Adherence to the Danish food-based dietary guidelines and risk of myocardial infarction: a cohort study

AbstractObjectiveA direct way to evaluate food-based dietary guidelines is to assess if adherence is associated with development of non-communicable diseases. Thus, the objective was to develop an index to assess adherence to the 2013 Danish food-based dietary guidelines and to investigate the association between adherence to the index and risk of myocardial infarction (MI).DesignPopulation-based cohort study with recruitment of participants in 1993–1997. Information on dietary intake was collected at baseline using an FFQ and an index ranging from 0 to 6 points was created to assess adherence to the 2013 Danish food-based dietary guidelines. MI cases were identified by record linkage to the Danish National Patient Register and the Causes of Death Register. Cox proportional hazards models were used to estimate hazard ratios (HR) of MI.SettingGreater areas of Aarhus and Copenhagen, Denmark.SubjectsMen and women aged 50–64 years (n55 021) from the Diet, Cancer and Health study.ResultsA total of 3046 participants were diagnosed with first-time MI during a median follow-up of 16·9 years. A higher Danish Dietary Guidelines Index score was associated with a lower risk of MI. After adjustment for potential confounders, the hazard of MI was 13 % lower among men with a score of 3–<4 (HR=0·87; 95 % CI 0·78, 0·96) compared with men with a score of <3. The corresponding HR among women was 0·76 (95 % CI 0·63, 0·93).ConclusionsAdherence to the 2013 Danish food-based dietary guidelines was inversely associated with risk of MI.

Download Full-text

Dietary selenium intake and mortality in two population-based cohort studies of 133 957 Chinese men and women

Public Health Nutrition ◽

10.1017/s1368980016001130 ◽

2016 ◽

Vol 19 (16) ◽

pp. 2991-2998 ◽

Cited By ~ 7

Author(s):

Jiang-Wei Sun ◽

Xiao-Ou Shu ◽

Hong-Lan Li ◽

Wei Zhang ◽

Jing Gao ◽

...

Keyword(s):

Cancer Mortality ◽

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Sensitivity Analyses ◽

Health Study ◽

Chinese Populations ◽

Urban City ◽

Cox Proportional Hazards Models ◽

Hazard Ratios

AbstractObjectiveTo investigate the potential influence of dietary Se intake on mortality among Chinese populations.DesignWe prospectively evaluated all-cause, CVD and cancer mortality risks associated with dietary Se intake in participants of the Shanghai Women’s Health Study (SWHS) and the Shanghai Men’s Health study (SMHS). Dietary Se intake was assessed by validated FFQ during in-person interviews. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95 % CI.SettingUrban city in China.SubjectsChinese adults (n 133 957).ResultsDuring an average follow-up of 13·90 years in the SWHS and 8·37 years in the SMHS, 5749 women and 4217 men died. The mean estimated dietary Se intake was 45·48 μg/d for women and 51·34 μg/d for men, respectively. Dietary Se intake was inversely associated with all-cause mortality and CVD mortality in both women and men, with respective HR for the highest compared with the lowest quintile being 0·79 (95 % CI 0·71, 0·88; Ptrend<0·0001) and 0·80 (95 % CI 0·66, 0·98; Ptrend=0·0268) for women, and 0·79 (95 % CI 0·70, 0·89; Ptrend=0·0001) and 0·66 (95 % CI 0·54, 0·82; Ptrend=0·0002) for men. No significant associations were observed for cancer mortality in both women and men. Results were similar in subgroup and sensitivity analyses.ConclusionsDietary Se intake was inversely associated with all-cause and cardiovascular mortality in both sexes, but not cancer mortality.

Download Full-text

Distinct eGFR trajectories are associated with risk of myocardial infarction in people with diabetes or pre-diabetes

10.21203/rs.3.rs-25392/v1 ◽

2020 ◽

Author(s):

Yingting Zuo ◽

Anxin Wang ◽

Shuohua Chen ◽

Xue Tian ◽

Shouling Wu ◽

...

