Weak Inverse Association Research Articles

Soy Consumption, but Not Dairy Consumption, Is Inversely Associated with Fatty Acid Desaturase Activity in Young Adults.

Past research using hepatic rat microsomes showed that soy protein suppressed delta-6 desaturase activity (D6D) compared to casein (a dairy protein). The effects of soy and dairy on desaturase pathway activity in humans remain poorly investigated. The objective of this analysis was to investigate the association between soy and dairy consumption with plasma fatty acids and estimate the desaturase pathway activity in a multiethnic Canadian population of young adults. We analyzed data from men (n = 319) and women (n = 764) previously collected for the Toronto Nutrigenomics and Health Study. Food frequency questionnaires and plasma fatty acids were assessed. Relationships between soy and dairy beverages and food consumption with estimated desaturase activities were assessed by regression models and by grouping participants according to beverage and food intake data. Weak inverse associations (p ≤ 0.05) were found between soy consumption and the overall desaturation pathway activity, specifically D6D activity. When participants were grouped based on soy and dairy consumption habits, omega-6 LC-PUFAs, as well as various estimates of the desaturase pathway activity, were significantly lower in individuals consuming soy (with or without dairy) compared to individuals consuming only fluid milk and dairy products. In conclusion, soy consumption, not dairy consumption, appears to suppress desaturase pathway activity.

Prenatal exposure to mixtures of persistent endocrine disrupting chemicals and postnatal body size in British girls

BackgroundEndocrine disrupting chemical (EDC) exposure is ubiquitous. EDC exposure during critical windows of development may interfere with the body's endocrine system, affecting growth. Previous human studies have examined one EDC at a time in relation to infant growth. By studying mixtures, the human experience can be better approximated. AimsWe investigated the association of prenatal exposure to persistent EDCs (per- and polyfluoroalkyl substances (PFAS), polychlorinated biphenyls (PCBs), and organochlorine pesticides (OCPs)) as mixtures with postnatal body size among female offspring. SubjectsWe used a sub-sample of the Avon Longitudinal Study of Parents and Children (N = 425), based in the United Kingdom. Study designWe quantified 52 EDCs in maternal serum collected during pregnancy. We used Bayesian kernel machine regression with a random intercept to examine the association of prenatal concentrations of EDC mixtures with longitudinal postnatal body size measures for each EDC class separately (PFAS, PCBs, and OCPs) and for all three classes combined. Outcome measuresWeight and height measures at 0, 2, 9, and 19 months were obtained by health professionals as part of routine child health surveillance. ResultsThe mixture representing all three classes combined (31 chemicals) (n = 301) was inversely associated with postnatal body size. Holding all EDCs in the 31-chemical mixture at the 75th percentile compared to the 50th percentile was associated with 0.15 lower weight-for-age z-score (95% credible interval −0.26, −0.03). Weak inverse associations were also seen for height-for-age and body mass index-for-age scores. ConclusionsThese results suggest that prenatal exposure to mixtures of persistent EDCs may affect postnatal body size.

Dairy foods, calcium, and risk of breast cancer overall and for subtypes defined by estrogen receptor status: a pooled analysis of 21 cohort studies

Epidemiologic studies examining the relations between dairy product and calcium intakes and breast cancer have been inconclusive, especially for tumor subtypes. To evaluate the associations between intakes of specific dairy products and calcium and risk of breast cancer overall and for subtypes defined by estrogen receptor (ER) status. We pooled the individual-level data of over 1 million women who were followed for a maximum of 8-20 years across studies. Associations were evaluated for dairy product and calcium intakes and risk of incident invasive breast cancer overall (n=37,861 cases) and by subtypes defined by ER status. Study-specific multivariable hazard ratios (HRs) were estimated and then combined using random-effects models. Overall, no clear association was observed between the consumption of specific dairy foods, dietary (from foods only) calcium, and total (from foods and supplements) calcium, and risk of overall breast cancer. Although each dairy product showed a null or very weak inverse association with risk of overall breast cancer (P, test for trend>0.05 for all), differences by ER status were suggested for yogurt and cottage/ricotta cheese with associations observed for ER-negative tumors only (pooled HR=0.90, 95% CI: 0.83, 0.98 comparing≥60 g/d with<1 g/d of yogurt and 0.85, 95% CI: 0.76, 0.95 comparing≥25 g/d with<1 g/d of cottage/ricotta cheese). Dietary calcium intake was only weakly associated with breast cancer risk (pooled HR=0.98, 95% CI: 0.97, 0.99 per 350mg/d). Our study shows that adult dairy or calcium consumption is unlikely to associate with a higher risk of breast cancer and that higher yogurt and cottage/ricotta cheese intakes were inversely associated with the risk of ER-negative breast cancer, a less hormonally dependent subtype with poor prognosis. Future studies on fermented dairy products, earlier life exposures, ER-negative breast cancer, and different racial/ethnic populations may further elucidate the relation.

