Value For Linear Trend Research Articles

Recurrence of Colonic Diverticulitis: Identifying Predictive CT Findings-Retrospective Cohort Study.

Purpose To identify computed tomographic (CT) findings that are predictive of recurrence of colonic diverticulitis. Materials and Methods Institutional review board approval was obtained for this HIPAA-compliant, retrospective cohort study. Six abdominal fellowship-trained radiologists reviewed the CT studies of 440 consecutive subjects diagnosed with acute colonic diverticulitis between January 2004 and May 2008 to determine the involved segments, maximum wall thickness in the inflamed segment, severity of diverticulosis, presence of complications (abscess, fistula, stricture, or perforation), and severity of the inflammation. Electronic medical records were reviewed for a 5-year period after the patients' first CT study to determine clinical outcomes. Predictors of diverticulitis recurrence were assessed with univariate and multiple Cox proportional hazard regression models. Results Colonic diverticulitis most commonly involved the rectosigmoid (70%, 309 of 440) and descending (30%, 133 of 440) colon segments. Complicated diverticulitis was present in 22% (98 of 440) of patients. On the basis of the results of univariate analysis, significant predictors of diverticulitis recurrence were determined to be maximum colonic wall thickness in the inflamed segment (hazard ratio [HR], 1.07 per every millimeter of increase in wall thickness; P < .001), presence of a complication (HR, 1.75; P = .002), and subjective severity of inflammation (HR, 1.36 for every increase in severity category; P value for linear trend = .003). The difference in maximum wall thickness in the inflamed segment (HR, 1.05 per millimeter; P = .016) and subjective inflammation severity (HR, 1.29 per category; P = .018)remained statistically significant in a Cox multiple regression model. Conclusion Maximum colonic wall thickness and subjective severity of acute diverticulitis allow prediction of recurrent diverticulitis and may be useful for stratifying patients according to the need for elective partial colectomy. © RSNA, 2017 Online supplemental material is available for this article.

Attitude and practice of physical activity and social problem-solving ability among university students

BackgroundEffective social problem-solving abilities can contribute to decreased risk of poor mental health. In addition, physical activity has a favorable effect on mental health. These previous studies suggest that physical activity and social problem-solving ability can interact by helping to sustain mental health. The present study aimed to determine the association between attitude and practice of physical activity and social problem-solving ability among university students.MethodsInformation on physical activity and social problem-solving was collected using a self-administered questionnaire. We analyzed data from 185 students who participated in the questionnaire surveys and psychological tests. Social problem-solving as measured by the Social Problem-Solving Inventory-Revised (SPSI-R) (median score 10.85) was the dependent variable. Multiple logistic regression analysis was employed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for higher SPSI-R according to physical activity categories.ResultsThe multiple logistic regression analysis indicated that the ORs (95% CI) in reference to participants who said they never considered exercising were 2.08 (0.69–6.93), 1.62 (0.55–5.26), 2.78 (0.86–9.77), and 6.23 (1.81–23.97) for participants who did not exercise but intended to start, tried to exercise but did not, exercised but not regularly, and exercised regularly, respectively. This finding suggested that positive linear association between physical activity and social problem-solving ability (p value for linear trend < 0.01).ConclusionsThe present findings suggest that regular physical activity or intention to start physical activity may be an effective strategy to improve social problem-solving ability.

The association of lead and cadmium exposure with frailty in US older adults.

Background: Environmental lead and cadmium exposure is associated with higher risk of several age-related chronic diseases, including cardiovascular disease, chronic kidney disease and osteoporosis. Moreover, these diseases may also lead to the frailty syndrome. However, no previous study has evaluated the association between lead or cadmium exposure with frailty in older adults. Methods: Cross-sectional study among individuals aged ≥60 years who participated in the third U.S. National Health and Nutrition Examination Survey (NHANES III) and had either blood lead (N=5,272) or urine cadmium (N=4,887) determinations. Frailty was ascertained based on a slight modification of the Fried criteria. The association between lead and cadmium with frailty was evaluated using logistic regression with adjustment for relevant confounders. Results: Median (intertertile range) concentrations of blood lead and urine cadmium were 3.9 µg/dl (2.9-4.9) and 0.69 µg/g (0.52-0.98), respectively. The prevalence of frailty was 7.1%. The adjusted odds ratio (95% confidence interval) of frailty comparing the second and third to the lowest tertile of blood lead were, respectively, 1.40 (0.96-2.04) and 1.75 (1.33-2.31); p value for linear trend &lt;0.01. Lead concentrations were also associated with the frequency of exhaustion, weakness and slowness. The corresponding odds ratios (95% confidence interval) for cadmium were, respectively, 0.70 (0.45-1.09) and 1.67 (1.05-2.66); p value for trend 0.03, but this association did not hold after excluding participants with reduced glomerular filtration rate: 1.12 (0.67-1.86) and 1.12 (0.82-1.53). Conclusions: In the US older adult population, blood lead concentrations showed a direct dose-response relationship with frailty; by contrast, the results did not support an association between cadmium and frailty.

