US Females Research Articles

EXPRESS: Association of exposure to non-persistent endocrine disruptors with sex hormones and metabolic health in US females.

Endocrine disruptive chemicals (EDCs) are considered as the potential attributes for the increasing trend in obesity and metabolic syndrome (MS) through disruption of sex hormones, particularly in women. We evaluated the association of understudied EDC compounds with total testosterone (TT), sex hormone-binding globulin (SHBG), obesity, and metabolic syndrome (MS). A population-based cross-sectional study was conducted using the National Health and Nutrition Examination Survey datasets collected during the years 2013-2016. Women of age ≥15 years with urinary measurements of non-persistent EDCs including bisphenol, triclosan, triclocarban, dichlorophenol, and paraben compounds were included in this study. Data were analyzed using the modified Poisson models to estimate the adjusted relative risk (RR) and 95% confidence interval (CI). The associations were also validated by considering TT and SHBG concentrations as the outcomes. The study included 1974 women with 11% high TT, 10.5% low SHBG, 40% obesity, and 46.2% MS. A medium to high exposure to bisphenol-A (RR=1.64; 95%CI: 1.14, 2.35, p=0.009), bisphenol-F (RR=1.83; 95%CI: 1.35, 2.49, p<0.001), bisphenol-S (RR=1.83; 95%CI: 1.35, 2.49, p=0.041) and 2, 4- dichlorophenol (RR=1.61; 95%CI: 1.06, 2.45, p=0.026) were associated with low SHBG but not with high TT. In addition, high exposure to triclosan was also inversely associated with lower SHBG concentrations (regression coefficient=-0.09; 95%CI: -0.15, -0.02, p=0.013). However, these EDCs were found to be associated with SHBG, obesity, and MS according to menopausal status. High exposure to certain non-persistent EDCs was associated with low SHBG, obesity, and MS according to menopausal status.

COVID-19 and US females’ portfolio decisions

This paper uses a panel survey (micro-level) dataset to explore the impact of the COVID-19 pandemic crisis on females’ portfolio decisions. Using 150,000 US annual female portfolio choice observations from the Census Bureau database over the period 2001–2021, as well as Difference-in-Difference (DiD) methodologies, the analysis documents that female investors significantly reduce their market investments in risky assets during the pandemic period. The findings survive certain robustness checks, while they clearly illustrate the rising effect of the pandemic uncertainty on such portfolio decisions. The results carry substantial implications by suggesting that the pandemic acts as a negative externality in the risky asset type of portfolio choices and has high significance for portfolio managers, as well as for regulators and policymakers.

Cervical Cancer Screening Rates Among Rural and Urban Females, From 2019 to 2022

Little nationally representative research has examined Papanicolaou testing rates from before the pandemic in 2019 through the COVID-19 pandemic in 2022. Papanicolaou testing rates among rural females are a concern as they have historically had lower screening rates than their urban counterparts. To examine the receipt of a Papanicolaou test in the past year among US females overall and females residing in rural and urban areas in 2019, 2020, and 2022. This repeated cross-sectional study used data from 3 years of the Health Information National Trends Survey (HINTS), a nationally representative survey that asks respondents about cancer screenings, sources of health information, and health and health care technologies. Study participants were females aged 21 to 65 years. Individuals who received a Papanicolaou test more than 1 to 3 years prior to a HINTS interview were excluded as they were likely not due for a Papanicolaou test. Survey year (2019, 2020, and 2022) and rural or urban residence were the main exposure variables. Self-reported receipt of a Papanicolaou test within the past year. Among the 188 243 531 (weighted; 3706 unweighted) females included in the analysis, 12.5% lived in rural areas and 87.5% in urban areas. Participants had a mean (SE) age of 43.7 (0.27) years and were of Hispanic (18.8%), non-Hispanic Asian (5.2%), non-Hispanic Black (12.2%), non-Hispanic White (59.6%), or non-Hispanic other (4.1%) race and ethnicity. In 2022, unadjusted past-year Papanicolaou testing rates were significantly lower among rural vs urban residents (48.6% [95% CI, 39.2%-58.1%] vs 64.0% [95% CI, 60.0%-68.0%]; P < .001). Adjusted odds of past-year Papanicolaou testing were lower in 2022 than 2019 (odds ratio, 0.70; 95% CI, 0.52-0.95; P = .02). This repeated cross-sectional study found that past-year Papanicolaou testing rates were lower in 2022 than 2019, pointing to a need to increase access to screenings to prevent an uptick in cervical cancer incidence. Rural-vs-urban differences in 2022 indicate a need to specifically target rural females.

