Using college alumni populations in epidemiologic research: the UNC Alumni Heart Study.

The UNC Alumni Heart Study (UNCAHS) is a prospective study of the role of psychosocial factors, in particular hostility, in the development of coronary heart disease. The target population is composed of persons who completed the Minnesota Multiphasic Personality Inventory while attending the University of North Carolina in the mid-1960s. Logistic regression analyses were used to determine whether hostility, demographic and other variables were significant determinants of the subjects' locatability and participation. It was found that MMPI hostility scores at initial testing were unrelated to either potential or actual locatability or participation. Thus there is no evidence that hostility is the source of selection bias in the UNCAHS. Selection into the study was predicted by age, sex, degree status and variables concerned with the conditions under which the MMPI was administered. It is concluded that follow-up studies of college cohorts may have study-specific sources of selection bias.     

Measurement of dietary intake in the UNC Alumni Heart Study. University of North Carolina

BACKGROUND: Research needs to identify diet and disease associations to provide direction about effecting change in individuals with dietary behaviors that increase risk of chronic disease. Inclusion of dietary assessment in the University of North Carolina Alumni Heart Study (UNCAHS) provides the opportunity to prospectively investigate dietary intake and chronic disease associations with measures of personality and behavioral risk factors. METHODS: Development of the UNCAHS food frequency questionnaire and nutrient intake of 4,443 middle-aged men and women is provided stratified by total fat and vitamin A intake within demographic and health behavior categories. RESULTS: Alumni consume diets close to that recommended by current dietary guidelines. Both men and women have low calcium intake. Thirty-nine percent of the alumni consume diets with 30% of kilocalories from fat or less and 88% meet the RDA for vitamin A. Never smokers had lower fat diets and greater intakes of vitamin A than former or current smokers. Over 54% of alumni currently took vitamin/mineral supplements. CONCLUSIONS: UNCAHS participants will be tracked as they approach older ages with apparently less risk for diet-related chronic diseases than many Americans. The psychosocial correlates of these eating behaviors will be evaluated as disease endpoints occur.     

Alcoholic beverage preference and risk of becoming a heavy drinker

BACKGROUND: Studies have suggested that wine drinkers are at lower risk of death than beer or spirits drinkers. The aim of this study is to examine whether the risk of becoming a heavy or excessive drinker differs among individuals who prefer different types of alcoholic beverages. METHODS: In a longitudinal study of 10,330 moderate drinkers from Copenhagen, Denmark, we used logistic regression analyses to address the risk of becoming a heavy or excessive drinker (above 14 and 21 drinks per week, respectively, for women and above 21 and 35 drinks per week for men) according to preference of wine, beer, or spirits. RESULTS: Compared with those who preferred wine, those who preferred beer tended to have increased risk of becoming heavy and excessive drinkers. Women who preferred beer had odds ratios of 1.14 (95% CI = 0.87-1.50) for becoming heavy drinkers and 1.50 (95% CI = 0.93-2.43) for becoming excessive drinkers. For men who preferred beer the ORs were 1.16 (95% CI = 0.84-1.58) and 1.81 (95% CI = 0.85-3.82). CONCLUSION: The finding that moderate wine drinkers appear to be at lower risk of becoming heavy and excessive drinkers may add to the explanation of the reported beverage-specific differences in morbidity and mortality.     

Hydration,water intake and beverage consumption habits among adults

Total water intake is seldom reported in dietary surveys and hydration status is rarely measured. Although adequate intake (AI) levels have been suggested by the European Food Safety Authority, the World Health Organization and the Institute of Medicine, uncertainties and confused messages abound regarding optimum intake. This paper reviews data on water intake internationally and examines associations with beverage consumption habits of adults in the UK, as determined from secondary analysis of individual diet records. On average, total water intake among British adults was equivalent to the European AI (2 l/day for women, 2.5 l/day for men) and 75% of this was derived from beverages. Factors that correlated with high total water intake included the consumption of a variety of beverages and drinking in the evening. Total water intake (and the contribution from soft drinks) is markedly higher in the USA than in Europe. Beverage consumption habits and trends were also reviewed. In the past 10 years, water beverages have become more popular and as such the overall energy contribution from beverages has declined slightly. Most people could be encouraged to drink a variety of beverages to maintain adequate hydration and to balance the energy content according to their needs. However, further work is needed to refine recommendations for water intake, as basing these on observational epidemiological data is essentially a circular argument. A standardized measurement tool, validated against biomarkers of hydration status, would be a step forward in assessing the adequacy of water intakes at a population level. Research may also be warranted to explore the context of drinking occasions (including time of day, weekdays weekends, lifestyle and meal patterns) as these may have an impact on water intake, hydration and also energy balance.     