Childhood abuse and suicidal ideation in a cohort of pregnant Peruvian women

Childhood abuse is a major global and public health problem associated with a myriad of adverse outcomes across the life course. Suicide is one of the leading causes of mortality during the perinatal period. However, few studies have assessed the relationship between experiences of childhood abuse and suicidal ideation in pregnancy. We sought to examine the association between exposure to childhood abuse and suicidal ideation among pregnant women. A cross-sectional study was conducted among 2964 pregnant women attending prenatal clinics in Lima, Peru. Childhood abuse was assessed using the Childhood Physical and Sexual Abuse Questionnaire. Depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 scale. Logistic regression procedures were performed to estimate adjusted odds ratios and 95% confidence intervals adjusted for potential confounders. Overall, the prevalence of childhood abuse in this cohort was 71.8% and antepartum suicidal ideation was 15.8%. The prevalence of antepartum suicidal ideation was higher among women who reported experiencing any childhood abuse compared to those reporting none (89.3% vs 10.7%, P < .0001). After adjusting for potential confounders, including antepartum depression and lifetime intimate partner violence, those with history of any childhood abuse had a 2.9-fold (2.90, adjusted odds ratio; 95% confidence interval, 2.12-3.97) increased odds of reporting suicidal ideation. Women who experienced both physical and sexual childhood abuse had much higher odds of suicidal ideation (adjusted odds ratio, 4.04; 95% confidence interval, 2.88-5.68). Women who experienced any childhood abuse and reported depression had 3.44-fold (3.44, adjusted odds ratio; 95% confidence interval, 1.84-6.43) increased odds of suicidal ideation compared with depressed women with no history of childhood abuse. Finally, the odds of suicidal ideation increased with increased number of childhood abuse events experienced (P value for linear trend < .001). Maternal history of childhood abuse was associated with increased odds of antepartum suicidal ideation. It is important for clinicians to be aware of the potential increased risk of suicidal behaviors among pregnant women with a history of childhood physical and sexual abuse.

Long Series of GNSS Integrated Precipitable Water as a Climate Change Indicator

Abstract This paper investigates information potential contained in tropospheric delay product for selected International GNSS Service (IGS) stations in climatologic research. Long time series of daily averaged Integrated Precipitable Water (IPW) can serve as climate indicator. The seasonal model of IPW change has been adjusted to the multi-year series (by the least square method). Author applied two modes: sinusoidal and composite (two or more oscillations). Even simple sinusoidal seasonal model (of daily IPW values series) clearly represents diversity of world climates. Residuals in periods from 10 up to 17 years are searched for some long-term IPW trend – self-evident climate change indicator. Results are ambiguous: for some stations or periods IPW trends are quite clear, the following years (or the other station) not visible. Method of fitting linear trend to IPW series does not influence considerably the value of linear trend. The results are mostly influenced by series length, completeness and data (e.g. meteorological) quality. The longer and more homogenous IPW series, the better chance to estimate the magnitude of climatologic IPW changes.