Self-perceived health among children with spina bifida in the West Bank: a cross-sectional study

BackgroundChildren born with spina bifida endure constant physical disability, which is challenging for themselves and their families. To date, the impact of spina bifida on the health-related quality of life (HRQOL; eg, physical, psychological, and social wellbeing) of these children has been assessed mainly through parent proxy reports, and self-perceived health among these children is rarely measured. This study aimed to measure self-perceived health in children with spina bifida in the West Bank, to compare this with that in a healthy reference group also from the West Bank, and to assess the potential association between self-perceived health and the level of disability in children with spina bifida. MethodsA cross-sectional study was conducted in the West Bank. The Paediatric Quality of Life Inventory (PedsQL) was administered to a convenience sample of 200 children aged 8–12 years, of whom 50 have spina bifida and 150 are healthy. For the children with spina bifida, their disability was categorised and ranked according to four aspects of impairment (mobility, bowel function, bladder function, and hydrocephaly). Data were analysed with SPSS version 24. Difference in PedsQL scores between the two groups of children was tested with the Mann-Whitney U-test. The Spearman's rank correlation coefficient was used to evaluate the association between the level of physical impairment in children with spina bifida and their self-perceived health. Written informed consent was obtained from the children's parents. The children's verbal assent was also obtained, and their right to withdraw from the study at any time was emphasised. FindingsChildren with spina bifida had lower overall PedsQL scores (mean 45·5, SD 14.5) than those reported by the reference group of healthy children (mean 80·0, SD 12·8). For children with spina bifida, social functioning had the lowest mean score (30·5, SD 20·8), followed by physical functioning (37·5, SD 16.6), emotional functioning (56·0, SD 17·2), and school functioning (62·6, SD 17.8), whereas the range for all of the PedsQL scores in the reference group was 71·7–84·5. The results demonstrate significant inverse associations between self-perceived health (overall PedsQL score) in children with spina bifida and both the level of mobility impairment (rs=−0·65, p<0·0001) and the presence of hydrocephalus (rs=−0·53, p<0·0001). A weak inverse association was found between self-perceived health and both bladder and bowel dysfunction. For both groups, no associations were found between demographic characteristics (age, gender, type of settlement of residence [city, village, camp]) and self-perceived health. InterpretationThe findings provide insights into the importance of social support and rehabilitation services for children with spina bifida in the occupied Palestinian territory. In particular, community awareness, and education of health care providers and family members, may be important. FundingNone.

Dietary sugar intake among preschool-aged children: a cross-sectional study.

