健康生活方式对代谢综合征发病影响的队列研究北大核心

目的探讨健康生活方式对代谢综合征(MS)发病风险的影响,为MS的生活方式干预提供参考依据。方法数据来源于贵州省自然人群队列研究,在基线调查的9280人中,排除不符合纳入标准、失访及死亡人数,最终将4663人纳入分析。对8种健康生活方式:从不吸烟、从不饮酒、蔬菜水果摄入≥400 g/d、烹调油摄入≤30 g/d、食盐≤6 g/d、静坐时间<6 h/d、睡眠时间7~8 h/d、(18.5≤BMI<24)kg/m^(2)进行组合分析,研究健康生活方式与MS之间的关系。采用SPSS 23.0统计软件进行χ^(2)检验、Cox模型评估MS发病风险,以0~3种健康生活方式为参照组,计算各组风险比(HR)及95%CI值。结果单个健康生活方式与MS发病关联的分析结果发现,从不吸烟、从不饮酒、摄入低油低盐及正常BMI与MS发病的风险均呈负相关关系,未发现睡眠时间、静坐时间及蔬菜水果摄入与MS有关。但通过任意组合多种健康生活方式进行分析发现,在全人群中,与0~3种相比,保持5、6及7种以上健康生活方式的人群发生MS的风险分别为HR:0.760(95%CI:0.627~0.921)、HR:0.600(95%CI:0.485~0.742)及HR:0.541(95%CI:0.413~0.707)。BMI是影响MS的主要关联因素,其次是盐摄入及静坐时间。结论多种健康生活方式的协同作用能有效降低MS的发病风险,健康生活方式越多,风险越小。     

中国10个地区成年人慢性肾脏病流行情况及其生活方式影响因素

目的描述中国慢性病前瞻性研究(CKB)项目人群的慢性肾脏病(CKD)分布, 分析生活方式与CKD发病风险的前瞻性关联。方法数据来源于CKB基线调查及随访监测(截至2018年12月31日), 描述CKD发病的地区和人群分布差异, 使用Cox比例风险回归模型分析生活方式因素与CKD的关联。结果研究纳入505 147名研究对象, 平均随访11.26年, 期间共有4 920例发病病例, 发病率为83.43/10万人年, 肾小球肾病为最主要亚型。CKD发病率在城市、男性、年龄≥60岁人群中更高, 分别为87.83/10万人年、86.37/10万人年、132.06/10万人年。相比于从不或偶尔吸烟者, 当前吸烟男性CKD风险增加(HR=1.18, 95%CI:1.05～1.31)。以非肥胖人群为参照组, 由BMI判定的全身性肥胖(HR=1.19, 95%CI:1.10～1.29)和腰围判定的中心性肥胖(HR=1.27, 95%CI:1.19～1.35)均与更高的CKD发病风险相关。结论 CKB项目人群CKD发病率存在明显的地区和人群差异, 且其发病风险受到生活方式多因素的影响。     

四川省30~79岁人群辣食摄入特征及与肥胖的关系

目的分析四川省彭州市成年人辣食摄入特征以及辣食与肥胖的关系,为慢性病预防控制和卫生决策提供科学依据。方法数据来源于中国慢性病前瞻性研究(China Kadoorie Biobank,CKB)项目四川省彭州市基线调查数据。于2004—2008年在四川省彭州市15个乡镇共完成55687名30~79岁常住居民的基线调查。调查内容包括问卷调查、体格测量和血样样本检测等内容,描述人群中辣食摄入、肥胖患病情况等。采用SAS 9.4和Excel 2013进行t检验、χ²检验和趋势χ²检验,采用非条件logistic回归分析辣食因素与肥胖的关系。结果彭州市人群辣食摄入率为77.66%,随年龄的增加呈递减趋势(P<0.05)。开始摄入辣食年龄为9.2岁,摄入时间以30~49年最多(64.36%)。同时摄入2种及以上辣食人群占97.51%。辣食摄入组肥胖患病率(8.56%)高于辣食非摄入组(7.25%),患病率随着辣食摄入频率增加呈上升趋势(P<0.05)。与不摄入辣食相比,女性和全人群辣食摄入与患肥胖高风险相关(OR值分别为1.24和1.19),均有统计学意义(P<0.05);而男性辣食摄入与患肥胖无关,无统计学意义(P>0.05)。女性和全人群每天或几乎每天摄入辣食(OR值分别为1.29和1.23),吃辣强度为中、高(女性OR值分别为1.11和1.38,全人群OR值分别为1.10和1.26),同时摄入辣食种类为5种(女性和全人群OR值分别为1.56和1.28)与患肥胖高风险相关,随着辣食摄入时间增加,OR值上升,50~59年组OR值最大(女性和全人群OR值分别为1.48和1.32),均有统计学意义(P<0.05)。结论四川省彭州市居民辣食摄入率较高,开始摄入辣食年龄小,摄入时间长,且以混合食用多种辣食为主。在总人群和女性中,辣食摄入频率、吃辣强度、摄入辣食种类与肥胖风险增加有关,在男性中未发现此种关联。     

