosapantaenoic acid (EPA) and docosahexaenoic acid (DHA). This systematic-analysis of the literature aims to review evidence for the roles of dietary-fish and fish-oil intake in prostate-cancer (PC) risk, aggressiveness and mortality. A systematic-review, following PRISMA guidelines was conducted. PubMed, MEDLINE and Embase were searched to explore PC-risk, aggressiveness and mortality associated with dietary-fish and fish-oil intake. 37 studies were selected. A total of 495,321 (37-studies) participants were investigated. These revealed various relationships regarding PC-risk (n = 31), aggressiveness (n = 8) and mortality (n = 3). Overall, 10 studies considering PC-risk found significant inverse trends with fish and fish-oil intake. One found a dose-response relationship whereas greater intake of long-chain-polyunsaturated fatty acids increased risk of PC when considering crude odds-ratios [OR: 1.36 (95% CI: 0.99-1.86); p = 0.014]. Three studies addressing aggressiveness identified significant positive relationships with reduced risk of aggressive cancer when considering the greatest intake of total fish [OR 0.56 (95% CI 0.37-0.86)], dark fish and shellfish-meat (p < 0.0001), EPA (p = 0.03) and DHA (p = 0.04). Three studies investigating fish consumption and PC-mortality identified a significantly reduced risk. Multivariate-OR (95% CI) were 0.9 (0.6-1.7), 0.12 (0.05-0.32) and 0.52 (0.30-0.91) at highest fish intakes. Fish and fish-oil do not show consistent roles in reducing PC incidence, aggressiveness and mortality. Results suggest that the specific fish type and the fish-oil ratio must be considered. Findings suggest the need for large intervention randomised placebo-controlled trials.

Pediatric Hospital Volume and Induction Mortality in Pediatric Acute Lymphoblastic Leukemia (ALL)

Introduction:Survival in pediatric acute lymphoblastic leukemia (ALL) has increased dramatically over the past 40 years from less than 10% to 85%. Despite these gains, induction mortality rates have been shown to vary between institutions. This variation may relate to hospital factors such as patient volume. A volume-outcome association describes the relationship between how frequently a service is provided by a hospital to the quality of care received at the patient level. In adult care, higher procedural and patient volume has been associated with improved outcomes. Few studies have investigated a volume-outcome relationship in pediatric leukemia. We hypothesized that an inverse relationship exists between a hospital’s pediatric volume and their pediatric ALL induction mortality rates.Methods:A retrospective cohort of new onset ALL patients ages 0 to <19 years was assembled using three years of consecutive data from the Pediatric Health Information System (PHIS) and Perspective Data Warehouse (Premier). PHIS is comprised of free-standing children’s hospitals while Premier represents community institutions caring for both adult and pediatric patients. The primary outcome was inpatient mortality in the first 60 days after initiation of induction chemotherapy. Hospital pediatric volume was defined as the average annual number of inpatient discharges for patients ages of 1–19-years. Hospitals were then grouped into tertiles as low, medium or high volume. Descriptive analysis represented by counts and percentages with 95% confidence intervals. Fisher’s exact test and the non-parametric tests for trend were applied to assess association between a hospital’s ALL mortality rate and their pediatric volume tertile using STATA version 13.Results:3456 patients with new onset ALL from 75 individual hospitals were included in our analysis. The induction mortality rate for the entire cohort was 0.87% (30/3456) with a range from 0.58% to 1.2% (Table 1). There was no significant inverse linear trend in mortality across the three pediatric volume categories (p= 0.218). Inpatient induction mortality was lowest in the low pediatric volume institutions, with resultant significant increased induction mortality rate when comparing medium volume institutions and high volume institutions to low volume institutions (Table 1). There was no difference in mortality rates between medium and high volume centers (p=0.468).Conclusions:Induction mortality in this pediatric ALL cohort is low and consistent with previously published literature. Contrary to our hypothesis, we observed a lower induction mortality rate in lowest volume institutions. While this finding may be real, it is likely that there are unmeasured confounders impacting the volume-outcome association in this ALL cohort. For instance, low pediatric volume centers may transfer sicker or more complex patients to medium or high volume centers due to lack of familiarity or comfort caring for a complicated patient with a rare diagnosis. The current dataset is limited and would require merger of alternate data sources to capture patient transfers from low to medium and high volume hospitals. Future analyses of these data will focus on adjusting for severity of illness at presentation among patients at the medium and high volume hospitals to see if an inverse association exists between volume and mortality.Table 1:Hospital Inpatient Volume and Disposition at Last Hospitalization in InductionHospital Inpatient Pediatric VolumeTotal ALL patientsPercent Mortality [95% CI of frequency]p value**Low (<6000) n= 275120% [0-0.72%]*refMedium (6000-9000) n=2513711.2% [0.67-1.8%]0.014High (>9000) n=2315730.89% [0.48-1.5%]0.032Total 75 Hospitals34560.87% [0.58-1.2%]*97.5% one sided confidence interval**p value of Fisher’s exact test with reference as low pediatric volume tertile. DisclosuresRheingold:Novartis: Consultancy.