Analysis of garment fit problems and body measurements of Ethiopian young female consumers

Purpose This paper aims to investigate fit problems with some ready-to-wear garments, analyse the body measurements of Ethiopian young female consumers and draw implications for the improvement of ready-to-wear garment fit. Design/methodology/approach A random sample of 970 university students aged 18–35 years were interviewed, and their 35 body dimensions were measured manually according to the procedures in ISO 8559: 2017. The fit problems and body measurements were examined with the body mass index (BMI) and ethnicity of the subjects. Moreover, 15 body dimensions were compared with that of Chinese and US females of similar age. Findings The results showed that fit problems are frequent in lower garments for underweight consumers. Nearly consistent and smaller differences in body measurements were observed with BMIs and ethnicity of the subjects, while inconsistent and larger differences were found among the subjects from the three countries. The Ethiopian subjects were smaller than the Chinese in height and weight, between the Chinese and US females in most body measurements, and larger than the US subjects in across shoulder and arm and shoulder lengths. The results alarm the need for the development of Ethiopian national garment size standards. Originality/value The paper relates ready-to-wear garment fit issues to demographic factors and demographic factors to body measurements. Moreover, it considers young female consumers in Ethiopia, an African country with less explored consumer needs for clothing.

Relationships among health-related social media use, knowledge, worry, and cervical cancer screening: A cross-sectional study of US females

ObjectiveThis study aimed to explore the relationship between health-related social media use and HPV-related health knowledge, attitudes, and practices (KAP). MethodData were derived from a subset of the national cohort from the 2022 Health Information National Trends Survey (HINTS 6), including only women aged 21 to 65 years old (n = 2013).Ordinary least squares regression and structural equation modeling were used to answer the research question and test hypotheses. ResultsParticipants with a family history of cancer, higher education, and White showed more HPV knowledge. Older females were associated with lower HPV knowledge, less worry and fewer timely cervical cancer screening. Additionally, HPV knowledge positively predicted worry and cervical cancer screening. Health-related social media use positively predicted HPV knowledge, worry, and cervical cancer screening. ConclusionThis study identified populations with HPV knowledge and hesitated cervical cancer screening and tested hypothesized models that combine social media use with the KAP survey. Practice implicationsFuture health interventions should strategically leverage the role of social media to enhance public awareness of HPV knowledge and cancer concerns. By promoting HPV knowledge and awareness, such interventions can subsequently encourage timely cervical cancer screening.

Trends in cocaine use among United States females of reproductive age, 2005-2019.

The prevalence of cocaine use has increased in the United States, with an estimated 5.5 million people have used it at least once in 2019. We report trends in cocaine use for reproductive age females who participated in the National Survey on Drug Use and Health (NSDUH, 2005-2019). Interviewers for NSDUH recruited and assessed a representative sample of the US noninstitutionalized population. The prevalence of cocaine use was estimated annually for females (15-44 years; n = 295,751). Joinpoint regression was then used to test for significant changes in trends. Approximately 2.4% of females (n = 8136) reported past 12-month cocaine use. Joinpoint regression revealed an initial decline in cocaine use prevalence between 2005 and 2011, followed by a robust increase (2011-2019 annual percent change = 5.2; 95% confidence interval = 2.6, 7.8%). This nonlinear trend was observed for all subgroups, except for adolescent and pregnant females for whom a decrease in cocaine use prevalence was observed. Although the prevalence of cocaine use remains scarce among US females, the uptake in use after a period of initial decline is concerning, highlighting the need for continued public health awareness and action. Cocaine use among females of reproductive age is particularly concerning given the increased likelihood of transitioning to disordered use and the risk of use during pregnancy. Previous studies have not reported cocaine use estimates specific to reproductive age females or only reported co-drug use patterns, without detail of specific cocaine use trends.

Consumption of Ultraprocessed Food and Risk of Depression

This cohort study examines the consumption of ultraprocessed food and risk of depression among 31 172 US females aged 42 to 62 years.

A practical guide to managing genitourinary syndrome of menopause in primary care.