北京60岁及以上老年人吸烟状况与死亡风险的关联研究

目的分析北京城乡老年人群吸烟状况与相关死亡风险间的关联。方法基于北京城乡老年人群健康综合研究2009—2014年的队列数据, 纳入符合标准的60岁及以上老年人群4 499名, 随访其生存与死亡结局。采用Cox比例风险模型分析吸烟状态、吸烟指数、戒烟年数与死亡风险间的关联。结果 4 499名研究对象年龄M(IQR)为70.00(10.00)岁, 其中男性1 814名(40.32%);从不吸烟者、戒烟者和现在吸烟者分别有69.50%(3 127/4 499)、13.20%(594/4 499)和17.30%(778/4 499)。多因素Cox回归分析结果显示, 调整人口社会学特征、生活方式等混杂因素后, 以从不吸烟者为参照, 戒烟者全因死亡风险增加30.6%[HR(95%CI):1.306(1.043～1.636)];现在吸烟者全因、恶性肿瘤和肺癌死亡风险的HR(95%CI)分别增加50.0%[HR(95%CI):1.500(1.199～1.877)]、80.3%[HR(95%CI):1.803(1.226～2.652)]和212.6%[HR(95%CI):3.126(1.626～6.01...     

辛辣食物摄入增加超重和肥胖的风险

目的探究人群中辛辣食物摄入与超重和肥胖的关系,为肥胖膳食预防提供理论依据。方法本研究数据来自中国慢性病前瞻性研究(China Kadoorie Biobank,CKB)哈尔滨市2004—2008年的横断面人群,采用整群随机抽样方法纳入57 555名30～79岁(男性23 254人,女性34 301人)研究对象。通过面对面问卷调查获得人口学信息及吸烟、饮酒等生活习惯信息,采用食物频率问卷获取各类食物包括辛辣食物摄入信息,体格检查获得身高、体重等指标,并应用Logistic回归方法分析辛辣食物摄入及其与偏爱肉食/素食膳食习惯的交互作用对超重与肥胖风险的影响。结果与摄入辛辣食物频率低的人群相比,摄入辛辣食物频率高的人群超重和肥胖的风险在男性中增加了29%(OR=1.285,95%CI 1.251～1.319,P<0.001),在女性中增加了33%(OR=1.329,95%CI 1.294～1.364,P<0.001)。与摄入微辣食物的人群相比,摄入极辣食物人群男女超重和肥胖的风险分别增加了20%(OR=1.198, 95%CI 1.137～1.259,P=0.011)和19%(OR=1.194, 95%CI 1.141～1.247,P=0.003)。在男性人群中,偏好肉食,且辛辣食物摄入频率及程度高的人群,超重和肥胖的风险最高,偏好肉食/素食的膳食习惯与辛辣食物摄入两因素间存在交互作用(P<0.001)。结论辛辣食物的摄入可能增加超重和肥胖的风险,同时减少辛辣食物和肉食的摄入可能能够更有效地预防超重和肥胖。     