Keyword(s):

Myocardial Infarction ◽

Proportional Hazards ◽

Exposure Period ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Models ◽

Hazard Ratios ◽

Increased Risk ◽

And Control ◽

Incident Cases

Abstract Background The relationship between estimated glomerular filtration rate (eGFR) trajectories and myocardial infarction (MI) remains unclear in people with diabetes or prediabetes. We aimed to identify common eGFR trajectories in people with diabetes or prediabetes and to examine their association with MI risk. Methods The data of this analysis was derived from the Kailuan study, which was a prospective community-based cohort study. The eGFR trajectories of 24,723 participants from year 2006 to 2012 were generated by latent mixture modeling. Incident cases of MI occurred during 2012 to 2017, confirmed by review of medical records. Cox proportional hazards models were used to calculate hazard ratios (HR) and their 95% confidence intervals (CIs) for the subsequent risk of MI of different eGFR trajectories. Results We identified 5 distinct eGFR trajectories, and named them as low-stable (9.4%), moderate-stable (31.4%), moderate-increasing (29.5%), high-decreasing (13.9%) and high-stable (15.8%) according to their range and pattern. During a mean follow-up of 4.61 years, there were a total of 235 incident MI. Although, the high-decreasing group had similar eGFR levels with the moderate-stable group at last exposure period, the risk was much higher (adjusted HR, 3.43; 95%CI, 1.56–7.54 versus adjusted HR, 2.82; 95%CI, 1.34–5.95). Notably, the moderate-increasing group had reached to the normal range, still had a significantly increased risk (adjusted HR, 2.55; 95%CI, 1.21–5.39). Conclusions eGFR trajectories were associated with MI risk in people with diabetes or prediabetes. Emphasis should be placed on early and long-term detection and control of eGFR decreases to further reduce MI risk.

Download Full-text

Visual impairment and risk of dementia in two population-based prospective cohorts: UK Biobank and EPIC-Norfolk

The Journals of Gerontology Series A ◽

10.1093/gerona/glab325 ◽

2021 ◽

Author(s):

Thomas J Littlejohns ◽

Shabina Hayat ◽

Robert Luben ◽

Carol Brayne ◽

Megan Conroy ◽

...

Keyword(s):

Visual Impairment ◽

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Uk Biobank ◽

Cox Proportional Hazards Models ◽

Hazard Ratios ◽

Promising Target ◽

Increased Risk

Abstract Visual impairment has emerged as a potential modifiable risk factor for dementia. However, there are a lack of large studies with objective measures of vison and with more than ten years of follow-up. We investigated whether visual impairment is associated with an increased risk of incident dementia in UK Biobank and EPIC-Norfolk. In both cohorts, visual acuity was measured using a “logarithm of the minimum angle of resolution” (LogMAR) chart and categorised as no (≤0.30 LogMAR), mild (>0.3 - ≤0.50 LogMAR), and moderate to severe (>0.50 LogMAR) impairment. Dementia was ascertained through linkage to electronic medical records. After restricting to those aged ≥60 years, without prevalent dementia and with eye measures available, the analytic samples consisted of 62,206 UK Biobank and 7,337 EPIC-Norfolk participants, respectively. In UK Biobank and EPIC-Norfolk. respectively, 1,113 and 517 participants developed dementia over 11 and 15 years of follow-up. Using multivariable cox proportional-hazards models, the hazard ratios for mild and moderate to severe visual impairment were 1.26 (95% Confidence Interval [CI] 0.92-1.72) and 2.16 (95% CI 1.37-3.40), in UK Biobank, and 1.05 (95% CI 0.72-1.53) and 1.93 (95% CI 1.05-3.56) in EPIC-Norfolk, compared to no visual impairment. When excluding participants censored within 5 years of follow-up or with prevalent poor or fair self-reported health, the direction of the associations remained similar for moderate impairment but were not statistically significant. Our findings suggest visual impairment might be a promising target for dementia prevention, however the possibility of reverse causation cannot be excluded.