Association between 24 h urinary sodium to potassium ratio and metabolic syndrome in Chinese adults

To examine the association between 24 h urinary sodium to potassium ratio and metabolic syndrome (MS) in Chinese adults. A population-based cross-sectional study was conducted among Chinese adults aged 18-69 years in Shandong province in 2011. Data on 24 h urinary excretion of sodium and potassium and components of MS were examined. Participants were divided into four groups according to the quartile of 24 h urinary sodium to potassium ratio. Of the 1 906 Chinese adults eligible for final data analysis, 471 (24.7%) were with MS. After completion of multivariate logistic regression analysis, when compared to the participants with 24 h urinary sodium to potassium ratio < 4.3, the OR (95% CI) of participants with 24 h urinary sodium to potassium ratio during 4.3-5.6, 5.7-8.1, and ≥ 8.1 were 1.27 (0.93-1.71), 1.06 (0.78-1.46), and 1.45 (1.06-1.97), respectively (P values for linear trend < 0.05). As for the components of MS, the odds of central obesity and elevated blood pressure but not the odds of elevated triglycerides, low high density lipoprotein cholesterol and elevated fasting glucose, had significantly increases with successive 24 h urinary sodium to potassium ratio quartiles (P values for linear trends < 0.05). The 24 h urinary sodium to potassium ratio appeared significantly associated with the odds of MS.

Association between diastolic dysfunction and future atrial fibrillation in the Tromsø Study from 1994 to 2010

ObjectiveTo investigate the association between echocardiographic measurements with emphasis on diastolic dysfunction and risk of atrial fibrillation (AF) in a population-based cohort study.MethodsWe followed 2406 participants from the Tromsø Study...

Monitoring of soil temperature and snow cover depth in the Irkutsk Region

Long-term data (1964–2000) from weather stations within the territory of Irkutsk region are analyzed in the paper. Quantitative assessment was made of the soil temperature response at a depth of 1.6 m to the modern climate changes. The majority of cases showed the tendency of soil temperature to rise; however, the values of linear trends are not always statistically significant. The snow depth varies slightly. The connection of soil temperature with air temperature and snow cover depth is discussed. The local physical-geographical conditions influence on the background of sufficiently significant relations between some parameters.

Warfarin untargeted metabolomics study identifies novel procoagulant ethanolamide plasma lipids

Warfarin untargeted metabolomics study identifies novel procoagulant ethanolamide plasma lipids

Egg consumption and insulin metabolism in the Insulin Resistance Atherosclerosis Study (IRAS).

To examine the association between egg consumption and measures of insulin sensitivity (SI), acute insulin response (AIR) and metabolic clearance rate of insulin (MCRI). Cross-sectional analysis. Egg consumption, categorized as <1/week, 1 to <3/week, 3 to <5/week and ≥5/week, was measured using a validated FFQ. SI, AIR and MCRI were determined from frequently sampled intravenous glucose tolerance tests. Non-diabetic participants (n 949) in the Insulin Resistance Atherosclerosis Study (IRAS). Egg consumption was inversely associated with SI and MCRI, and positively associated with fasting insulin in regression models adjusted for demographic, socio-economic, lifestyle and dietary factors (β = -0·22, 95 % CI -0·38, -0·045, P = 0·05 for SI; β = -0·20, 95 % CI -0·34, -0·055, P = 0·005 for MCRI; β = 0·35, 95 % CI 0·15, 0·54, P = 0·002 for fasting insulin; all P values for linear trend). These associations remained significant after additionally adjusting for energy intake or dietary saturated fat, although dietary cholesterol and BMI attenuated these associations to non-significance. Egg consumption was not associated with AIR. Dietary cholesterol and BMI appear to mediate the inverse association of egg consumption with insulin sensitivity and clearance. Alternatively, egg consumption may be clustered with other dietary behaviours which increase BMI, hence negatively impacting on insulin sensitivity and clearance.

Coffee and risk of prostate cancer incidence and mortality in the Cancer of the Prostate in Sweden Study

Coffee intake has recently been associated with significantly lower risk of lethal and advanced prostate cancer in a US population. We studied the association between coffee and prostate cancer risk in the population-based case-control study Cancer of the Prostate in Sweden. Dietary data were available for 1,499 cases and 1,112 controls. We calculated odds ratios (ORs) for the risk of prostate cancer in high versus low categories of coffee intake using logistic regression. We studied overall prostate cancer risk as well as risk of fatal, advanced, localized, high-grade, grade 7, and low-grade disease. Mean coffee intake was 3.1 cups per day among both cases and controls. Coffee intake was not associated with overall prostate cancer risk. Risk of fatal prostate cancer was inversely, but not statistically significantly, associated with coffee intake, with an odds ratio of 0.64 [95% confidence interval (CI) 0.34-1.19, p value for linear trend=0.81] for men consuming greater than 5 cups per day compared to men drinking less than 1 cup per day. The highest intake of coffee was associated non-significantly with lower risk of advanced disease (OR=0.73, 95% CI 0.41-1.30, p trend=0.98) and associated significantly with lower risk of high-grade cancer (Gleason 8-10; OR=0.50, 95% CI 0.26-0.98, p trend=0.13). Risk of localized, grade 7, and low-grade cancers was not associated with coffee intake. This study provides some support of an inverse associationbetween coffee and lethal and high-grade prostate cancer.