苏州队列人群慢性阻塞性肺疾病发病状况及其危险因素研究

目的了解苏州队列人群慢性阻塞性肺疾病(COPD)的发病状况及人群分布特征, 探索其发病的危险因素, 为防控COPD提供科学依据。方法基于中国慢性病前瞻性研究苏州市吴中区项目点数据, 剔除基线气流受限及基线调查时自报患有慢性支气管炎/肺气肿/肺心病的个体后, 最终纳入分析45 484人。采用Cox比例风险回归模型筛选影响队列人群COPD发病的危险因素并计算风险比(HR)及其95%可信区间(CI), 同时分析吸烟在其他危险因素与COPD发病关联中是否存在效应修饰作用。结果截至2017年12月31日, 研究对象中位随访时间为11.12年, 随访期间共诊断COPD 524人, COPD的发病密度为105.54/10万人年。多因素Cox比例风险回归分析显示, 年龄(HR=3.78, 95%CI:3.32～4.30)、曾经吸烟(HR=2.00, 95%CI:1.24～3.22)、当前吸烟(<10支/d, HR=2.14, 95%CI:1.36～3.35;≥10支/d, HR=2.69, 95%CI:1.60～4.54)、有呼吸系统疾病史(HR=2.08, 95%CI:1.33～3.26)、每...     

咖啡摄入与东亚人群恶性肿瘤死亡风险关联的Meta分析

目的分析咖啡摄入与东亚人群恶性肿瘤死亡风险的关联。方法检索中国知网、万方数据知识服务平台、维普中文科技期刊数据库和Pub Med,收集建库至2018年12月10日国内外发表的有关亚洲人群咖啡摄入与恶性肿瘤死亡风险关联研究的文献;采用Stata 15.0软件对纳入的文献进行分类Meta分析和剂量-反应Meta分析。结果共检索到相关文献335篇,最终纳入分析5篇,其中4篇研究日本人群,1篇研究新加坡华人人群,总样本量为361 802人,恶性肿瘤死亡17 664例。咖啡摄入降低东亚人群的恶性肿瘤死亡风险(RR=0.93,95%CI:0.87～0.99);其中咖啡摄入与东亚男性恶性肿瘤死亡风险未见统计学关联(RR=0.94,95%CI:0.77～1.15),但可使东亚女性恶性肿瘤死亡风险下降12%(RR=0.88,95%CI:0.81～0.95)。恶性肿瘤死亡风险总体随咖啡摄入量增加呈降低趋势,每天饮1.5杯咖啡,恶性肿瘤死亡风险最低(RR=0.92,95%CI:0.86～0.98)。结论咖啡摄入可以降低东亚人群恶性肿瘤死亡风险,这种保护作用对女性更为明显;每天饮1.5杯咖啡,恶性肿瘤的死亡风险最低。     

海南省成年人吸烟与心血管疾病发病风险的前瞻性研究

目的 探讨海南省成年人吸烟与各类心血管疾病发病风险的关联。方法 利用中英合作项目“中国慢性病前瞻性研究”项目海南省人群数据,剔除基线调查时自报患有冠心病、脑卒中和恶性肿瘤的个体后,纳入基线年龄为30～79岁的研究对象共28 940人,利用Cox回归分析计算非吸烟者、戒烟者和当前吸烟者的心血管疾病发病风险HR值和95%CI。结果 研究人群平均随访6.2年,累积随访177 279人年。随访期间男性1 310人,女性2 200人发病。男性吸烟率（47.0%）远高于女性吸烟率（0.3%）。多因素调整后,与非吸烟者相比,吸烟人群心血管疾病的发病风险有所增加,HR值(95%CI)分别为急性冠心病1.63(1.12～2.38)和缺血性心脏病1.53(1.22～1.91)。在当前吸烟者中,每天吸烟量多于30支的人群急性冠心病、缺血性脑卒中和出血性脑卒中的发病风险最高。结论 吸烟能够增加心血管疾病的发病风险,应基于不同心血管疾病风险制定吸烟者戒烟目标和全人群控烟措施。     

浏阳市居民新鲜水果摄入频率与脑卒中发病的关联

目的 了解湖南省浏阳市居民新鲜水果摄入频率情况,探讨新鲜水果摄入频率与脑卒中发病关联。 方法 利用中国慢性病前瞻性研究湖南省浏阳市项目点30～79岁常住居民基线调查数据和随访获得的脑卒中发病数据,利用Cox比例风险模型,在调整混杂因素后,评估新鲜水果摄入频率与脑卒中发病的关联。 结果 共57 288名研究对象纳入分析,浏阳市仅7.38%的研究对象每周有4 d及以上吃新鲜水果 。男性、家庭年收入水平低、文化程度低、吸烟、饮酒人群新鲜水果摄入频率较低(P<0.001)。2015—2019年共随访观察到2 720例脑卒中发病。增加新鲜水果摄入频率对脑卒中的发病有保护作用,与不吃或极少吃新鲜水果相比,每周有4 d及以上吃新鲜水果脑卒中的发病风险降低了28%(HR=0.72,95%CI:0.61~0.85),缺血性脑卒中的发病风险降低了25%(HR=0.75,95%CI:0.60~0.94),出血性脑卒中的发病风险降低了51%(HR=0.49,95%CI:0.35~0.76)。 结论 新鲜水果摄入频率增加能降低脑卒中发病风险。浏阳市居民新鲜水果摄入频率情况不容乐观,针对这一问题,需要采取适当措施以增加居民新鲜水果摄入频率。     