Download Full-text

Predictors of 10-year hospital use in a community-dwelling population of Brazilian elderly: the Bambuí cohort study of aging

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2011001500003 ◽

2011 ◽

Vol 27 (suppl 3) ◽

pp. s336-s344 ◽

Cited By ~ 6

Author(s):

James Macinko ◽

Vitor Camargos ◽

Josélia O. A. Firmo ◽

Maria Fernanda Lima-Costa

Keyword(s):

Cohort Study ◽

Chronic Conditions ◽

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Community Dwelling ◽

Proportional Hazards Models ◽

Cox Proportional Hazards Models ◽

Male Sex

We use data from a population-based cohort of elderly Brazilians to assess predictors of hospitalizations during ten years of follow-up. Participants were 1,448 persons aged 60 years and over at baseline (1997). The outcome was self-reported number of hospitalizations per year. Slightly more than a fifth (23%) experienced no hospitalizations during the 10 year follow-up. About 30% had 1-2 events, 31% had between 3 and 7 events, and about 18% had 8 or more events during this time. Results of multivariable hurdle and Cox proportional hazards models showed that the risk of hospitalization was positively associated with male sex, increased age, chronic conditions, and visits to the doctors in the previous 12 months. Underweight was a predictor of any hospitalization, while obesity was an inconsistent predictor of hospitalization.

Download Full-text

Abstract 90: Race, Ethnic, and Sex Disparities in Stroke Incidence in the Northern Manhattan Study

Stroke ◽

10.1161/str.51.suppl_1.90 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Hannah Gardener ◽

Ralph L Sacco ◽

Tatjana Rundek ◽

Consuelo Mora-McLaughlin ◽

Ying Kuen Cheung ◽

...

Keyword(s):

Incidence Rate ◽

Low Socioeconomic Status ◽

Stroke Risk ◽

Proportional Hazards ◽

Population Based ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Stroke Incidence ◽

Cox Proportional Hazards Models ◽

Hazard Ratios

Background: An excess incidence of strokes among blacks vs whites has been shown previously, but data on disparities related to Hispanic ethnicity remains limited. This study examines race, ethnic, and sex differences in stroke incidence in the multi-ethnic, yet largely Caribbean Hispanic, Northern Manhattan Study (NOMAS). Methods: The study population included participants in the prospective population-based NOMAS, followed for a mean of 13±7 years. Cox proportional hazards models were constructed to estimate the hazard ratios and 95% confidence intervals (HR, 95%CI) for the association between race/ethnicity and sex with confirmed incident stroke of any subtype and ischemic stroke, stratified by age and adjusting for sociodemographics and vascular risk factors. Results: Among 3,298 participants (mean baseline age 69±10, 37% men, 24% black, 21% white, 52% Hispanic), 477 incident strokes accrued (394 ischemic, 43 ICH, 9 SAH). The most common ischemic subtype was cardioembolic, followed by lacunar infarcts, then cryptogenic. The greatest incidence rate was observed in blacks (13/1000 person-years [PY]), followed by Hispanics (11/1000 PY), and lowest in whites (8/1000 PY), and this order was observed for crude incidence rates until age 75. By age 85 the greatest incidence rate was in Hispanics. Blacks had an increased stroke risk vs whites overall in fully adjusted models (HR=1.37, 95% CI=1.02-1.84), and stratified analyses showed that this disparity was driven by women age ≥70 (HR=1.69, 1.05-2.73). The increased rate of stroke observed for Hispanics (age/sex-adjusted HR=1.50, 1.15-1.94) was largely explained by education and insurance status (a proxy for socieoeconomic status; HR after further adjusting for these variables=1.15, 0.84-1.58), but remained significant for women age ≥70. Men had an increased rate of stroke compared to women (fully adjusted HR=1.48, 1.21-1.81). Conclusions: This study provides novel data regarding the increased stroke risk among Caribbean Hispanics. Results highlight the need to create culturally-tailored campaigns to reach blacks and Hispanic populations to reduce race/ethnic stroke disparities, and support the important role of low socioeconomic status in driving an elevated risk among Caribbean Hispanics.