Support for a tobacco endgame strategy in 18 European countries

ObjectiveThe feasibility of a tobacco endgame strategy, aiming to bring smoking prevalence to near-zero levels, is currently under debate. We provide information on public support for such a strategy in Europe. MethodsIn 2010 we conducted a face-to-face representative survey in 18 European countries (Albania, Austria, Bulgaria, the Czech Republic, Croatia, England, Finland, France, Greece, Hungary, Ireland, Italy, Latvia, Poland, Portugal, Romania, Spain and Sweden). The present analysis is based on 16,947 individuals aged ≥15years providing information on their attitudes towards a complete ban on the use or sale of tobacco. ResultsOverall, 34.9% of adults (32.8% in men and 37.0% in women; p<0.001) supported a complete ban strategy on use or sale of tobacco, 41.2% of never, 29.4% of ex- and 25.6% of current smokers. The highest support was observed in southern Europe (42.5%), followed by eastern (39.1%), northern (27.5%) and western Europe (23.0%; p<0.001). A significant inverse trend was observed with both age and education. ConclusionApproximately one in three adults (and one in four smokers) supports a comprehensive tobacco endgame intervention. This first study in Europe provides a baseline for evaluating future trends in public support for extreme propositions to end or drastically cut smoking.

Physical activity in pregnancy and neonatal body composition: the Healthy Start study.

To examine associations between pregnancy physical activity and neonatal fat mass and fat-free mass, birth weight, and small for gestational age (SGA). We analyzed 826 mother-neonate pairs (term births) participating in the longitudinal Healthy Start study. The Pregnancy Physical Activity Questionnaire was used to assess total energy expenditure and meeting American College of Obstetricians and Gynecologists (College) guidelines for physical activity during early pregnancy, midpregnancy, and late pregnancy. Models were adjusted for maternal and neonatal characteristics. Neonates had mean fat mass of 292.9 g, fat-free mass of 2,849.8 g, and birth weight of 3,290.7 g. We observed 107 (12.9%) SGA and 30 (3.6%) large-for-gestational age neonates. A significant inverse linear trend between total energy expenditure during late pregnancy and neonatal fat mass (Ptrend=.04) was detected. Neonates of mothers in the highest compared with the lowest quartile of total energy expenditure during late pregnancy had 41.1 g less fat mass (249.4 compared with 290.5 g; P=.03). No significant trend was found with total energy expenditure and neonatal fat-free mass or birth weight. Early-pregnancy and midpregnancy total energy expenditure were not associated with neonatal outcomes. No significant trend was observed between late-pregnancy total energy expenditure and SGA (Ptrend=.07), but neonates of mothers in the highest compared with the lowest quartile had a 3.0 (95% confidence interval 1.4-6.7) higher likelihood of SGA. Meeting the College's physical activity guidelines during pregnancy was not associated with differences in neonatal outcomes. Increasing levels of late-pregnancy total energy expenditure are associated with decreased neonatal adiposity without significantly reduced neonatal fat-free mass. II.