代谢综合征及其组分与肾功能损害的相关性研究

目的 全面评估代谢综合征(MetS)及其组分与肾功能损害[患慢性肾脏疾病(CKD)和肾小球滤过率(eGFR)下降]之间的关联。方法 基于2013—2018年北京市某医院健康体检数据，使用Cox比例风险模型研究MetS及其组分与CKD发生之间的风险比(HR)和95%置信区间(95%CI)，使用线性混合效应模型研究MetS及其组分与eGFR降低之间的关联。结果 在为期6年的随访中，有2 082名研究对象纳入研究，研究期间有186例CKD事件的发生。调整混杂因素后，MetS(HR=0.75, 95%CI:0.53～1.07),MetS的不同组分TG升高(HR=1.03, 95%CI:0.74～1.42)、HDL-C降低(HR=0.94, 95%CI:0.66～1.34)、血压升高(HR=1.11,95%CI:0.81～1.51)、中心性肥胖(HR=0.95, 95%CI:0.65～1.39)、高血糖(HR=0.71,95%CI:0.45～1.13)，以及MetS组分数1项(HR=1.30, 95%CI:0.80～2.12)、2项(HR=1.39, 95%CI:0.84～2.31)、3项(HR...     

中国成年人饮茶与死亡风险的前瞻性关联研究

目的分析中国成年人饮茶与全因死亡和死因别死亡风险间的关联。方法本研究分析基于中国慢性病前瞻性研究项目。饮茶信息为基线自报。死亡信息主要通过链接死亡监测系统获取。使用Cox比例风险回归模型计算风险比(HR)及其95%CI。结果纳入分析的438 443例研究对象随访11.1年共发生死亡34 661例。与从不饮茶者相比, 当前非每日饮茶者和每日饮茶者全因死亡HR值(95%CI)依次为0.89(0.86～0.91)和0.92(0.88～0.95)。分性别分析显示, 饮茶对全因死亡风险的保护作用主要见于男性(交互P<0.05)。与从不饮茶者相比, 当前每日饮茶者死于缺血性心脏病、缺血性脑卒中、出血性脑卒中、恶性肿瘤、呼吸系统疾病及其他死因的HR值(95%CI)依次为0.83(0.76～0.92)、0.82(0.69～0.97)、0.86(0.78～0.94)、1.03(0.97～1.09)、1.00(0.87～1.16)、0.84(0.78～0.90)。在不吸烟且不过量饮酒者中, 每日饮茶与恶性肿瘤死亡风险间不存在有统计学显著性的关联, 但在吸烟或过量饮酒者中, 每日饮茶者死于恶性肿瘤的风...     

Consumption of Tea,Alcohol, and Fruits and Risk of Kidney Stones: A Prospective Cohort Study in 0.5 Million Chinese Adults

A few prospective studies have suggested that tea, alcohol, and fruit consumption may reduce the risk of kidney stones. However, little is known whether such associations and their combined effect persist in Chinese adults, for whom the popular tea and alcohol drinks are different from those investigated in the aforementioned studies. The present study included 502,621 participants from the China Kadoorie Biobank (CKB). Information about tea, alcohol, and fruit consumption was self-reported at baseline. The first documented cases of kidney stones during follow-up were collected through linkage with the national health insurance system. Cox regression was used to calculate the hazard ratio (HR) and 95% confidence interval (CI). During a median of 11.1 years of follow-up, we collected 12,407 cases of kidney stones. After multivariable adjustment, tea, alcohol, and fruit consumption were found to be negatively associated with kidney stone risk, but the linear trend was only found in tea and fruit consumption. Compared with non-tea consumers, the HR (95% CI) for participants who drank ≥7 cups of tea per day was 0.73 (0.65–0.83). Compared with non-alcohol consumers, the HR (95% CI) was 0.79 (0.72–0.87) for participants who drank pure alcohol of 30.0–59.9 g per day but had no further decrease with a higher intake of alcohol. Compared with less-than-weekly consumers, the HR (95% CI) for daily fruit consumers was 0.81 (0.75–0.87). Even for those who did not drink alcohol excessively, increasing tea and fruit consumption could also independently reduce the stone risk. Among Chinese adults, tea, alcohol, and fruit consumption was associated with a lower risk of kidney stones.     