Females spend a third to half of their life in menopause, and the number of US females in menopause is growing. A high percentage of postmenopausal females experience bothersome, sometimes debilitating genitourinary symptoms, which can affect quality of life. The genitourinary syndrome of menopause (GSM) describes the condition previously referred to as vulvovaginal atrophy, atrophic vaginitis, or urogenital atrophy. Of concern, many patients with symptoms of GSM have never been asked about nor have they initiated conversations about these concerns with a healthcare provider. This article addresses the need to improve screening, identification, and patient-centered management in primary care of females with GSM.

A pre-conception clinical trial to reduce intergenerational obesity and diabetes risks: The NDPP-NextGen trial protocol

BackgroundIntrauterine exposure to maternal overweight/obesity or diabetes transmits risks to offspring, perpetuating a disease cycle across generations. Prenatal interventions to reduce maternal weight or dysglycemia have limited impact, while postpartum interventions can alter the intrauterine environment only if child-bearing continues. Efficacious preconception interventions are needed, especially for underserved populations, and with the potential to be scaled up sustainably. Research is also needed to assess intervention effects at conception, throughout pregnancy, and among offspring. MethodsThis two-arm, parallel randomized clinical trial will include 360 biological females with overweight/obesity and moderate-to-high likelihood of pregnancy within 24 months. Participants will be randomized 1:1 to a yearlong pre-conception lifestyle intervention based on the National Diabetes Prevention Program (NDPP-NextGen) or usual care. Data collection will occur at enrollment (before conception), post-conception (<8 weeks gestation), late pregnancy (28–32 weeks gestation), and delivery (before discharge) for participants who become pregnant within 24 months of enrollment. Main outcomes are post-conception body mass index (<8 weeks gestation; primary outcome), post-conception fasting glucose (<8 weeks gestation; secondary outcome), and neonatal adiposity (<2 days post-birth). Additional clinical, behavioral, perinatal and offspring data will be collected, and biospecimens (blood, urine, stool, cord blood) will be banked for future ancillary studies. ConclusionThis clinical trial will evaluate an intervention model (NDPP-NextGen) with potential to improve maternal health among the >50% of US females with overweight/obesity or diabetes risks in pregnancy. If successful, it can be scaled among >1800 organizations delivering NDPP in the United States to benefit the health of future generations.

Factors affecting serum PFAS concentrations among US females with surgically and naturally induced menopause: data from NHANES 2003-2018.

Sex hormones influence excretion of the biopersistent per-and polyfluoroalkyl substances (PFAS) in rodents, but such influences in human studies are less clear. Data from National Health and Nutrition Examination Survey (NHANES) for 2003-2018 for US females aged ≥ 20 years who reported having hysterectomy (HYST, N=1064) and who reported being in natural menopause (MENOP, N=1505) were analyzed for associations of ever use of birth control pills, past pregnancies, live births, and other factors with serum concentrations of six per- and polyfluoroalkyl substances (PFAS). For both HYST and MENOP, PFAS concentrations computed as adjusted geometric means (AGM) were higher among those who took female replacement hormone therapy (HRT) compared to nonusers in multivariable adjusted models, for example PFOS in HRT takers (10.70 ng/mL; 95% C.I. 9.46-12.11) vs. 8.70 ng/mL (95% C.I. 8.07-9.37) in nonusers (p<0.01), and PFOA in HRT users was 2.85 ng/mL (95% C.I. 2.53-3.21) vs. 2.44 ng/mL (95% C.I. 2.32-2.36) in nonusers (p=0.01), with similar findings across race/ethnicity stratifications. HYST participants with retained ovaries sometimes had higher serum PFAS than those without ovaries in post-HYST participants not taking HRT, but results had overlapping confidence intervals in all cases and were inconsistent. PFASs were inversely associated with obesity and directly associated with higher SES as reflected in poverty income ratio (PIR) in most cases, yet HRT results for the entire population are robust to adjustments for obesity and PIR. The results suggest the hypothesis that exogenous hormone use, and specifically estrogen hormones, are associated with higher serum PFAS in postmenopausal women. We discuss potential explanations for the findings, including data from other populations that estrogens may delay the onset of kidney disease, a finding which might paradoxically increase serum PFAS among the HRT population to explain some or all of our findings in a menopausal population.

Prevalence of Iron Deficiency and Iron-Deficiency Anemia in US Females Aged 12-21 Years, 2003-2020

This study examines prevalence of iron deficiency among females aged 12 to 21 years to inform future screening strategies for iron deficiency and iron-deficiency anemia.