THU0221 Pain Predicts Relatively Low Leg Muscle Mass in Knee Osteoarthritis

BackgroundLeg muscle mass is related to development and progression of knee OA, and some studies suggested low leg muscle mass quantified by cross-sectional images of CT or MRI was related...

G473(P)Nutritional adequacy of Prader-Willi syndrome children on restricted diets: A 10 year review from a multidisciplinary clinic

AimsA vital component of the management of Prader-Willi Syndrome (PWS) is strict control of dietary intake whilst ensuring sufficient nutrition to prevent deficiencies. Surprisingly however there is very limited data...

Dietary Intakes of Individual Flavanols and Flavonols Are Inversely Associated with Incident Type 2 Diabetes in European Populations1–3

Dietary flavanols and flavonols, flavonoid subclasses, have been recently associated with a lower risk of type 2 diabetes (T2D) in Europe. Even within the same subclass, flavonoids may differ considerably in bioavailability and bioactivity. We aimed to examine the association between individual flavanol and flavonol intakes and risk of developing T2D across European countries. The European Prospective Investigation into Cancer and Nutrition (EPIC)–InterAct case-cohort study was conducted in 8 European countries across 26 study centers with 340,234 participants contributing 3.99 million person-years of follow-up, among whom 12,403 incident T2D cases were ascertained and a center-stratified subcohort of 16,154 individuals was defined. We estimated flavonoid intake at baseline from validated dietary questionnaires using a database developed from Phenol-Explorer and USDA databases. We used country-specific Prentice-weighted Cox regression models and random-effects meta-analysis methods to estimate HRs. Among the flavanol subclass, we observed significant inverse trends between intakes of all individual flavan-3-ol monomers and risk of T2D in multivariable models (all P-trend < 0.05). We also observed significant trends for the intakes of proanthocyanidin dimers (HR for the highest vs. the lowest quintile: 0.81; 95% CI: 0.71, 0.92; P-trend = 0.003) and trimers (HR: 0.91; 95% CI: 0.80, 1.04; P-trend = 0.07) but not for proanthocyanidins with a greater polymerization degree. Among the flavonol subclass, myricetin (HR: 0.77; 95% CI: 0.64, 0.93; P-trend = 0.001) was associated with a lower incidence of T2D. This large and heterogeneous European study showed inverse associations between all individual flavan-3-ol monomers, proanthocyanidins with a low polymerization degree, and the flavonol myricetin and incident T2D. These results suggest that individual flavonoids have different roles in the etiology of T2D.

Experience Related Factors Compensate for Haptic Loss in Robot-Assisted Laparoscopic Surgery

Surgeons anecdotally report awareness of nontactile sensory cues that compensate for absent haptic feedback in robot-assisted surgery. This study investigates this poorly understood adaptive process by evaluating frequency of in vivo suture damage. Consecutive cases of children undergoing robot-assisted dismembered pyeloplasty were examined. Suture damage was defined as incomplete (i.e., fraying) or complete (i.e., broken) loss of thread integrity and prospectively recorded with clinical data. Suture technique, size, and robotic instruments used for suturing were subjected to post hoc analysis. Statistical analysis was undertaken using appropriate nonparametric tests. Overall frequency of suture damage was 2.6% among 1135 sutures used in 52 patients. The mean number of sutures used for cases in this series was 22 (standard deviation±6). There was a significant inverse trend between surgeon experience and suture damage frequency (P=0.014), implying that greater surgeon experience was associated with less suture damage. The impact of experience on suture damage was most apparent when comparing the earliest quartile subgroup (Q1) with the later three quartile subgroups (Q2-Q4) (P<0.001). Plateau of suture damage frequency was seen after approximately 28 cases. Continuous sutures had significantly higher damage frequency compared with interrupted sutures (P=0.022). Significantly higher frequency of suture damage was seen with cases in which forceps instruments were used for suturing compared with paired needle drivers (1.4% vs 7.1%, P<0.001). All events of inadvertent tissue injury involved damage to exposed edges of the renal pelvis (n=5). Suture damage is likely to be encountered during the learning curve of robot-assisted surgery but decreases with surgeon experience. Preferential use of larger suture size, interrupted sutures, and paired needle driver instruments may help to minimize suture damage. Experience-related perceptual skills that compensate for haptic loss are likely to be acquirable in a preclinical simulation environment.