Relationship between Air–Sea Density Flux and Isopycnal Meridional Overturning Circulation in a Warming Climate

Abstract This study aims to explore the relationship between air–sea density flux and isopycnal meridional overturning circulation (MOC), using the Intergovernmental Panel on Climate Change (IPCC) Fourth Assessment Report (AR4) model projections of the twenty-first-century climate. The focus is on the semiadiabatic component of MOC beneath the mixed layer; this component is described using the concept of the push–pull mode, which represents the combined effects of the adiabatic push into the deep ocean in the Northern Hemisphere and the pull out of the deep ocean in the Southern Hemisphere. The analysis based on the GFDL Climate Model version 2.1 (CM2.1) simulation demonstrates that the push–pull mode and the actual isopycnal MOC at the equator evolve similarly in the deep layers, with their maximum transports decreasing by 4–5 Sv (1 Sv ≡ 106 m3 s−1) during years 2001–2100. In particular, the push–pull mode and actual isopycnal MOC are within approximately 10% of each other at the density layers heavier than 27.55 kg m−3, where the reduction in the MOC strength is the strongest. The decrease in the push–pull mode is caused by the direct contribution of the anomalous heat, rather than freshwater, surface fluxes. The agreement between the deep push–pull mode and MOC in the values of linear trend and variability on time scales longer than a decade suggests a largely adiabatic pole-to-pole mechanism for these changes. The robustness of the main conclusions is further explored in additional model simulations.

Some Quantitative Issues in Pairs Trading

In this study, Pairs Trading (PT) is considered. An example of its application using real data is shown and a time series simulation of the Saudi stock market using the Vector Auto-Regressive model (VAR) is performed on two stocks. In addition, the influence of different simulation model parameters on the total profit is investigated. We conducted a quantitative analysis of different cross-correlations that occurred between simulated stocks, as well as of different values of linear trends in the auto-regressive model. Furthermore, the optimal conditions for the application of a PT strategy, as well as the optimal parameters used for this strategy were obtained. It was shown that parallel trends and a high correlation between considered stocks can lead to significant profits. In the case of highly correlated series with limited volatility, benchmarks should be used for opening and closing positions.

Abstract 219: Prognostic Significance of Serum Albumin on Long-Term Mortality in Survivors of Out-of-Hospital Cardiac Arrest

Introductions: Hypoalbuminemia is known as a reliable predictor of mortality in patients with various illnesses. However, the prognostic value of serum albumin on out of hospital cardiac arrest (OHCA) patients has not been established. The purpose of study is to investigate whether serum albumin concentration on hospital arrival may be useful in predicting the long-term mortality in survivors from OHCA. Methods: Retrospective analysis of emergency departments OHCA registry from January 2008 to December 2011 has been conducted. The individual medical records were reviewed for the data including Utstein predictors of OHCA, underlying disease, and initial laboratory finding including serum albumin. Primary outcome was survival at 6 months. The secondary outcome was CPC (Cerebral Performance Category) at 6 months. Albumin was categorized as quartiles as &lt; 2.7g/dL, 2.7 to 3.2g/dL, 3.2 to 3.9 g/dL and &gt; 3.9g/dL. Hazard ratios (HRs) were estimated using Cox-proportional hazard models in both univariate and multivariate analysis. All prognostic variables with their p value &lt; 0.1 in univariate analysis were used in multivariate analysis for adjustment. Results: Of 546 OHCA patients, 139 patients had sustained ROSC. Of those, 23 patients (16.5%) survived at 6 month and 16 patients (11.5%) had favorable neurological outcome (CPC 1,2). Survival rate at 6 months were significantly higher in patients with a higher albumin group and neurological outcomes were also more favorable in higher albumin group. In a Cox proportional hazard regression analysis for 6-month survival, patients with lower categories of albumin had increased mortality rates before and after multivariable adjustment. (p value for linear trend &lt; 0.05) Conclusion: Serum albumin is a robust predictor of long-term mortality and associated with neurological outcome in patients with sustained ROSC from OHCA