Background:Excessive intake of sugar in young children is a public health concern. Our study objectives were to examine intakes of total, free and added sugar among preschool-aged children and to investigate their associations with body weight, body mass index Z-scores, percent fat mass and waist circumference.Methods:The cross-sectional cohort study included preschool-aged children between 1.5 and 5 years of age, enrolled in pilot studies of the Guelph Family Health Study, Guelph, Ontario, from 2014 to 2016. Daily intake of total sugar was determined using a food processor software; daily intakes of free and added sugar, and food sources were determined through manual inspection of 3-day food records. Anthropometric measures were completed by trained research staff. We used linear regression models with generalized estimating equations to estimate associations between sugar intakes and anthropometric measures.Results:We included 109 children (55 girls and 54 boys) in 77 families. Mean daily intakes were 86 (standard deviation [SD] 26) g for total sugar, 31 (SD 15) g for free sugar and 26 (SD 13) g for added sugar. Of participants, 80% (n = 87) had intakes of free sugar greater than 5% of their daily energy intake. The most frequent food sources of free and added sugar were bakery products. A weak inverse association between free sugar intake (kcal/1000 kcal) and waist circumference (cm) (β = −0.02, 95% confidence interval −0.04 to −0.0009) was found, but no significant associations were noted between sugar intake and other anthropometric measures.Interpretation:Most of the preschool-aged children in this study had free sugar intakes greater than current recommendations; overall, their total, free and added sugar intakes were not associated with the anthropometric measures. This study can be used to inform policy development for sugar intake in young children and apprise early intervention programs.

Dairy consumption and mortality after myocardial infarction: a prospective analysis in the Alpha Omega Cohort

ABSTRACTBackgroundPopulation-based studies generally show neutral associations between dairy consumption and ischemic heart disease (IHD) mortality, whereas weak inverse associations were found for cardiovascular disease (CVD) and stroke mortality. Whether dairy consumption affects long-term survival after myocardial infarction (MI) is unknown.ObjectivesWe studied types of dairy and long-term mortality risk in drug-treated post-MI patients.MethodsWe included 4365 Dutch patients from the Alpha Omega Cohort aged 60–80 y (21% women) with an MI ≤10 y before enrollment. Dietary data were collected at baseline (2002–2006) using a 203-item FFQ and patients were followed for cause-specific mortality through December 2018. HRs of CVD, IHD, stroke, and all-cause mortality for types of dairy were obtained from Cox models, adjusting for age, sex, energy intake, physical activity, smoking, alcohol intake, diabetes, obesity, and dietary factors.ResultsMost patients were Dutch, 24% were obese, 20% had diabetes, and 97% used cardiovascular medication. Median intakes were 39 g/d for plain yogurt, 88 g/d for total nonfermented milk, and 17 g/d for hard cheeses. Of the cohort, 10% consumed high-fat milk. During ∼12 y of follow-up (48,473 person-years) 2035 deaths occurred, including 903 from CVD, 558 from IHD, and 170 from stroke. Yogurt was linearly inversely associated with CVD mortality (HR: 0.96; 95% CI: 0.93, 0.99; per 25 g/d) and nonlinearly inversely associated with all-cause mortality. Milk was not associated with any of the outcomes (HRs: ∼1.0 per 100 g/d), except for a higher mortality risk in high-fat milk consumers (HR: 1.30; 95% CI: 1.13, 1.49). Other dairy groups were not associated with mortality risk.ConclusionsIn Dutch post-MI patients, yogurt consumption was inversely associated with CVD mortality and all-cause mortality. Associations for milk and other dairy products were neutral or inconsistent.This trial was registered at clinicaltrials.gov as NCT03192410.

Abstract 843: Coffee consumption and risk of renal cell carcinoma: A meta-analysis of cohort evidence