The effects of well ness program attendance on physiologic measures, health practices and diet habits

An impact evaluation was conducted on a 22-week wellness programimplemented in a public school district where 257 employeesvoluntarily completed the program. Impact of the program wasestimated with a one-group pre-test/post-test design. Whilemost measurements showed significant improvements for the totalparticipants, analyses based on people with measurements beyondnormal limits during pre-test evaluation (people at higher risk)showed even greater improvements. Across the risk factors examined,21–91% of the people at higher risk changed thenelevatedmeasurements to within a normal range. Multiple regression analysesshowed that higher program attendance was only significantlyassociated with increased exercise time, better improved diethabits and higher employee satisfaction. Possible confoundingfactors commonly associated with wellness program evaluationare discussed. These include possible selection bias, contaminatingactivities, small sample size and short response time.     

Alcoholic beverage consumption and the risk of endometrial cancer. Cancer and Steroid Hormone Study Group

Previous studies have suggested that alcoholic beverage consumption may lead to a decrease in a woman's oestrogen levels. It is possible that any such alcohol-associated decrease could lead to a decrease in endometrial cancer risk. To study the association between alcohol consumption and endometrial cancer, we examined data from the Cancer and Steroid Hormone Study, a multi-centre, population based, case-control study. A total of 351 women with primary epithelial endometrial cancer and 2247 women selected from the same geographical areas as the cases were interviewed for the study. As part of the interview, the participants provided information regarding their alcohol consumption during the preceding five years. Analysis of these data revealed that women who were non-drinkers had a risk of endometrial cancer of 1.83 relative to the risk of women who had consumed an average of 150 grams or more of alcohol per week (95% Cl, 1.11, 3.01). Women who drank, but who consumed less than 150 grams of alcohol per week, were at an intermediate risk. The increased risk associated with abstinence from alcohol consumption was particularly great in overweight women and was virtually absent in lean women. These results argue that alcohol ingestion may reduce a woman's risk of endometrial cancer, particularly if she is overweight.     

Alcoholic beverage consumption and breast cancer in a French case-control study

An association between regular consumption of alcohol with meals and breast cancer was found in a French case-control study of 1,010 women with breast cancer and 1,950 women with nonmalignant diseases; the relative risk of breast cancer for women drinking alcoholic beverages with meals compared with nondrinkers was 1.47 (p = 10(-4) allowing for classical risk factors. Detailed information on alcohol consumption was obtained from 500 cases and 945 controls; the risks of breast cancer were greater for women drinking beer and for women drinking wine than for nondrinkers, and the risk increased with the amount of beer, of wine and of total alcohol consumption in grams of pure alcohol.     

飞行员饮食生活习惯调查与健康管理模式探讨

目的了解飞行员生活方式及饮食习惯方面存在的问题,提出有针对性的飞行员健康管理建议。方法采用问卷调查方法对飞行员进行健康知识掌握情况、饮食习惯和生活方式调查,统计分析采用SPSS 11.5统计软件进行。结果平均知识得分38.87±9.35。不良生活饮食习惯从高往低排位是:肉类摄入超量(90.28%),水果摄入不足(63.89%),经常饮酒(61.57%),吸烟(57.41%),蔬菜摄入不足(53.70%),经常吃夜宵(41.20%),经常去饭店聚餐(32.87%),常吃非健康食品(31.02%),奶制品摄入不足(28.70%),喜食油腻(27.78%),常喝含糖饮料(21.76%),鱼摄入不足(19.44%),豆制品摄入不足(12.50%)。结论飞行员存在不良生活方式和饮食习惯,健康知识缺乏。应加强健康教育,采取综合管理措施,改变不良的生活方式和饮食习惯。     

Recruitment issues, health habits, and the decision to participate in a health promotion program

To understand the external validity of experimental studies, it is important to estimate the extent to which the participants are representative of the general population. This paper describes recruitment methods and considers the representativeness of participants in the San Diego Family Health Project. The study was designed to experimentally evaluate the effectiveness of a family-based behavior change intervention in Anglo and Mexican-American families. Initial contact with the families was made through a household health survey that was sent home with all fifth- and sixth-grade children in 12 participating elementary schools. The survey asked about a variety of demographic characteristics, dietary habits, and physical activity habits. Parents were also asked if they were interested in participating in the project. Respondents were classified by level of participation into one of three groups: not interested, expressed initial interest but did not attend the recruitment meeting, and volunteered to participate. Level of participation was the independent variable in the analyses. In separate analyses for Anglo and Mexican-American responders, our data suggested many similarities and a few differences among participant groups. The differences that were observed suggest that participants may already have healthier diets than nonparticipants, although only one of four dietary variables differed by participation status in each ethnic group. The external validity of these data and general recruitment issues are discussed.     