Rice Consumption is associated with Better Nutrient Intake and Diet Quality in Children: National Health and Nutrition Examination Survey (NHANES) 2005-2010

The goal of this study was to determine the association of rice consumption with nutrient intake and diet quality in a nationally representative sample of US children. NHANES data were used to assess the association of rice consumption by children (2-18 yrs; N=8,367) with nutrient intake and diet quality. 24-hour dietary intakes were used to calculate usual intake (UI) of rice consumption, consumption categories were <0.25, ≥ 0.25 to <0.5, ≥ 0.5 to <1.0, and ≥ 1.0 ounce equivalent (oz eq) of UI of rice. Diet quality, covariate adjusted least square means ± SE, and, quartile trends across the rice consumption categories were examined. Significant positive trends (p <0.05) (β coefficient across rice categories) were seen for adjusted intakes of vitamins A (48.3 μg RAE), B12 (0.3 μg) and D (0.41 μg), folate (54.1 μg DFE), magnesium (7.8 mg), iron (0.8 mg), protein (2.0 g), thiamin (0.07 mg), niacin (0.7 mg), zinc (0.5 mg), and sodium (38 mg). Significant inverse trends were seen for intakes of SFA (-1.1 g), added sugars (-0.9 tsp), and total sugars (-3.3 g). Significant (p <0.0001) trends were seen in diet quality; diet quality scores increased 6.8 points between the lowest and the highest rice consumers. Significant positive trends (p <0.05) (β coefficient across rice categories) were seen for component scores for total fruit (0.15), whole fruit (0.23), dark green and orange vegetables (0.29), total grains (0.06), and meat and beans (0.37). HEI-2005 component scores for SFA (0.48) and solid fats, alcohol, and added sugars (SoFAAS) (1.21) were higher but sodium scores (-0.16) were lower. Consumption of rice should be encouraged to improve nutrient intake and diet quality. Nutrition education can provide ways to reduce sodium added to rice dishes.

Serum Vitamin D status and its relations to body fatness and fitness and risk factors in young adults.

The study examined the relations of serum vitamin D levels to body fatness, cardiorespiratory fitness (CRF), and metabolic risk factors in young adults in Korea. A total of 593 young men completed a health examination, body fatness, maximal treadmill exercise test, and assessment of metabolic risk factors. Participants were classified by serum vitamin D levels as deficient (< 20 ng/mL), insufficient (20~30 ng/mL), and sufficient (> 30 ng/mL). Body fatness, CRF, and metabolic risk factors were evaluated according to serum vitamin D classification. Significant inverse trends in body fatness and metabolic risk factors were observed, as was a significant linear trend for CRF across incremental vitamin D categories in this study population. Serum vitamin D levels were negatively associated with body fatness parameters, blood pressures, total cholesterol, triglycerides, and insulin and positively associated with high-density lipoprotein cholesterol and CRF. Compared to the BMI-based lean group, the obese groups had significantly higher odds ratio for serum vitamin D insufficiency before and after adjusting for age, CRF, and physical activity. Similarly, compared to percent body fat- and waist circumference-based lean groups, the obese groups had significant higher odds ratios for serum vitamin D insufficiency. In conclusion, the current findings of the study suggest that along with vitamin D intakes, body fat loss and outdoor physical activity should be promoted as non-pharmacologic means to improve metabolic risk factors in young adults.