Abstract Background: Coffee consumption has been associated with a reduced risk of some cancers, although for renal cell carcinoma (RCC) the evidence is inconclusive. Several cohort analyses investigating coffee intake and RCC have been conducted, although most have been limited by small case numbers. To summarize the cohort evidence of this relationship, we conducted a meta-analysis. Methods: A literature search was performed in PubMed, Embase and The Cochrane Library for all studies published up to May 2020 using the key words “cancer”, “tumor”, “carcinoma”, “malignant neoplasm”, “renal cell carcinoma”, “kidney cancer”, “renal cancer” “coffee”, “caffeine” and “beverages”. Additionally, the reference lists of all retrieved articles and previous meta-analysis studies were checked to identify additional studies. From our collection of full-text articles (n=7219) we excluded irrelevant topic articles (n=7125), non-English articles (n=2), systematic reviews or editorial letter (n=46), relevant articles not reporting measure of association (n=9), case-control studies (n=27). Following these exclusions, 10 cohort studies remained. Meta-analyses using a random effects model were conducted for relative risks (RRs) contrasting the highest vs lowest level of coffee intake per day. In addition, meta-analyses were conducted for reported sex-specific findings as well as findings restricted to non-smokers. Between-study heterogeneity was assessed using Cochran Q-statistic and quantified by Higgins I2 statistic. Results: In a meta-analysis of the 10 identified studies, we found a summary RR of 0.88 (95% CI 0.78-0.99) relating the highest study category of coffee intake (vs. the lowest category or non-drinkers) and renal cancer risk, with no significant between-study heterogeneity observed (I2=35%, p = 0.13). The summary RR was comparable for men and women (0.89 and 0.85 respectively). A slightly stronger inverse association was observed among non-smokers (RR 0.78, 95% CI 0.59-1.03), although with moderate evidence of study heterogeneity (I2=62%, p = 0.07). Conclusions: In this meta-analysis of cohort evidence, we observed overall evidence suggestive of a weak inverse association between higher coffee consumption and lower renal cancer risk. Citation Format: Jongeun Rhee, Rachel Lim, Mark P. Purdue. Coffee consumption and risk of renal cell carcinoma: A meta-analysis of cohort evidence [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 843.

Air pollution and retinal vessel diameter and blood pressure in school-aged children in a region impacted by residential biomass burning

Little is known about the early-life cardiovascular health impacts of fine particulate air pollution (PM2.5) and oxidant gases. A repeated-measures panel study was used to evaluate associations between outdoor PM2.5 and the combined oxidant capacity of O3 and NO2 (using a redox-weighted average, Ox) and retinal vessel diameter and blood pressure in children living in a region impacted by residential biomass burning. A median of 6 retinal vessel and blood pressure measurements were collected from 64 children (ages 4–12 years), for a total of 344 retinal measurements and 432 blood pressure measurements. Linear mixed-effect models were used to estimate associations between PM2.5 or Ox (same-day, 3-day, 7-day, and 21-day means) and retinal vessel diameter and blood pressure. Interactions between PM2.5 and Ox were also examined. Ox was inversely associated with retinal arteriolar diameter; the strongest association was observed for 7-day mean exposures, where each 10 ppb increase in Ox was associated with a 2.63 μm (95% CI − 4.63, − 0.63) decrease in arteriolar diameter. Moreover, Ox modified associations between PM2.5 and arteriolar diameter, with weak inverse associations observed between PM2.5 and arteriolar diameter only at higher concentrations of Ox. Our results suggest that outdoor air pollution impacts the retinal microvasculature of children and interactions between PM2.5 and Ox may play an important role in determining the magnitude and direction of these associations.

Umbilical Cord Blood Metal Mixtures and Birth Size in Bangladeshi Children.

Background:Studies have evaluated environmental exposure to toxic metals such as arsenic (As), cadmium (Cd), manganese (Mn), or lead (Pb) on birth size; however, information on potential effects of exposures to metal mixtures is limited.Objectives:We assessed the association between metal mixtures (As, Cd, Mn, Pb) in umbilical cord blood and neonate size in Bangladeshi children.Methods:In this birth cohort study, pregnant women who were of age with an ultrasound-confirmed singleton pregnancy of gestation were recruited from two Bangladesh clinics between 2008 and 2011. Neonate size metrics were measured at the time of delivery. Metals in cord blood were measured using inductively coupled plasma mass spectrometry. We employed multivariable linear regression and Bayesian kernel machine regression (BKMR) to estimate associations of individual metals and metal mixtures with birth size parameters.Results:Data from 1,088 participants was assessed. We found a significant negative association between metal mixture and birth length and head circumference when all metal concentrations were above the 60th and 55th percentiles, respectively, compared with the median. An interquartile range (IQR) increase in log Cd concentration {log[Cd (in micrograms per deciliter)] } was associated with a 0.13-standard deviation (SD) decrease in mean birth length (95% CI: , ) and a 0.17-SD decrease in mean head circumference (95% CI: , ), based on linear regression models adjusted for covariates and the other metals. An IQR increase in log Mn concentration {log[Mn (in micrograms per deciliter)] } was associated with a 0.07-SD decrease in mean birth weight (95% CI: , 0.002).Discussion:Metal mixtures in cord blood were associated with reduced birth size in Bangladeshi children. Results from linear regression models adjusted and the BKMR mixtures analyses suggest adverse effects of Cd and Mn, as individual metal exposures, on birth size outcomes. https://doi.org/10.1289/EHP7502