体力活动、膳食和吸烟行为的环境影响因素

目前对缺乏体力活动、不健康膳食、吸烟等3种慢性病行为危险因素的干预仍集中在个体水平,效果通常有限。从社会关系、支持环境、宏观政策等多水平进行干预已越来越受到重视。但目前这种综合策略的制定和实施面临着种种困难,相关证据的数量和效力不足是其中一个原因。本文主要对目前研究较多的与3种行为有关的环境影响因素（自然环境、建成环境、社会环境）进行介绍,综述它们对行为造成的影响以及研究现状,对今后类似研究的开展有重要意义。     

The Troms? Heart Study: food habits, serum total cholesterol, HDL cholesterol, and triglycerides

Associations between food habits and total serum cholesterol, high density lipoprotein (HDL) cholesterol, and serum triglycerides were examined in 7,410 men and 7,257 women in Troms?, Norway, following a screening in 1979-1980. High body mass index was associated with high serum cholesterol, high triglycerides, and low HDL cholesterol. Positive associations were observed between high serum cholesterol and high coffee consumption, use of butter or hard margarine, not selecting low-fat milk, and low bread consumption. The HDL cholesterol level was virtually independent of the dietary items recorded. Use of low-fat milk and frequent use of fish dishes for dinner seemed to be related to low serum triglyceride levels.     

Self-determination,smoking, diet and health

A Clinical Trial will test (1) a Self-Determination Theory (SDT) model of maintained smoking cessation and diet improvement, and (2) an SDT intervention, relative to usual care, for facilitating maintained behavior change and decreasing depressive symptoms for those who quit smoking. SDT is the only empirically derived theory which emphasizes patient autonomy and has a validated measure for each of its constructs, and this is the first trial to evaluate an SDT intervention. Adult smokers will be stratified for whether they are at National Cholesterol Education Program (1996) recommended goal for low-density lipoprotein cholesterol (LDL-C). Those with elevated LDL-C will be studied for diet improvement as well as smoking cessation. Six-month interventions involve a behavior-change counselor using principles of SDT to facilitate autonomous motivation and perceived competence for healthier behaving. Cotinine-validated smoking cessation and LDL-C-validated dietary recall of reduced fat intake, as well as depressive symptoms, will be assessed at 6 and 18 months. Structural equation modeling will test the model for both behaviors within the intervention and usual-care conditions.     

Sedentary habits, health, and function in older women and men

PURPOSE: To evaluate the relation of physical activity and cardiorespiratory fitness to morbidity, mortality, and functional limitations in older persons. DATA SOURCES: We reviewed published reports related to the review's purpose. Sources were identified from recent major reports and position statements from scientific and public health organizations, our files, and reference lists of published papers. STUDY INCLUSION AND EXCLUSION CRITERIA: We included prospective epidemiological studies and clinical trials published in the peer-reviewed literature that included data from age groups of people 60 years and older. We evaluated study methods and included studies that used valid measures of exposures, clearly specified outcomes, and controlled for confounders. DATA EXTRACTION METHODS: We extracted by detailed review data on sample characteristics, outcomes, and rates and relative risks. DATA SYNTHESIS: Extracted data were included in tables, figures, or the text and were synthesized by nonquantitative methods. MAJOR CONCLUSIONS: Active and fit individuals were at much lower risk for morbidity, mortality, and loss of function when compared with sedentary and unfit persons. Data from the studies generally conformed to a steep inverse dose-response gradient across activity or fitness categories. Results were consistent, temporally appropriate, strong, and graded, and therefore support a causal hypothesis that a fit and active way of life improves health and function in older individuals.     

Time preference,duration and health state valuations

There is increasing interest in health status measurement and the relative weights that people attach to different states of health and illness. One important issue which has been raised is the effect that the time spent in a health state may have on the way that state is perceived. Previous studies have suggested that the worse a state is, the more intolerable it becomes as it lasts longer. However, for most of these studies, it is impossible to determine how much of what was observed is attributable to the time spent in the state and how much is attributable to when it was occurring. This paper reports on a pilot study designed to test the feasibility of using the Time Trade-Off (TTO) method to isolate the effect of pure time preference from the effect of duration per se. Interviews were conducted with 39 members of the general population who were asked to rate 5 health states for durations of one month, one year and ten years. In aggregate, rates of time preference were very close to zero which suggests that the implicit assumption of the TTO method that there is no discounting may be a valid one. However, that more respondents had negative (rather than positive) rates, casts some doubt on the axioms of discounted utility theory. In addition, implied valuations for states lasting for short periods were often counter-intuitive which questions the feasibility of using the TTO method to measure preferences for temporary health states.     

保定市农村老年人饮食行为习惯与虚弱的关系

目的 探讨农村老年人饮食行为习惯与其躯体虚弱和精神虚弱的关系。方法 采取整群抽样方法抽取保定农村地区191名老年人。结果 PHYFI随年龄增长增加,MNTFI随年龄增长降低,男女间差异均有统计学意义（均有P<0.05）。饮食行为中“经常食用水果蔬菜”比例最高,占76.96%;饮食习惯中“喜好食肉食”比例最高,占53.93%。多因素分析显示,是否喜好咸食与农村老年人躯体虚弱有关,是否经常食用水果蔬菜、是否喜好咸食和是否喜好肉食与农村老年人精神虚弱有关。结论 经常食用水果蔬菜、喜好肉食、不喜好咸食的农村老年人躯体健康、心理健康水平更高。