Foods, nutrients and the risk of oral and pharyngeal cancer.

Background:Besides tobacco and alcohol, dietary habits may have a relevant role in oral cavity and pharyngeal (OCP) cancer.Methods:We analysed the role of selected food groups and nutrients on OCP cancer in a case–control study carried out between 1997 and 2009 in Italy and Switzerland. This included 768 incident, histologically confirmed squamous cell carcinoma cases and 2078 hospital controls. Odds ratios (ORs) were estimated using logistic regression models including terms for tobacco, alcohol and other relevant covariates.Results:Significant inverse trends in risk were observed for all vegetables (OR=0.19, for the highest vs the lowest consumption) and all fruits (OR=0.39), whereas significant direct associations were found for milk and dairy products (OR=1.50), eggs (OR=1.71), red meat (OR=1.55), potatoes (OR=1.85) and desserts (OR=1.68), although trends in risk were significant only for potatoes and desserts. With reference to nutrients, significant inverse relations were observed for vegetable protein (OR=0.45, for the highest vs the lowest quintile), vegetable fat (OR=0.54), polyunsaturated fatty acids (OR=0.53), α-carotene (OR=0.51), β-carotene (OR=0.28), β-cryptoxanthin (OR=0.37), lutein and zeazanthin (OR=0.34), vitamin E (OR=0.26), vitamin C (OR=0.40) and total folate (OR=0.34), whereas direct ones were observed for animal protein (OR=1.57), animal fat (OR=2.47), saturated fatty acids (OR=2.18), cholesterol (OR=2.29) and retinol (OR=1.88). Combinations of low consumption of fruits and vegetables, and high consumption of meat with high tobacco and alcohol, led to 10- to over 20-fold excess risk of OCP cancer.Conclusion:Our study confirms and further quantifies that a diet rich in fruits and vegetables and poor in meat and products of animal origin has a favourable role against OCP cancer.

CIGARETTE SMOKING, ALCOHOL CONSUMPTION AND CAFFEINE INTAKE IN PD AND PD SUBTYPES: A COMMUNITY–BASED, INCIDENT COHORT WITH MATCHED CONTROLS

BackgroundPrevious studies have demonstrated negative associations between cigarette smoking, alcohol consumption and caffeine intake and Parkinson's disease (PD), but most data come from unrepresentative cohorts (1). One previous study suggested...

The Association of Depressive Symptoms and Pulmonary Function in Healthy Adults

Chronic lung disease is exacerbated by comorbid psychiatric issues and treatment of depression may improve disease symptoms. We sought to add to the literature as to whether depression is associated with pulmonary function in healthy adults. In 2551 healthy adults from New York State, we studied the association of depression via the Center for Epidemiologic Studies Depression scale (CES-D) scale score and forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) using general linear models and a cross-sectional design. We identified statistically significant inverse trends in FEV1, FVC, FEV1%, and FVC% by CES-D category, especially in ever-smokers and men. When adjusted for covariates, the difference in FEV1 and FEV1% for smokers with more than 18.5 lifetime pack-years from CES-D scores 0 to 3 to 16 or more (depressed) is approximately 0.25 l and 5.0% (adjusted p values for trend are <.001 and .019, respectively). In men, we also observed statistically significant inverse trends in pulmonary function with increasing CES-D. We identified an inverse association of depressive symptoms and pulmonary function in healthy adults, especially in men and individuals with a heavy smoking history. Further studies of these associations are essential for the development and tailoring of interventions for the prevention and treatment of chronic lung disease.