Effects of Age, Sex, and Obesity on N-Terminal Pro B-Type Natriuretic Peptide Concentrations in the General Population.

Data regarding complex relationships between age, sex, obesity and N-terminal pro B-type natriuretic peptide (NT-proBNP) remain scarce. Thus, we investigated sex-specific associations of obesity and NT-proBNP levels among adults in the general healthy population in Korea. The associations of age, sex and obesity-associated parameters (waist circumference [WC], body mass index [BMI] and body weight) with NT-proBNP were analyzed in 39,937 healthy adult participants. Multivariable regression models adjusted for factors known to affect NT-proBNP were used to identify associations between NT-proBNP and obesity-related parameters. NT-proBNP levels were higher in females than males. Older age was also associated with higher NT-proBNP levels in the overall population (P<0.001). When accounting for age in multivariable linear regression models, there was a strong inverse association between WC, BMI, and NT-proBNP in females and a weaker inverse association in males, with a significant difference between the sexes (P interaction <0.001). After adjusting for the effects of WC and BMI on each other, abdominal obesity was associated with lower NT-proBNP levels in females but not males (P interaction <0.001). In this large sample of young and healthy Asians, younger age, male sex, and increases in obesity-related parameters were related to lower levels of NT-proBNP. Further comprehensive studies are needed to understand the factors affecting NT-proBNP levels in different populations.

Diet as a possible influencing factor in thyroid cancer incidence: the point of view of the nutritionist.

The incidence of differentiated thyroid cancer has increased in the last decades all over the world. Different environmental factors are possible perpetrators of this exponential growth. Nutritional factors are among the main environmental factors studied for thyroid cancer in recent years. This review aims to overview the main dietary factors involved in thyroid cancer risk, providing specific nutrition recommendations from the endocrinological Nutritionist point of view. Among the single food, fish and shellfish are the primary natural source of iodine, selenium and vitamin D in the human diet. These nutrients are essential for the synthesis of thyroid hormones; however, their consumption is not consistently related to thyroid cancer risk. The high intake of fruit and vegetables, probably due to their vitamin and antioxidant content, shows a weak inverse association with thyroid cancer risk. Alcohol, meat, or other food groups/nutrients showed no significant effect on thyroid cancer. In conclusion, to date, no definite association among dietary factors, specific dietary patterns, and thyroid cancer, and its clinical severity and aggressiveness have been found. However, it is essential to underline that in the future, prospective studies should be carried out to precisely evaluate the qualitative and quantitative intake of nutrients by patients to establish with more confidence a potential correlation between food intake and the occurrence and development of thyroid cancer.

Parental Education and Children’s Sleep Problems: Minorities’ Diminished Returns

Background and aims: While increased parental education reduces children’s sleep problems, less is known about racial variation in such protection. According to Minorities’ Diminished Returns (MDRs) theory, economic resources such as parental education show weaker health effects for minority groups such as Blacks and Latinos than non-Latino Whites, which is due to racism and social stratification. In this study, we investigated the association between parental education and children’s sleep problems, as a proxy of sleep problems, by race. Methods: This cross-sectional study included 11718 American children aged 9-10. All participants were recruited to the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was parental education, a five-level nominal variable. The dependent variable – sleep problems, was a continuous variable. Race/ethnicity was the effect modifier. Age, sex, and marital status were the covariates. Mixed-effects regression models were used for data analysis. Results: Parental education was associated with children’s sleep problems. However, there was a weaker inverse association seen in non-Latino Black and Latino families compared to non-Latino White families. This was documented by a significant statistical interaction between race and ethnicity and parental education on children’s sleep problems. Conclusion: Diminished protective effect of parental education on children’s sleep problems for non-Latino Black and Latino families compared to non-Latino White families is similar to the MDRs in other domains. Worse than expected sleep may contribute to higher-than-expected health risks of middle-class Black and Latino children.

