18 May 2018 In General Health

Background -Americans have a shorter life expectancy compared with residents of almost all other high-income countries. We aim to estimate the impact of lifestyle factors on premature mortality and life expectancy in the US population.

Methods -Using data from the Nurses' Health Study (1980-2014; n=78 865) and the Health Professionals Follow-up Study (1986-2014, n=44 354), we defined 5 low-risk lifestyle factors as never smoking, body mass index of 18.5 to 24.9 kg/m(2), >/=30 min/d of moderate to vigorous physical activity, moderate alcohol intake, and a high diet quality score (upper 40%), and estimated hazard ratios for the association of total lifestyle score (0-5 scale) with mortality. We used data from the NHANES (National Health and Nutrition Examination Surveys; 2013-2014) to estimate the distribution of the lifestyle score and the US Centers for Disease Control and Prevention WONDER database to derive the agespecific death rates of Americans. We applied the life table method to estimate life expectancy by levels of the lifestyle score.

Results -During up to 34 years of follow-up, we documented 42 167 deaths. The multivariable-adjusted hazard ratios for mortality in adults with 5 compared with zero low-risk factors were 0.26 (95% confidence interval [CI], 0.22-0.31) for all-cause mortality, 0.35 (95% CI, 0.27-0.45) for cancer mortality, and 0.18 (95% CI, 0.12-0.26) for cardiovascular disease mortality. The population-attributable risk of nonadherence to 5 low-risk factors was 60.7% (95% CI, 53.6-66.7) for all-cause mortality, 51.7% (95% CI, 37.1-62.9) for cancer mortality, and 71.7% (95% CI, 58.1-81.0) for cardiovascular disease mortality. We estimated that the life expectancy at age 50 years was 29.0 years (95% CI, 28.3-29.8) for women and 25.5 years (95% CI, 24.7-26.2) for men who adopted zero low-risk lifestyle factors. In contrast, for those who adopted all 5 low-risk factors, we projected a life expectancy at age 50 years of 43.1 years (95% CI, 41.3-44.9) for women and 37.6 years (95% CI, 35.8-39.4) for men. The projected life expectancy at age 50 years was on average 14.0 years (95% CI, 11.8-16.2) longer among female Americans with 5 lowrisk factors compared with those with zero low-risk factors; for men, the difference was 12.2 years (95% CI, 10.1-14.2).

Conclusions -Adopting a healthy lifestyle could substantially reduce premature mortality and prolong life expectancy in US adults.

18 May 2018 In Cancer

Importance: Inflammation is important in colorectal cancer development. Diet modulates inflammation and may thus be a crucial modifiable factor in colorectal cancer prevention.

Objective: To examine whether proinflammatory diets are associated with increased colorectal cancer risk by using an empirical dietary inflammatory pattern (EDIP) score based on a weighted sum of 18 food groups that characterizes dietary inflammatory potential based on circulating levels of inflammation biomarkers.

Design, Settings, and Participants: Cohort study of 46804 men (Health Professionals Follow-up Study: 1986-2012) and 74246 women (Nurses' Health Study: 1984-2012) followed for 26 years to examine associations between EDIP scores and colorectal cancer risk using Cox regression. We also examined associations in categories of alcohol intake and body weight. Data analysis began January 17, 2017, and was completed August 9, 2017.

Exposures: EDIP scores calculated from food frequency questionnaires administered every 4 years.

Main Outcomes and Measures: Incident colorectal cancer.