Plasma Leptin Levels, LEPR Q223R Polymorphism and Mammographic Breast Density: A Cross-sectional Study

Obesity is associated with breast cancer in post-menopausal women, and breast density is a marker of breast cancer risk. Leptin is produced by the adipose tissue, acts through receptors that are polymorphic in nature, and is considered a cancer growth factor. The relationship between body mass index, leptin, leptin receptors and breast density is not well studied. A cross-sectional analysis in 392 post-menopausal healthy women was conducted; participants provided permission to obtain copies of their most recent screening mammogram. Non-fasting plasma leptin levels were determined using a commercially available leptin ELISA kit. Analysis of the Q223R genotypes of the LEPR gene were performed by PCR followed by restriction fragment length polymorphism analysis using DNA extracted from buffy coat samples. A statistically significant positive relationship was observed between leptin levels and body mass index (p<0.0001); leptin was significantly positively associated with mammography total breast area and non-dense breast area (p<0.0001), while it was inversely associated with percent breast density (p<0.0001). Leptin levels varied across the LEPR Q223R polymorphism, and were higher in women homozygous for the AA variant. Percent breast density decreased across the LEPR Q223R genotype, with lower percent density in women with the AA genotype. When dense area was considered according to quartiles of leptin and stratified by LEPR Q223R, a significant inverse trend between leptin levels and dense breast area was observed only among women with the G/G genotype (p-trend<0.001). After adjustment for possible confounders, leptin levels were significantly inversely associated with percent breast density (p=0.01). A significant interaction between body mass index and leptin levels on percent breast density was observed (p=0.03). These findings suggest that the association between leptin and breast density may vary by LEPR Q223R genotype, and that body mass index and leptin may act in an interactive way in determining breast density.

Maximal Estimated Cardiorespiratory Fitness, Cardiometabolic Risk Factors, and Metabolic Syndrome in the Aerobics Center Longitudinal Study

ObjectiveTo examine the relationship between estimated maximal cardiorespiratory fitness (CRF) and metabolic syndrome (MetSyn). Patients and MethodsWe performed a cross-sectional analysis of 38,659 Aerobics Center Longitudinal Study participants seen between January 1, 1979, and December 31, 2006, to examine CRF levels defined as low (lower 20%), moderate (middle 40%), and high (upper 40%) of age- and sex-specific distributions vs National Cholesterol Education Program–derived MetSyn expressed as a summed z-score continuous variable. We used a general linear model for continuous variables, the χ2 test for distribution of categorical variables, and multiple linear regression for single and cumulative MetSyn scores adjusted for body mass index, smoking status, alcohol intake, and family history of cardiovascular disease. ResultsWe observed significant inverse trends for MetSyn vs CRF in both sexes (P for trend <.001). The CRF associations vs individual components were as follows: waist circumference–men: β=−.14, r2=0.78; women: β=−.04, r2=0.71; triglycerides–men: β=−.29, r2=0.18; women: β=−.17, r2=0.18; high-density lipoprotein cholesterol–men: β=.25, r2=0.17; women: β=.08, r2=0.19; fasting glucose–men: β=−.09, r2=0.09; women: β=.09, r2=0.01; systolic blood pressure–men: β=−.09, r2=0.09; women: β=−.01, r2=0.21; and diastolic blood pressure–men: β=−.07, r2=0.12; women: β=−.05, r2=0.14. All associations except for systolic blood pressure (both sexes) and glucose (women) are significant (P<.001). ConclusionCardiorespiratory fitness demonstrated a strong inverse relationship with MetSyn in both sexes, with the strongest single associative component being waist circumference.

Serum 25-hydroxyvitamin D and markers of insulin resistance in a Japanese working population