Change in habitual intakes of flavonoid-rich foods and mortality in US males and females

BackgroundHigher baseline intakes of flavonoid-rich foods and beverages are associated with a lower risk of chronic disease and mortality in observational studies. However, associations between changes in intakes and mortality remain unclear. We aimed to evaluate associations between 8-year changes in intakes of (1) individual flavonoid-rich foods and (2) a composite measure (termed the ‘flavodiet’) of foods and beverages that are known to be main contributors to flavonoid intake and subsequent total and cause-specific mortality.MethodsWe evaluated associations between 8-year changes in intakes of (1) individual flavonoid-rich foods and (2) a novel ‘flavodiet’ score and total and cause-specific mortality. We included 55,786 females from the Nurses’ Health Study (NHS) and 29,800 males from the Health Professionals Follow-up Study (HPFS), without chronic disease at baseline in our analyses. Using multivariable-adjusted Cox proportional hazard models, we examined associations of 8-year changes in intakes of (1) flavonoid-rich foods and (2) the flavodiet score with subsequent 2-year lagged 6-year risk of mortality adjusting for baseline intakes. Data were pooled using fixed-effects meta-analyses.ResultsWe documented 15,293 deaths in the NHS and 8988 deaths in HPFS between 1986 and 2018. For blueberries, red wine and peppers, a 5%, 4% and 9% lower risk of mortality, respectively, was seen for each 3.5 servings/week increase in intakes while for tea, a 3% lower risk was seen for each 7 servings/week increase [Pooled HR (95% CI) for blueberries; 0.95 (0.91, 0.99); red wine: 0.96 (0.93, 0.99); peppers: 0.91 (0.88, 0.95); and tea: 0.97 (0.95, 0.98)]. Conversely, a 3.5 servings/week increase in intakes of onions and grapefruit plus grapefruit juice was associated with a 5% and 6% higher risk of total mortality, respectively. An increase of 3 servings per day in the flavodiet score was associated with an 8% lower risk of total mortality [Pooled HR: 0.92 (0.89, 0.96)], and a 13% lower risk of neurological mortality [Pooled HR: 0.87 (0.79, 0.97)], after multivariable adjustments.ConclusionsEncouraging an increased intake of specific flavonoid-rich foods and beverages, namely tea, blueberries, red wine, and peppers, even in middle age, may lower early mortality risk.

Expectations for family building, assisted reproduction, and adoption among lesbians in the National Survey of Family Growth, 2017–2019

To characterize the family-building goals and experiences of lesbians compared with those of heterosexual females in the United States. Secondary analysis of nationally representative, cross-sectional survey data. National Survey of Family Growth 2017-2019. 159 reproductive-age lesbian respondents and 5,127 reproductive-age heterosexual respondents. We characterized family-building goals and the use of assisted reproduction and adoption among lesbians using nationally representative female respondent data from the 2017-2019 National Survey of Family Growth. We performed bivariate analyses examining variations in these outcomes between lesbian and heterosexual individuals. Wantedness of children, use of assisted reproductive technology, and pursuit of adoption among reproductive-age lesbian and heterosexual participants. We identified 159 reproductive-age lesbian respondents of the National Survey of Family Growth, representing 2.3% or approximately 1.75 million US individuals of reproductive age. The lesbian respondents were younger, less religious, and less likely to have children than heterosexual respondents. These groups did not differ significantly by race/ethnicity, education, or income. More than half of the individuals reported wanting a child in the future, with proportions similar between the lesbian and heterosexual individuals (48% vs. 51%, respectively; P = .52). Accordingly, 18% of both the lesbian and heterosexual individuals reported that they would be greatly bothered if they were unable to have children. Nevertheless, health care providers reportedly asked the lesbians about their desire to get pregnant less frequently than they asked the heterosexual individuals (21% vs. 32%, respectively; P = .04). Only 26% of the lesbians had ever been pregnant compared with 64% of the heterosexual individuals (P<.01). Approximately one third (31%) of lesbians with medical insurance were seeking reproductive services compared with 10% of heterosexual individuals (P = .05). Lesbians were significantly more likely to be seeking adoption than heterosexual individuals (7.0% vs. 1.3%, respectively; P = .01), although they were more likely to report being turned down (17% vs. 10%, respectively; P=.03), not knowing why they were unable to adopt (19% vs. 1%, respectively; P = .02), and quitting because of the adoption process (100% vs. 45%, respectively; P = .04). Approximately half of US females of reproductive age desire to have a child, a proportion that is not different between lesbian and heterosexual individuals. However, fewer lesbians are asked about their desires to get pregnant, and fewer ever become pregnant. Lesbians are significantly more likely to pursue assisted reproductive services when covered by insurance and more likely to seek adoption. Unfortunately, lesbians are more likely to face challenges with adoption.