Two-Year Responses of Heart Rate and Heart Rate Variability to First Occupational Lead Exposure.

[Figure: see text].

Understanding the relationship between positive and negative social support and the quality of life among African American breast cancer survivors.

Social support improves several quality of life (QOL) domains among African American breast cancer survivors. How different dimensions of social support are associated with QOL among African American breast cancer survivors may howeverdiffer from other populations. This study explores this hypothesis by examining associations of positive social support (supportive interactions that promote affection) and negative social support (non-supportive interactions wherein the provider of support may not have the best intended actions) with QOL among Chicago-based African American breast cancer survivors. Study participants were eligible if they (1) were identified as being an African American female, (2) were at least 18 years of age or older, and (3) were diagnosed with breast cancer during or after navigation was implemented at the study hospital. Participants completed validated questionnaires via telephone or in-person interviews. Among our sample of 100 participants, positive support was associated with greater mental well-being in non-imputed (Std β=1.60, CI: 0.51, 2.69, p= 0.004) and imputed models (Std β= 1.67, CI: 0.68, 2.73, p=0.001). There was also a weaker inverse association with negative support and mental well-being when using non-imputed data (Std β=-0.82, CI:-1.65, 0.02, p= 0.05). Our findings suggest that positive support, in particular, is highly influential for improving mental well-being among African American breast cancer survivors. Simultaneously, negative support appears to be an independent, albeit weaker, determinant of mental well-being.

Lifetime alcohol intake, drinking patterns over time and risk of stomach cancer: A pooled analysis of data from two prospective cohort studies.

Alcohol consumption is causally linked to several cancers but the evidence for stomach cancer is inconclusive. In our study, the association between long‐term alcohol intake and risk of stomach cancer and its subtypes was evaluated. We performed a pooled analysis of data collected at baseline from 491 714 participants in the European Prospective Investigation into Cancer and Nutrition and the Melbourne Collaborative Cohort Study. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for incident stomach cancer in relation to lifetime alcohol intake and group‐based life course intake trajectories, adjusted for potential confounders including Helicobacter pylori infection. In all, 1225 incident stomach cancers (78% noncardia) were diagnosed over 7 094 637 person‐years; 984 in 382 957 study participants with lifetime alcohol intake data (5 455 507 person‐years). Although lifetime alcohol intake was not associated with overall stomach cancer risk, we observed a weak positive association with noncardia cancer (HR = 1.03, 95% CI: 1.00‐1.06 per 10 g/d increment), with a HR of 1.50 (95% CI: 1.08‐2.09) for ≥60 g/d compared to 0.1 to 4.9 g/d. A weak inverse association with cardia cancer (HR = 0.93, 95% CI: 0.87‐1.00) was also observed. HRs of 1.48 (95% CI: 1.10‐1.99) for noncardia and 0.51 (95% CI: 0.26‐1.03) for cardia cancer were observed for a life course trajectory characterized by heavy decreasing intake compared to light stable intake (P homogeneity = .02). These associations did not differ appreciably by smoking or H pylori infection status. Limiting alcohol use during lifetime, particularly avoiding heavy use during early adulthood, might help prevent noncardia stomach cancer. Heterogeneous associations observed for cardia and noncardia cancers may indicate etiologic differences.