Comparison of Nonculprit Coronary Plaque Characteristics Between Patients With and Without Diabetes: A 3-Vessel Optical Coherence Tomography Study

The aim of the present study was to compare the characteristics of nonculprit coronary plaques between diabetes mellitus (DM) and non-DM patients using 3-vessel optical coherence tomography (OCT) imaging. DM patients have a higher recurrent cardiovascular event rate. Patients who had undergone 3-vessel OCT imaging were identified from the Massachusetts General Hospital OCT Registry. Characteristics of nonculprit plaques were compared between DM and non-DM patients. A total of 230 nonculprit plaques were identified in 98 patients. Compared with non-DM patients, DM patients had a larger lipid index (LI) (averaged lipid arc × lipid length; 778.6 ± 596.1 vs. 1358.3 ± 939.2, p < 0.001) and higher prevalence of calcification (48.4% vs. 72.2%, p = 0.034) and thrombus (0% vs. 8.3%, p = 0.047). DM patients were divided into 2 groups based on glycated hemoglobin (A(1C)) levels of ≤7.9% and ≥8.0%. LI was significantly correlated with diabetic status (778.6 ± 596.1 [non-DM] vs. 1,171.5 ± 708.1 [A(1C) ≤7.9%] vs. 1,638.5 ± 1,173.8 [A(1C) ≥8%], p value for linear trend = 0.005), and fibrous cap thickness was inversely correlated with the A(1C) level (99.4 ± 46.7 μm [non-DM] vs. 91.7 ± 29.6 μm [A(1C) ≤7.9%] vs. 72.9 ± 22.7 μm [A(1C) ≥8%], p value for linear trend = 0.014). Patients with A(1C) ≥8% also had the highest prevalence of thin-cap fibroatheroma (TCFA) and macrophage infiltration. Compared with non-DM patients, DM patients have a larger LI and a higher prevalence of calcification and thrombus. The LI was larger and TCFA and macrophage infiltration were frequent in patients with A(1C) ≥8%.

OP50 Alcohol Intake, Drinking Behaviour and Drinking Patterns as Predictors Of Employment Status in Working-Age Men in Izhevsk, Russia

BackgroundHazardous alcohol consumption and unemployment are both associated with high mortality in Russia. Unemployment adversely affects mental and physical health. The relationship between alcohol and employment is complex as alcohol...

EFFECT OF FARM MILK ON DEVELOPMENT OF ASTHMA AND ALLERGIES

Background and Aims: Several epidemiological studies found consumption of farm milk to be inversely associated with the occurrence of hay fever, pollen sensitization. GABRIELA, a large cross-sectional multi-centre study, offered for the first time the opportunity to relate analytically measured milk components to asthma and atopy outcomes in children and possibly explain the previously reported protective farm milk effect. Methods: In four rural regions of Germany, Austria, and Switzerland, farm and milk exposure of 7606 5–13 year old children was assessed by a detailed questionnaire and they also provided blood samples to determine specific IgE levels. Viable bacterial counts, whey protein levels, and total fat content were analysed in 800 milk samples that were collected at the participant’s homes. Associations of milk consumption and asthma, atopy, hay fever, and atopic dermatitis were computed by stratified weighted logistic regression analyses adjusted for potential confounders. Results: Raw milk consumption, that was reported in questionnaires, was inversely associated with asthma (aOR: 0.59, 95%-CI: 0.46–0.74), atopy (0.74, 0.61–0.90), and hay fever (0.51, 0.37–0.69) independent of other farm exposures. Consumption of exclusively boiled farm did not show a protective effect. The heating status of consumed milk as reported by parents was in very good agreement with objective measurements. Total viable bacterial counts or total fat content of milk were not significantly related to asthma or atopy. Yet, increased levels of the whey proteins were inversely associated with asthma but not with atopy. Significant inverse dose-response relations were observed for lactoferrin (p–value for linear trend = 0.02), TGF-beta2 (0.02), alpha-lactalbumin (0.02), and beta-lactoglobulin (0.04). Conclusions: The protective effect of raw milk consumption on asthma seems to be associated with the whey protein fraction of unprocessed farm milk. Relevant immunomodulatory compounds of farm milk and underlying mechanisms need to be explored in more detail.