Effects of body size and countermeasure exercise on estimates of life support resources during all-female crewed exploration missions

Employing a methodology reported in a recent theoretical study on male astronauts, this study estimated the effects of body size and aerobic countermeasure (CM) exercise in a four-person, all-female crew composed of individuals drawn from a stature range (1.50- to 1.90-m) representative of current space agency requirements (which exist for stature, but not for body mass) upon total energy expenditure (TEE), oxygen (O2) consumption, carbon dioxide (CO2) and metabolic heat (Hprod) production, and water requirements for hydration, during space exploration missions. Assuming geometric similarity across the stature range, estimates were derived using available female astronaut data (mean age: 40-years; BMI: 22.7-kg·m−2; resting VO2 and VO2max: 3.3- and 40.5-mL·kg−1·min−1) on 30- and 1080-day missions, without and with, ISS-like countermeasure exercise (modelled as 2 × 30-min aerobic exercise at 75% VO2max, 6-day·week−1). Where spaceflight-specific data/equations were not available, terrestrial equivalents were used. Body size alone increased 24-h TEE (+ 30%), O2 consumption (+ 60%), CO2 (+ 60%) and Hprod (+ 60%) production, and water requirements (+ 17%). With CM exercise, the increases were + 25–31%, + 29%, + 32%, + 38% and + 17–25% across the stature range. Compared to the previous study of theoretical male astronauts, the effect of body size on TEE was markedly less in females, and, at equivalent statures, all parameter estimates were lower for females, with relative differences ranging from -5% to -29%. When compared at the 50th percentile for stature for US females and males, these differences increased to − 11% to − 41% and translated to larger reductions in TEE, O2 and water requirements, and less CO2 and Hprod during 1080-day missions using CM exercise. Differences between female and male theoretical astronauts result from lower resting and exercising O2 requirements (based on available astronaut data) of female astronauts, who are lighter than male astronauts at equivalent statures and have lower relative VO2max values. These data, combined with the current move towards smaller diameter space habitat modules, point to a number of potential advantages of all-female crews during future human space exploration missions.

Abstract 6473: Association of sun-seeking behaviors with indoor tanning habit in US females