Folate intake, alcohol use, and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

BACKGROUND: Several epidemiologic studies suggest that higher folate intakes are associated with lower breast cancer risk, particularly in women with moderate alcohol consumption. OBJECTIVE: We investigated the association between dietary folate, alcohol consumption, and postmenopausal breast cancer in women from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial cohort. DESIGN: Dietary data were collected at study enrollment between 1993 and 2001. Folate content was assigned on the basis of prefortification (ie, pre-1998) databases. Of the 25 400 women participants with a baseline age of 55-74 y and with complete dietary and multivitamin information, 691 developed breast cancer between September 1993 and May 2003. We used Cox proportional hazard models with age as the underlying time metric to generate hazard ratios (HRs) and 95% CIs. RESULTS: The adjusted HRs were 1.19 (95% CI: 1.01, 1.41; P for trend = 0.04) for women reporting supplemental folic acid intake >/=400 mug/d compared with subjects reporting no supplemental intake. Comparison of the highest with the lowest quintile gave adjusted HRs of 1.04 (95% CI: 0.83, 1.31; P for trend = 0.56) and 1.32 (95% CI: 1.04, 1.68; P for trend = 0.03) for food and total folate intake, respectively. Alcohol consumption was positively associated with breast cancer risk (highest compared with lowest quintile: HR = 1.37; 95% CI: 1.08, 1.76; P for trend = 0.02); the risk was greatest in women with lower total folate intake. CONCLUSIONS: Our results do not support the hypothesis that high folate intake reduces breast cancer risk; instead, they suggest that a high intake, generally attributable to supplemental folic acid, may increase the risk in postmenopausal women. However, our results confirm previous studies showing positive associations between moderate alcohol consumption and breast cancer.     

Citrus Consumption and Risk of Cutaneous Malignant Melanoma in the Women’s Health Initiative

Abstract

Citrus products are rich sources of furocoumarins, a class of photoactive compounds. Certain furocoumarins combined with ultraviolet radiation can induce skin cancer. We examined the relationship between citrus consumption and cutaneous melanoma risk among 56,205 Caucasian postmenopausal women in the Women’s Health Initiative. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of melanoma by citrus intake level. During a mean follow-up of 15.7?years, 956 incident melanoma cases were documented. In multivariable adjusted models, the HR (95% CI) for melanoma was 1.12 (0.91, 1.37) among the highest citrus consumers (1.5+ servings/day of fruit or juice) versus the lowest (<2 servings/week), 0.95 (0.76, 1.20) among the highest citrus fruit consumers (5+ servings/week) versus non-consumers, and was 1.13 (0.96, 1.32) for the highest citrus juice consumers (1+ servings/day) versus the lowest (<1 serving/week). In stratified analyses, an increased melanoma risk associated with citrus juice intake was observed among women who spent the most time outdoors in summer as adults; the HR for the highest versus lowest intake was 1.22 (1.02, 1.46) (p trend = 0.03). Further research is needed to explore the association of melanoma with citrus juices among women with high sun exposure.     

Intake of coffee and tea and risk of ovarian cancer: a prospective cohort study

There is some evidence from case-control studies that coffee consumption might be positively associated with ovarian cancer risk, whereas the epidemiologic evidence regarding tea consumption and ovarian cancer is inconsistent. To date, there have been few prospective studies of these associations. Therefore, we examined ovarian cancer risk in association with both coffee and tea intake in a prospective cohort study of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food frequency questionnaire between 1980 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000. Data from the food frequency questionnaire were used to estimate daily intake of coffee and tea. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between categories of coffee and tea intake and ovarian cancer risk. During a mean 16.4 years of follow-up, we observed 264 incident ovarian cancer cases. Tea intake was not associated with ovarian cancer risk in our study population. In contrast, a borderline positive association was observed among women who drank > 4 cups coffee/day compared to women who did not drink coffee (HR = 1.62, 95% CI = 0.95-2.75, P(trend) = 0.06). Given the pervasive use of these beverages, the associations between coffee and tea consumption and ovarian cancer risk warrant investigation in further prospective studies.     