Associations for preschool environmental quality with outdoor time and moderate-to-vigorous physical activity in Norwegian preschools

Various aspects of the preschool environment may either promote or restrict children’s moderate- to-vigorous physical activity (MVPA), for example through opportunities for outdoor play. The aim of the present study was to determine associations for preschool environmental quality with outdoor time and MVPA in preschoolers. In total, 358 Norwegian 2–6-year-old children had 1–3 valid 14-day periods of accelerometer-determined MVPA (ActiGraph GT3X+) and corresponding logs of preschool outdoor time collected during 2015–2016. The children were enrolled in 30 different preschool departments for which we assessed environmental quality using the Early Childhood Environment Rating Scale-Revised (ECERS-R). Associations for preschool quality with outdoor time and MVPA were determined using multivariate pattern analysis. We found strong inverse associations between preschool quality and outdoor time (51.4 % explained variance), and weak inverse associations between preschool quality and MVPA (5.4 % explained variance). Associations were strongest for the “Space and Furnishings”, “Personal Care Routines”, “Language-Reasoning”, and “Interaction” subscales of ECERS-R, in particular for aspects of safety practices. Children enrolled in departments rated as high quality spent less time outdoors and less time in MVPA. Thus, recognized quality aspects of preschool environments, in particular safety practices, might restrict children’s movement opportunities.

American Children's Screen Time: Diminished Returns of Household Income in Black Families.

While increased household income is associated with overall decreased screen time for children, less is known about the effect of racial variation on this association. According to Minorities' Diminished Returns (MDRs) theory, family income and other economic resources show weaker association with children's developmental, behavioral, and health outcomes for racialized groups such as black families, due to the effect of racism and social stratification. In this study, we investigated the association, by race, between family income and children's screen time, as a proxy of screen time. This longitudinal study followed 15,022 American children aged 9-11 over a 1-year period. The data came from the baseline of the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was family income, and it was categorized as a three-level nominal variable. The dependent variable, screen time, was a continuous variable. Ethnicity, gender, parental education, and marital status were the covariates. The results showed that family income was inversely associated with children's screen time. However, there was a weaker inverse association seen in black families when compared with white families. This was documented by a significant statistical interaction between race and family income on children's screen time. Diminished association between family income and children's screen time for black families, compared with white families, is similar to MDRs and reflects a health risk to high-income black children. In a society where race and skin color determine opportunities and treatment by society, children from middle class black families remain at risk across multiple domains. We should not assume that income similarly promotes the health of all racial and ethnic groups. Addressing health and behavioral inequalities requires interventions that go beyond equalizing socioeconomic resources for black families. Marginalization, racism, and poverty interfere with the normal family income-related development of American children.

Association Between Alzheimer Disease and Cancer With Evaluation of Study Biases

Observational studies consistently report inverse associations between cancer and Alzheimer disease (AD). Shared inverse etiological mechanisms might explain this phenomenon, but a systematic evaluation of methodological biases in existing studies is needed. To systematically review and meta-analyze evidence on the association between cancer and subsequent AD, systematically identify potential methodological biases in studies, and estimate the influence of these biases on the estimated pooled association between cancer and AD. All-language publications were identified from PubMed, Embase, and PsycINFO databases through September 2, 2020. Longitudinal cohort studies and case-control studies on the risk of AD in older adults with a history of any cancer type, prostate cancer, breast cancer, colorectal cancer, or nonmelanoma skin cancer, relative to those with no cancer history. Two reviewers independently abstracted the data and evaluated study biases related to confounding, diagnostic bias, competing risks, or survival bias. Random-effects meta-analysis was used to provide pooled estimates of the association between cancer and AD. Metaregressions were used to evaluate whether the observed pooled estimate could be attributable to each bias. The study was designed and conducted according to the Preferring Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Incidence, hazard, or odds ratios for AD comparing older adults with vs without a previous cancer diagnosis. In total, 19 cohort studies and 3 case-control studies of the associations between any cancer type (n = 13), prostate cancer (n = 5), breast cancer (n = 1), and nonmelanoma skin cancer (n = 3) with AD were identified, representing 9 630 435 individuals. In all studies combined, cancer was associated with decreased AD incidence (cohort studies: random-effects hazard ratio, 0.89; 95% CI, 0.79-1.00; case-control studies: random-effects odds ratio, 0.75; 95% CI, 0.61-0.93). Studies with insufficient or inappropriate confounder control or greater likelihood of AD diagnostic bias had mean hazard ratios closer to the null value, indicating that these biases could not explain the observed inverse association. Competing risks bias was rare. Studies with greater likelihood of survival bias had mean hazard ratios farther from the null value. The weak inverse association between cancer and AD may reflect shared inverse etiological mechanisms or survival bias but is not likely attributable to diagnostic bias, competing risks bias, or insufficient or inappropriate control for potential confounding factors.