Abstract Introduction: Frequent exposure to ultraviolet in early life has more detrimental and long-term effects on skin than in adulthood. Teenagers with strong sun-seeking behaviors are more likely to use an indoor tanning bed than those who seek less sun, probably due to addictive component of ultraviolet exposure. We aimed to examine the associations between sun exposure behaviors and average annual indoor tanning usage frequency during high school/college in US females. Methods: In this cross-sectional study, we included a total of 76,122 US females who answered the average annual frequency of indoor tanning during high school/college from the Nurses’ Health Study II, a large prospective cohort of US female nurses. We adjusted for age, daily number of cigarettes, number of alcohol drinks, strenuous sports frequency, hair color, family history of melanoma, chronic disease history, and mole numbers. Results: In multivariable-adjusted multinomial logistic regression models, we demonstrated positive and dose response associations between sun exposure behaviors and annual times of indoor tanning bed usage. Specifically, teenagers who spent daily outdoors in a swimsuit (adjusted odds ratio [aOR], 95% confidence interval [CI] for daily vs. &amp;lt;1/week: 3.17, 1.63-6.15) were more likely to use indoor tanning beds. High school students and undergraduates who spent ≥5hours/week outdoors in direct sunlight during daytime also showed more usage of indoor tanning beds (aOR, 95% CI for ≥5hours vs. &amp;lt;1/week: 2.01, 1.06-3.79). Teenagers who had ≥10 sunburns that blistered also tended to more frequently use indoor tanning beds (aOR, 95% CI for ≥10 vs. Never: 2.32, 1.41-3.82). Conclusions and Relevance: Teenagers who more spent outdoors in a swimsuit or in direct sunlight during daytime, or got more sunburns tended to use indoor tanning more frequently than those who did not. These findings provide evidence that teenagers with strong sun-seeking behaviors have excessive exposure to ultraviolet through indoor tanning. Table 1. aORs (95% CIs) on the association between sun-exposure behaviors and tanning bed use habit None 1-2 3-11 ≥12 N N Age-adjusted model Multivariable-adjusted model N Age-adjusted model Multivariable-adjusted model N Age-adjusted model Multivariable-adjusted model Average weekly time spent outdoors in a swimsuit as a teenager &amp;lt;1 7,650 202 1.00 1.00 127 1.00 1.00 51 1.00 1.00 1 5,891 223 1.35 (1.11-1.64) 1.25 (0.88-1.78) 154 1.46 (1.15-1.85) 1.26 (0.80-1.97) 48 1.10(0.74-1.63) 1.70 (0.77-3.73) 2 10,057 425 1.46 (1.23-1.73) 1.32 (0.97-1.79) 314 1.66 (1.34-2.04) 1.32 (0.89-1.96) 103 1.29 (0.92-1.81) 1.47 (0.71-3.02) Several 28,395 1,490 1.75 (1.51-2.04) 1.40 (1.07-1.85) 1,253 2.26 (1.88-2.72) 1.81 (1.28-2.57) 551 2.34 (1.75-3.12) 2.80 (1.47-5.31) Daily 9,761 535 1.80 (1.53-2.13) 1.36 (1.01-1.84) 497 2.55 (2.10-3.11) 1.91 (1.32-2.76) 263 3.18 (2.35-4.30) 3.17 (1.63-6.15) Average percentage of time of wearing sunscreen at the pool or beach as a teenager 100% 858 33 1.00 1.00 17 1.00 1.00 16 1.00 1.00 75% 2,430 122 1.22 (0.82-1.81) 0.94 (0.44-2.00) 86 1.63 (0.96-2.77) 3.12 (0.93-10.49) 41 0.81 (0.45-1.45) 4.96 (0.64-38.39) 50% 5,986 298 1.23 (0.85-1.78) 1.10 (0.56-2.17) 254 2.00 (1.22-3.29) 3.20 (1.00-10.29) 96 0.79 (0.46-1.36) 3.63 (0.49-27.04) 25% 13,617 829 1.55 (1.09-2.22) 1.20 (0.63-2.31) 629 2.28 (1.40-3.72) 3.06 (0.97-9.71) 253 0.98 (0.59-1.63) 4.26 (0.59-30.91) 0% 37,946 1,588 1.25 (0.88-1.78) 1.12 (0.59-2.13) 1,351 2.21 (1.36-3.58) 3.12 (0.99-9.82) 605 1.15 (0.70-1.91) 4.72 (0.65-34.01) Average weekly hours spent outdoors in direct sunlight in the middle of the day during high school/college &amp;lt;1 4,900 136 1.00 1.00 71 1.00 1.00 32 1.00 1.00 2-4 22,416 965 1.44 (1.20-1.72) 1.19 (0.87-1.62) 618 1.71 (1.34-2.19) 1.29 (0.83-2.00) 211 1.25 (0.86-1.82) 0.94 (0.48-1.85) ≥5 40,863 2,133 1.65 (1.38-1.97) 1.20 (0.89-1.62) 1,940 2.74 (2.16-3.49) 2.07 (1.35-3.15) 911 2.70 (1.89-3.85) 2.01 (1.06-3.79) The number of severe sunburns which blistered between ages 15-20 Never 22,970 856 1.00 1.00 735 1.00 1.00 318 1.00 1.00 1-2 26,939 1,393 1.38 (1.27-1.51) 1.40 (1.20-1.63) 1,106 1.28 (1.16-1.40) 1.33 (1.12-1.58) 470 1.25 (1.08-1.45) 1.43 (1.11-1.85) 3-4 11,837 637 1.47 (1.33-1.64) 1.53 (1.27-1.84) 475 1.29 (1.15-1.45) 1.36 (1.10-1.68) 199 1.26 (1.06-1.51) 1.23 (0.89-1.70) 5-9 5,190 265 1.42 (1.23-1.63) 1.54 (1.21-1.96) 242 1.53 (1.32-1.78) 1.52 (1.17-1.98) 116 1.73 (1.39-2.15) 1.88 (1.30-2.74) ≥10 1,747 94 1.50 (1.20-1.87) 1.55 (1.08-2.23) 87 1.64 (1.31-2.07) 1.36 (0.90-2.06) 59 2.64 (1.98-3.50) 2.32 (1.41-3.82) Citation Format: Bojung Seo, Eunyoung Cho, Abrar A. Qureshi, Jiali Han. Association of sun-seeking behaviors with indoor tanning habit in US females [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6473.