Results: We documented 2699 incident colorectal cancer cases over 2571831 person-years of follow-up. Compared with participants in the lowest EDIP quintile (Q) who had a colorectal cancer incidence rate (per 100000 person-years) of 113 (men) and 80 (women), those in the highest Q had an incidence rate of 151 (men) and 92 (women), leading to an unadjusted rate difference of 38 and 12 more colorectal cancer cases, respectively, among those consuming highly proinflammatory diets. Comparing participants in the highest vs lowest EDIP Qs in multivariable-adjusted analyses, higher EDIP scores were associated with 44% (men: hazard ratio [HR], 1.44; 95% CI, 1.19-1.74; P < .001 for trend), 22% (women: HR, 1.22; 95% CI, 1.02-1.45; P = .007 for trend), and 32% (men and women: pooled HR, 1.32; 95% CI, 1.12-1.55; P < .001 for trend) higher risk of developing colorectal cancer. In both men and women, associations were observed in all anatomic subsites except for the rectum in women. In subgroups (P </= .02 for all interactions), associations differed by alcohol intake level, with stronger associations among men (Q5 vs Q1 HR, 1.62; 95% CI, 1.05-2.49; P = .002 for trend) and women (Q5 vs Q1 HR, 1.33; 95% CI, 0.97-1.81; P = .03 for trend) not consuming alcohol; and by body weight, with stronger associations among overweight/obese men (Q5 vs Q1 HR, 1.48; 95% CI, 1.12-1.94; P = .008 for trend) and lean women (Q5 vs Q1 HR, 1.31; 95% CI, 0.99-1.74; P = .01 for trend).

Conclusions and Relevance: Findings suggest that inflammation is a potential mechanism linking dietary patterns and colorectal cancer development. Interventions to reduce the adverse role of proinflammatory diets may be more effective among overweight/obese men and lean women or men and women who do not consume alcohol.

03 May 2018 In Liver Disease
To what extent could alcohol consumption affects female fertility is still unclear. The aim of this study was to quantitatively summarize the dose-response relation between total and specific types of alcohol beverage (beer, wine, and spirits) consumption in female and the fecundability. Four electronic databases were searched. Observational studies (cohort and case-control) that provided female alcohol consumption and fecundity were eligible. Nineteen studies, involving 98657 women, were included in this study. Compared to non-drinkers, the combined estimate (with relative risk, RR) of alcohol consumers on fecundability was 0.87 (95% CI 0.78-0.95) for overall 19 studies. Compared to non-drinkers, the pooled estimates were 0.89 (95% CI 0.82-0.97) for light drinkers (=12.5 g/day of ethanol) and 0.77 (95% CI 0.61-0.94) for moderate-heavy drinkers (>12.5 g/day of ethanol). Moreover, compared to non-drinkers, the corresponding estimates on fecundability were 0.98 (95% CI 0.85-1.11), 1.02 (95% CI 0.99-1.05), and 0.92 (95% CI 0.83-1.01) for studies focused on wine, beer and spirits, respectively. Dose-response meta-analysis suggested a linear association between decreased fecundability and every 12.5 g/d increasing in alcohol consumption with a RR 0.98 (95% CI 0.97-0.99). This first systematic review and meta-analysis suggested that female alcohol consumption was associated with a reduced fecundability
03 May 2018 In General Health
BACKGROUND: There is little knowledge about the consumption of alcohol among Chinese and Norwegian older adults aged 65 years and over. The aim of this study was to investigate the prevalence and factors related to alcohol consumption among older adults in China and Norway. METHODS: The Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2008-2009 conducted in China and The Nord-Trondelag Health Study data in 2006-2008 (HUNT3) conducted in Norway were used. Mulitvariable logistic regression was used to test the factors related to alcohol consumption. RESULTS: The prevalence of participants who drink alcohol in the Chinese and Norwegian sample were 19.88% and 46.2%, respectively. The weighted prevalence of participants with consumption of alcohol in the Chinese sample of women and men were 7.20% and 34.14%, respectively. In the Norwegian sample, the prevalence of consumption of alcohol were 43.31% and 65.35% for women and men, respectively. Factors such as younger age, higher level of education, living in urban areas, living with spouse or partner, and better health status were related to higher likelihood of alcohol consumption among Norwegian older women and men; while reported better health status and poorer life satisfaction were related to higher likelihood of alcohol consumption among Chinese. In addition, rural males and older females with higher level of education were more likely to consume alcohol. CONCLUSION: The alcohol consumption patterns were quite different between China and Norway. Besides economic development levels and cultures in the two different countries, demographic characteristics, socioeconomic status, overall health status, and life satisfaction were associated with alcohol consumption as well
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