Prospective study of coffee and tea consumption in relation to risk of type 2 diabetes mellitus among men and women: the Whitehall II study

At least fourteen cohort studies have documented an inverse association between coffee consumption and risk of type 2 diabetes. We examined the prospective association between coffee and tea consumption and the risk of type 2 diabetes mellitus among British men (n 4055) and women (n 1768) from the Whitehall II cohort. During 11.7 years follow-up there were a total of 387 incident cases of diabetes confirmed by self-report of doctor's diagnosis or glucose tolerance tests. Despite an inverse association between coffee intake and 2 h post-load glucose concentration at the baseline assessment, combined caffeinated and decaffeinated coffee (hazard ratio (HR) 0.80; 95 % CI 0.54, 1.18) or only decaffeinated coffee intake (HR 0.65; 95 % CI 0.36, 1.16) was not significantly associated with diabetes risk at follow-up after adjustment for possible confounders. There was an association between tea intake and diabetes (HR 0.66; 95 % CI 0.61, 1.22; P < 0.05) after adjustment for age, gender, ethnicity and social status, which was not robust to further adjustments. There was, however, an association between combined intake of tea and coffee (two or more cups per day of both beverage) and diabetes (HR 0.68; 95 % CI 0.46, 0.99; P < 0.05) after full adjustment. In conclusion, relatively moderate intake (more than three cups per day) of coffee and tea were not prospectively associated with incidence of type 2 diabetes although there was evidence of a combined effect. The limited range of exposure and beverage consumption according to socio-economic class may explain these conflicting findings.     

Dietary Micronutrients and Risk of Chronic Kidney Disease: A Cohort Study with 12 Year Follow-Up

We investigated the association between dietary micronutrient intakes and the risk of chronic kidney disease (CKD) in the Ansan-Ansung study of the Korean Genome and Epidemiologic Study (KoGES), a population-based prospective cohort study. Of 9079 cohort participants with a baseline estimate glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m² and a urine albumin to creatinine ratio (UACR) <300 mg/g and who were not diagnosed with CKD, we ascertained 1392 new CKD cases over 12 year follow-up periods. The risk of CKD according to dietary micronutrient intakes was presented using hazard ratios (HRs) and 95% confidence intervals (95% CIs) in a full multivariable Cox proportional hazard models, adjusted for multiple micronutrients and important clinico-epidemiological risk factors. Low dietary intakes of phosphorus (<400 mg/day), vitamin B2 (<0.7 mg/day) and high dietary intake of vitamin B6 (≥1.6 mg/day) and C (≥100 mg/day) were associated with an increased risk of CKD stage 3B and over, compared with the intake at recommended levels (HR = 6.78 [95%CI = 2.18–21.11]; HR = 2.90 [95%CI = 1.01–8.33]; HR = 2.71 [95%CI = 1.26–5.81]; HR = 1.83 [95%CI = 1.00–3.33], respectively). In the restricted population, excluding new CKD cases defined within 2 years, an additional association with low folate levels (<100 µg/day) in higher risk of CKD stage 3B and over was observed (HR = 6.72 [95%CI = 1.40–32.16]). None of the micronutrients showed a significant association with the risk of developing CKD stage 3A. Adequate intake of micronutrients may lower the risk of CKD stage 3B and over, suggesting that dietary guidelines are needed in the general population to prevent CKD.     

Dietary Intake of Vegetables,Fruits, and Meats/Beans as Potential Risk Factors of Acute Myeloid Leukemia: A Texas Case-Control Study

Diet has been identified as a risk factor for some cancers, but its role in adult de novo acute myeloid leukemia (AML) is unclear. This study was conducted at the University of Texas MD Anderson Cancer Center to evaluate associations between consumption of vegetables, fruits, and meats with AML risk among Texas residents. All participants, 323 adult de novo AML cases and 380 frequency-matched controls, completed demographic and food frequency questionnaires. Overall, AML risk was significantly decreased among those who consumed the most dark green vegetables, seafood, and nuts/seeds; and it was significantly increased among greatest consumers of red meat. Among men, AML risk was lowest among those whose consumption was in the highest quartile for fruits [odds ratio (OR) = 0.25, 95% confidence interval (CI) = 0.10–0.69], poultry (OR = 0.28, 95%CI = 0.10–0.78), and seafood (OR = 0.39, 95%CI = 0.16–0.96) compared to those in the lowest. Among women, risk was lowest among those whose consumption was in the highest quartile of dark-green vegetables (OR = 0.28, 95%CI = 0.12–.68), orange vegetables (OR = 0.40, 95%CI = 0.17–.96) and nuts/beans (OR = 0.26, 95%CI = 0.11–0.60). Based on these findings, interventions can be developed to modify intake of specific dietary components to reduce cancer risk.     