Association between phthalates and sleep problems in the U.S. adult females from NHANES 2011-2014

ABSTRACT There is little research on the relationship between phthalates exposure and sleep problems in adult females, with existing studies only assessing the association between exposure to individual phthalates with sleep problems. We aimed to analyse the relationship between phthalates and sleep problems in 1366 US females aged 20 years and older from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) by age stratification. Multivariate logistic regression showed that the fourth quartile of MECPP increased the risk of sleep problems in females aged 20–39 compared with the reference quartile (OR: 1.87, 95% CI: 1.14, 3.08). The WQS index was significantly associated with the sleep problems in females aged 20–39. In the BKMR, a positive overall trend between the mixture and sleep problems in females aged 20–39. In this study, we concluded that phthalates might increase the risk of sleep problems in females aged 20–39.

Diverging Neisseria gonorrhoeae Morbidity in Non-Hispanic Black and White Females: Application of Group-Based Trajectory Modeling to Trends in County-Level Morbidity 2003-2018.

National trends in gonorrhea rates may obscure informative local variations in morbidity. We used group-based trajectory models to identify groups of counties with similar gonorrhea rate trajectories among non-Hispanic White (NHW) and non-Hispanic Black (NHB) females using county-level data on gonorrhea cases in US females from 2003 to 2018. We assessed models with 1-15 groups and selected final models based on fit statistics and identification of divergent trajectory groups with distinct intercepts and/or slopes. We mapped counties by assigned trajectory group and examined the association of county characteristics with group membership. We identified 7 distinct gonorrhea trajectory groups for NHW females and 9 distinct trajectory groups for NHB females. All identified groups for NHW female morbidity experienced increasing gonorrhea rates with a limited range (11.6-183.3/100,000 NHW females in 2018); trajectories of NHB female morbidity varied widely in rates (146.6-966.0/1000 NHB females in 2018) and included 3 groups of counties that experienced a net decline in gonorrhea rates. Counties with higher NHW female morbidity had lower adult sex ratios, lower health insurance coverage, and lower marital rates among NHW adults. Counties with higher NHB female morbidity were more urban, experienced higher rates of poverty, and had lower rates of marriage among NHB adults. Morbidity patterns did not always follow geographic proximity, which could be explained by variation in social determinants of health. Our results demonstrated a highly heterogenous gonorrhea epidemic among NHW and NHB US females, which should prompt further analysis into the differential drivers of gonorrhea morbidity.

Dietary phytoestrogens and total and cause-specific mortality: results from 2 prospective cohort studies

BackgroundEvidence regarding dietary phytoestrogens in relation to mortality remains limited. ObjectivesThe objective of the study is to examine the associations of intake of isoflavones, lignans, and coumarins with total and cause-specific mortality in US males and females. MethodsWe followed 75,981 females in the Nurses’ Health Study (1984–2018) and 44,001 males in the Health Professionals Follow-up Study (1986–2018), who were free of cardiovascular disease (CVD), diabetes, or cancer at baseline. Their diet was repeatedly assessed using validated food frequency questionnaires every 2–4 y. Associations with mortality were assessed using time-dependent Cox models with adjustments for demographics, dietary and lifestyle factors, and medical history. ResultsDuring 3,427,156 person-years of follow-up, we documented 50,734 deaths, including 12,492 CVD deaths, 13,726 cancer deaths, and 24,516 other non-CVD and noncancer deaths. After multivariable adjustment, the higher total phytoestrogen intake was associated with lower risk of total CVD and other non-CVD and noncancer mortality: comparing extreme quintiles, the pooled HRs (95% CIs) were 0.89 (0.87, 0.92), 0.90 (0.85, 0.96), and 0.86 (0.82, 0.90), respectively. We did not find a significant association with cancer mortality [0.97 (0.92, 1.03)]. For individual phytoestrogens in relation to total mortality, the pooled HRs (95% CIs) comparing extreme quintiles were 0.90 (0.87, 0.92) for isoflavones, 0.93 (0.90, 0.96) for lignans, and 0.93 (0.90, 0.95) for coumarins. Individual phytoestrogens were also significantly associated with lower risk of CVD mortality and other types of mortality. Primary food sources of phytoestrogens, including tofu, soy milk, whole grains, tea, and flaxseed, were also inversely associated with total mortality. ConclusionsA higher intake of total phytoestrogens, including isoflavones, lignans, and coumarins, and foods rich in these compounds was associated with lower risk of total and certain cause-specific mortality in generally healthy US adults. These data suggest that these phytochemicals and their dietary sources may be integrated into an overall healthy diet to achieve a longer life span.