Association Between Type 2 Diabetes and Exposure to Persistent Organic Pollutants

OBJECTIVEThe prevalence of type 2 diabetes is increasing alarmingly in both developed and developing countries. Recently, exposure to persistent organic pollutants (POPs) has been associated with the prevalence of type 2 diabetes. The purpose of this cross-sectional study is to examine the association between type 2 diabetes and POP exposure in the Helsinki Birth Cohort Study.RESEARCH DESIGN AND METHODSThe cohort consists of 8,760 people born in Helsinki during 1934–1944, before the global POP emission peak. In 2003, a clinical examination was performed, including blood sampling for laboratory analyses of serum lipids and POPs. Complete data from the examination were available for 1,988 participants. The concentrations of each POP were categorized into four groups on the basis of percentile intervals, and logistic regression was performed to examine diabetes prevalence across the POP categories, adjusting for sex, age, waist circumference, and mean arterial pressure and using the lowest category as the reference group.RESULTSAmong the participants with the highest exposure to oxychlordane, trans-nonachlor, 1,1-dichloro-2,2-bis-(p-chlorophenyl)-ethylene (p,p’-DDE, and polychlorinated biphenyl 153, the risk of type 2 diabetes was 1.64–2.24 times higher than that among individuals with the lowest exposure (Plin = 0.003–0.050, where Plin is the P value for linear trend across POP categories). In the stratified analysis, the associations between type 2 diabetes and oxychlordane and trans-nonachlor remained significant and were strongest among the overweight participants. Exposure to 2,2′,4,4′-tetrabromodiphenyl ether (BDE 47) and 2,2′,4,4′,5,5′-hexabromodiphenyl ether (BDE 153) was not associated with type 2 diabetes.CONCLUSIONSThis study confirms the association between type 2 diabetes and adult-only exposure to organochlorine pesticides in a general urban population.

Alcohol Consumption and Risk of Lung Cancer in the VITamins And Lifestyle Study

The effect of alcoholic beverage consumption on lung cancer risk was investigated in the VITamins And Lifestyle (VITAL) Study. The VITAL study is a prospective cohort of residents aged 50–76 yr in Washington state. Five hundred and eighty incident lung cancer cases diagnosed between study baseline (2000–2002) and 2007 were identified among 66,186 participants without previous cancer through the Washington Surveillance Epidemiology and End Result cancer registry. Multivariable Cox's regression was used to examine the effects of beer, red wine, white wine, liquor, combined alcoholic beverage intake at study baseline, and alcohol intake at age 30 and 45 on lung cancer risk, with careful adjustment for smoking. There was no clear association between lung cancer and consumption of beer, red wine, white wine, or liquor at ≥1 drink/day. Combined alcoholic beverage intake of up to ≥3 drink/day was not associated with elevated overall lung cancer risk. Heavy consumption of alcohol at study baseline and at age 45 was, however, associated with more than doubling of risk for squamous cell carcinoma (hazard ratio for ≥3 drink/day at study baseline = 2.54, 95% CI: 1.36–4.73, P value for linear trend = 0.002) but not for adenocarcinoma. Alcohol intake at age 30 was not associated with lung cancer risk.

Fish consumption in relation to other foods in the diet

Our aim was to investigate whether fish consumption is associated with the consumption of other healthy foods. The study population consisted of 2605 men and 3199 women from the nationally representative Health 2000 survey and 114 professional fishermen and 114 fishermen's wives (the Fishermen substudy) in Finland. Dietary data were collected using a calibrated (i.e. determined to have relative validity) FFQ. Model-adjusted means for food consumption and P values for linear trend were calculated across fish consumption tertiles. Those with the highest fish consumption had the highest consumption of vegetables, fruit and berries, potatoes, oil and wine even after adjusting for other food groups. The consumption of red meat and sausages had a tendency to decrease across fish consumption tertiles but the associations were inconsistent in the study populations. In conclusion, fish consumption had a positive linear association with the consumption of some other healthy foods such as vegetables, fruit, berries, and oil both in the general population of Finland and in a population with high fish consumption. Additional adjustment for other food groups had a clear effect on some of the studied associations. Therefore, when evaluating the health effects of fish consumption, confounding by other foods characterising a healthy diet needs to be considered.