Fruit and vegetable consumption and diabetes mellitus incidence among U.S. adults

BACKGROUND: Adequate fruit and vegetable intake may lower the risk of several chronic diseases, but little is known about how it affects the risk of diabetes mellitus. METHODS: We examined whether fruit and vegetable consumption was associated with diabetes incidence in a cohort of U. S. adults aged 25-74 years who were followed for about 20 years. RESULTS: In the analytic sample of 9,665 participants, 1,018 developed diabetes mellitus. The mean daily intake of fruits and vegetables as well as the percentage of participants consuming five or more fruits and vegetables per day was lower among persons who developed diabetes than among persons who remained free of this disease (P < 0.001). After adjustments for age, race or ethnicity, cigarette smoking, systolic blood pressure, use of antihypertensive medication, serum cholesterol concentration, body mass index, recreational exercise, nonrecreational exercise, and alcohol consumption, the hazard ratio for participants consuming five or more servings of fruits and vegetables per day compared with those consuming none was 0.73 (95% confidence interval (CI), 0.54-0.98) for all participants, 0.54 (95% CI, 0.36-0.81) for women, and 1.09 (95% CI, 0.63-1.87) for men. Adding education to the model changed the hazard ratios to 0.79 (95% CI, 0.59-1.06) for all participants, 0.61 (95% CI, 0.42-0.88) for women, and 1.14 (95% CI, 0.67-1.93) for men. CONCLUSIONS: Fruit and vegetable intake may be inversely associated with diabetes incidence particularly among women. Education may explain partly this association.     

Adherence to the DASH,MeDi, and MIND diet scores and the incidence of metabolically unhealthy phenotypes

BackgroundA metabolically unhealthy phenotype is associated with the risk of cardiometabolic events and can be prevented by adherence to healthy dietary patterns. The present study was designed to investigate the association between high adherence to the Dietary Approaches to Stop Hypertension (DASH), Mediterranean (MeDi), and Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet scores and the incidence of metabolically unhealthy phenotypes in adults across body mass index (BMI) categories.MethodsIn this cohort study, 512 subjects with metabolically healthy normal weight (MHNW) at baseline and 787 subjects with metabolically healthy overweight/obesity (MHOW/MHO) at baseline were included. Dietary intake was collected by a validated food frequency questionnaire, and DASH, MeDi, and MIND scores were calculated. The Joint Interim Statement (JIS) criteria were used to define a metabolically unhealthy status.ResultsA total of 137 and 388 subjects with metabolically unhealthy normal weight (MUNW) and metabolically unhealthy overweight/obesity (MUOW/MUO) phenotypes, respectively, were observed, over a mean of 5.91 years of follow-up. The Cox proportional hazard regression indicated participants in the third tertile of the DASH score had a lower risk of the MUNW phenotype (HR: 0.59; 95% CI: 0.37–0.92) than those in the lowest tertile. Similarly, the highest adherence to the MeDi and MIND scores was also linked to a 46% (HR: 0.54; 95% CI: 0.36–0.81) and 47% (HR: 0.53; 95% CI: 0.34–0.83) lower risk of the MUNW phenotype, respectively. As well, there was an inverse relationship between the highest adherence to the DASH (HR: 0.66; 95% CI: 0.50–0.86), MeDi (HR: 0.74; 95% CI: 0.58–0.93), and MIND (HR: 0.57; 95% CI: 0.43–0.74) scores and the risk of MUOW/MUO. There was no interaction between age and the three dietary patterns in relation to a metabolically unhealthy phenotype.ConclusionHigh compliance with the DASH, MeDi, and MIND scores was associated with a lower risk of MUNW. An inverse relationship between these three dietary patterns and the incidence of the metabolically unhealthy phenotype was also observed in individuals who had MHOW/MHO at baseline.