Insulinemic potential of diet and risk of total and subtypes of breast cancer among US females

Insulin resistance and hyperinsulinemia play important roles in the progression of multiple chronic disease and conditions. Diet modulates insulin response; however, evidence is limited regarding whether diets with higher insulinemic potential increase the risk of invasive breast cancer. We aimed to prospectively evaluate the association between a food-based empirical dietary index for hyperinsulinemia (EDIH) and the incidence of invasive breast cancer. We prospectively followed 76,686 women from the Nurses' Health Study (NHS; 1984-2016) and 93,287 women from the Nurses' Health Study II (NHSII; 1991-2017). Diet was assessed by food-frequency questionnaires every 4 y. The insulinemic potential of diet was evaluated using the previously established EDIH based on circulating C-peptide concentrations. Higher scores indicate higher insulinemic potential of the diet. Covariates included reproductive, hormonal, and anthropometric factors (height and BMI at age 18 y); race; socioeconomic status; total alcohol intake; total caloric intake; and physical activity. During 4,216,106 person-years of follow-up, we documented 10,602 breast cancer cases (6689 NHS, 3913 NHSII). In the pooled multivariable-adjusted analyses, women in the highest, compared with the lowest, EDIH quintile (Q) were at higher breast cancer risk (HRQ5 vs. Q1=1.15; 95% CI: 1.07, 1.24; P-trend<0.01). Although heterogeneity by estrogen receptor (ER) status was nonsignificant, the strongest association between EDIH and breast cancer was observed for ER-negative tumors (HRQ5 vs. Q1=1.21; 95% CI: 1.00, 1.46; P-trend=0.02). Among tumor molecular subtypes, the strongest associations were observed for human epidermal growth factor receptor 2 (HER2)-enriched tumors (HRQ5 vs. Q1=1.62; 95% CI: 1.01, 2.61; P-trend=0.02). A dietary pattern contributing to hyperinsulinemia and insulin resistance was associated with greater breast cancer risk, especially ER-negative and HER2-enriched tumors. Our findings suggest that dietary modifications to reduce insulinemic potential may reduce the risk of breast cancer.

The Effect Of A12 Weeks Physical Activity Program On Muscular Strength In Breast Cancer Survivors

Breast cancer is the second cause of death due to cancer in females in US. The deleterious side effects of the treatments on their physiological and psychological health are powerful, limiting their daily living and quality of life. Therefore, interventions that help ameliorate the side effects of the treatments and rehabilitate the survivors to regain their daily living and improve their quality of life are necessary. Physical activity programs have shown to have a positive effect on body composition, cardiovascular fitness, flexibility, and muscle strength in breast cancer survivors. PURPOSE: The aim of this analysis was to determine the effect of a 12 weeks physical activity program that included 4 weeks of resistance training, on static and dynamic muscular strength. METHODS: Twenty one breast cancer survivors participated on a 12 weeks physical activity program. The variables measured were static arm strength and dynamic muscular strength assessed before and after the intervention. The arm static strength was measured using a hand dynamometer and the upper/lower dynamic strength was measured performing a 1RM test for bench press and leg press exercises. The physical activity program consisted of different aerobic and anaerobic activities throughout 12 weeks. The resistance program consisted of 2 consecutive weeks, twice in the intervention (week 2 and 3; and later week 8 and 9), were they completed 10 exercises using resistance machines. The intensity for each exercise was individualized and were as follow: week 2- 3 sets x 16 reps @50%1RM, week 3-3 sets X 18 reps @50% 1RM. For week 8, 3 sets x 8 reps @60%1RM and week 9 was 3 sets x 8 [email protected] 70% 1RM. (IRB #1314-201) RESULTS: Static muscle strength increased in both arms (right arm: 18kg to34 kg; left arm: 19kg to 32 kg). Dynamic strength increased for bench press exercise (21kg to 30kg) and in the leg press exercise (77 kg to 103 kg). The results showed that the participants significantly increased their static arm strength in both arms (p<.05). Also, the participants significantly increased their dynamic muscular strength as measured in the bench press and leg press (p<.05). CONCLUSION: A 12 week physical activity program that included 4 weeks of resistance training was effective in increasing upper and lower body strength in breast cancer survivors.