Cross-Sectional Associations of Plasma Per- and Polyfluoroalkyl Substances with Kidney Function among Pre-Diabetic Adults-Report from the Diabetes Prevention Program

Background: Exposure to per- and polyfluoroalkyl substances (PFAS) has been linked with kidney cancer and reduced kidney function, but findings for plasma PFAS concentrations and kidney function are inconsistent. We evaluated cross-sectional associations of plasma concentrations of 6 PFAS [perfluorooctane sulfonate, perfluorooctanoate (PFOA), perfluorohexane sulfonate, N-ethyl-perfluorooctane sulfonamido acetate (EtFOSAA), N-methyl-perfluorooctane sulfonamido acetate, and perfluorononanoate] with estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR) among prediabetic adults at risk for kidney disease. Methods: We used baseline data from the Diabetes Prevention Program (enrolled 1996-1999) and applied linear regression to estimate associations between plasma PFAS concentrations (log-2 transformed) with eGFR and ACR. We accounted for sex, age, race, marital status, income, smoking, menopause status, medication use, and diet score in the models, and tested for effect modification by sex and hypertension status. Results: Plasma PFAS concentrations of 925 overweight or obese adults (64.9% female, 57.8% non-Hispanic White) and those among the U.S. population were similar. Mean kidney functions were normal (eGFR: 97.3 ± 15.5 ml/min/1.73m2; ACR: 11.2 ± 30.5). We found no significant associations between PFAS concentrations and eGFR but detected inverse associations of EtFOSAA [β: -3.7 (95% CI: -7.1, -0.3)] and PFOA [(β: -6.4 (95% CI: -12.3, -0.1)] with ACR. We observed potential effect modification by hypertension status (inverse associations among those with hypertension but positive associations among those without hypertension), but none of the effect estimates were statistically significant. Conclusions: We observed weak inverse associations between plasma concentrations of some PFAS with ACR, suggesting higher plasma PFAS concentrations are associated with lower microalbumin ratio in the urine, thus better kidney function. Our main limitation is the potential for reverse causation due to the cross-sectional nature of the data. Longitudinal studies are needed to establish temporality of associations.

Dietary patterns generated by the Treelet Transform and risk of stroke: a Danish cohort study.

To relate empirically derived dietary patterns identified using the Treelet Transform (TT) to risk of stroke. A prospective cohort study using the Danish Diet, Cancer and Health cohort. Dietary information was obtained in 1993-1997 using a validated semi-quantitative FFQ. Incident stroke diagnoses, obtained from the Danish National Patient Register, were verified by record review. Dietary patterns were generated using TT, and participants were categorised into quintiles based on their adherence to each pattern. Sex-specific Cox proportional hazard models estimated associations between dietary patterns and stroke. Denmark. 55 061 men and women aged 50-64 years at the time of enrolment. Three dietary patterns explaining 15·4 % of the total variance were identified: a Prudent pattern, a Western pattern and a Wine & Snacks pattern. During a follow-up time of 10 years, 1513 cases occurred. Comparing the highest to lowest quintiles of intake, adherence to a Prudent pattern was inversely associated with stroke (HRmen 0·74, 95 % CI 0·60, 0·91; HRwomen 0·82, 95 % CI 0·62, 1·08), while adherence to a Western pattern was associated with greater risk (HRmen 1·61, 95 % CI 1·23, 2·10; HRwomen 2·01, 95 % CI 1·48, 2·72). No association was found for a Wine & Snacks pattern for women, but a weak inverse association was found for men (HR 0·81, 95 % CI 0·67, 0·99). The results of this study are broadly in line with current recommendations for a healthy diet to prevent stroke.