The association between vitamin D status and insulin resistance (IR) has been less studied among Asians, and it remains elusive whether calcium could modify such an association. We examined the association of serum 25-hydroxyvitamin D (25(OH)D) concentrations with IR markers and the potential effect modification by calcium intake among a Japanese population. The authors analyzed data (n=494) from a cross-sectional survey conducted in 2009 among a Japanese working population aged 20-68 years. Fasting serum 25(OH)D and insulin, as well as fasting plasma glucose were determined, and homeostatic model assessment of IR (HOMA-IR) was calculated. Calcium intake was assessed using a validated diet history questionnaire. Multiple linear regression was done with adjustment of potential confounding variables. Fasting insulin and HOMA-IR were significantly inversely associated with 25(OH)D concentration across quartiles of 25(OH)D after fully adjusting for covariates (P(trend)=0.04 and 0.02, respectively). Across clinically relevant categories of 25(OH)D, compared with participants in the vitamin D sufficiency group, those in the vitamin D insufficiency group had a 5% higher HOMA-IR score, and those in the hypovitaminosis D group had an 18% higher HOMA-IR score (P(trend)=0.01). In an analysis by calcium intake, the HOMA-IR score was highest among participants with both a low calcium intake and lowest 25(OH)D concentrations, with significant inverse trend being observed in the group with lower calcium intake (P(trend)=0.02). Our findings suggest that low vitamin D status is associated with IR among Japanese adults.

Association between dietary intake of micronutrients and cardiorespiratory fitness in Japanese men.

Previous studies have demonstrated that meeting the dietary recommendations for macronutrients was significantly associated with higher cardiorespiratory fitness (CRF) levels in adults. However, the relation between the status of micronutrient intake and CRF still remains unclear. This study examined the association between micronutrient intake status (based on adherence to the dietary reference intakes (DRI)) and CRF in Japanese men. The study comprised 373 Japanese men aged 30-69 years. Dietary intake was assessed with a self-administered diet history questionnaire. Overall micronutrient intake status was quantified using an overall nutrient adequacy score (ONAS) for thirteen selected micronutrients. ONAS was calculated based on adherence to the DRI for Japanese. CRF was defined as V̇O2max during a maximal incremental test on a bicycle ergometer. Physical activity was measured using accelerometer-based activity monitors for seven consecutive days. We observed a significant inverse trend for the prevalence of inadequacy for the intake of vitamin A and Ca across incremental CRF categories (P<0·05). In a multivariate model, the ONAS was positively associated with absolute (β=0·10, P=0·02) and relative V̇O2max (β=0·09, P=0·04), independent of physical activity. The OR for being unfit (the lowest 25% of the age-specific distribution of V̇O2max) in the third ONAS tertile compared with the first ONAS tertile was 0·52 (95% CI 0·28, 0·96). These results demonstrated that the intake of several individual micronutrients and overall micronutrient intake status are independently and positively associated with CRF in Japanese men.

Prediagnostic circulating carotenoid levels and the risk of non-Hodgkin lymphoma: the Multiethnic Cohort

AbstractThis analysis examined the association of non-Hodgkin lymphoma (NHL) with prediagnostic carotenoid levels, a marker for a diet rich in fruits and vegetables. We conducted a nested case-control study within the Multiethnic Cohort with 271 NHL cases and 538 controls matched on sex, ethnicity, location (Hawaii or Los Angeles), birth year, date and time of blood draw, and hours fasting before blood draw. Serum carotenoid levels were obtained by high-pressure liquid chromatography with photodiode array detection. Conditional logistic regression was used to calculate odds ratios (ORs) according to tertiles of serum carotenoids and trend tests using continuous variables. Higher total serum carotenoids (ORT3 vs T1 = 0.66 [0.46-0.96]; Ptrend = .02), lycopene (OR = 0.54 [0.38-0.78]; Ptrend = .003), and α-cryptoxanthin (OR = 0.53 [0.36-0.78]; Ptrend = .003) were associated with a lower risk of NHL. For retinol (OR = 0.90 [0.61-1.33]; Ptrend = .04), a statistically significant inverse linear trend was detected. Risk estimates remained unchanged with adjustment for NHL risk factors and were similar in analyses stratified by sex and ethnicity; heterogeneity with NHL subtype was detected only for β-carotene. Other carotenoids, including α-carotene, β-carotene, lutein, β-cryptoxanthin, and zeaxanthin, showed no association with risk. These data provide support for a protective role of carotenoid-rich fruits and vegetables in the etiology of NHL.