Download Full-text

Colours of fruit and vegetables and 10-year incidence of CHD

British Journal Of Nutrition ◽

10.1017/s0007114511001942 ◽

2011 ◽

Vol 106 (10) ◽

pp. 1562-1569 ◽

Cited By ~ 33

Author(s):

Linda M. Oude Griep ◽

W. M. Monique Verschuren ◽

Daan Kromhout ◽

Marga C. Ocké ◽

Johanna M. Geleijnse

Keyword(s):

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Fruit And Vegetables ◽

Orange Yellow ◽

Cox Proportional Hazards Models ◽

Hazard Ratios ◽

Orange Fruit ◽

Incident Cases

The colours of the edible part of fruit and vegetables indicate the presence of specific micronutrients and phytochemicals. The extent to which fruit and vegetable colour groups contribute to CHD protection is unknown. We therefore examined the associations between fruit and vegetables of different colours and their subgroups and 10-year CHD incidence. We used data from a prospective population-based cohort including 20 069 men and women aged 20–65 years who were enrolled between 1993 and 1997. Participants were free of CVD at baseline and completed a validated 178-item FFQ. Hazard ratios (HR) for the association between green, orange/yellow, red/purple, white fruit and vegetables and their subgroups with CHD were calculated using multivariable Cox proportional hazards models. During 10 years of follow-up, 245 incident cases of CHD were documented. For each 25 g/d increase in the intake of the sum of all four colours of fruit and vegetables, a borderline significant association with incident CHD was found (HR 0·98; 95 % CI 0·97, 1·01). No clear associations were found for the colour groups separately. However, each 25 g/d increase in the intake of deep orange fruit and vegetables was inversely associated with CHD (HR 0·74; 95 % CI 0·55, 1·00). Carrots, their largest contributor (60 %), were associated with a 32 % lower risk of CHD (HR 0·68; 95 % CI 0·48, 0·98). In conclusion, though no clear associations were found for the four colour groups with CHD, a higher intake of deep orange fruit and vegetables and especially carrots may protect against CHD.

Download Full-text

Risk of developing pneumonia associated with clinically diagnosed hypothyroidism: a nationwide population-based cohort study

Family Practice ◽

10.1093/fampra/cmab027 ◽

2021 ◽

Author(s):

Huei-Kai Huang ◽

Jen-Hung Wang ◽

Sheng-Lun Kao

Keyword(s):

Cohort Study ◽

Lower Risk ◽

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Research Database ◽

Hazard Ratios ◽

Hospital Acquired Pneumonia ◽

Thyroxine Replacement Therapy ◽

Hospital Acquired

Abstract Background Hypothyroidism has a detrimental effect on the immune system, which may predispose patients to infection. However, evidence about the risk of developing either community- or hospital-acquired pneumonia in patients with hypothyroidism is scarce. Objective To evaluate the association between hypothyroidism and the risk of developing pneumonia. Methods This was a retrospective population-based cohort study from Taiwan’s National Health Insurance Research Database. After 1:1 propensity score matching, 9749 patients (age ≥20 years) newly diagnosed with hypothyroidism between 2001 and 2014 and 9749 patients without hypothyroidism or other thyroid diseases were included in the hypothyroidism and non-hypothyroidism cohorts, respectively, and followed up until 2015. The development of pneumonia was defined as the primary outcome. Cox proportional hazards regression models were used to calculate the hazard ratios (HRs) of developing pneumonia between hypothyroidism and non-hypothyroidism cohorts after adjusting for age, sex and baseline comorbidities. To evaluate whether thyroxine replacement therapy (TRT) modified the risk for pneumonia, we divided patients with hypothyroidism into subgroups: patients who received TRT and those who did not. Results Hypothyroidism was associated with a higher risk of pneumonia [adjusted HR (aHR) 1.38, 95% confidence interval (CI) 1.29–1.49, P < 0.001]. Patients with hypothyroidism who received TRT had a lower risk of pneumonia than patients who did not (aHR 0.85, 95% CI 0.76–0.93, P = 0.001). Similar results were obtained in the age- and sex-stratified analyses. Conclusions Clinically diagnosed hypothyroidism was independently associated with the risk of pneumonia. In patients with hypothyroidism, TRT was associated with a lower risk of pneumonia.

Download Full-text

Sleep Timing May Predict Congestive Heart Failure: A Community‐Based Cohort Study

Journal of the American Heart Association ◽

10.1161/jaha.120.018385 ◽

2021 ◽

Vol 10 (6) ◽

Author(s):

Bin Yan ◽

Ruohan Li ◽

Jiamei Li ◽

Xuting Jin ◽

Fan Gao ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Cohort Study ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Health Study ◽

Sleep Timing ◽

Cox Proportional Hazards Models ◽

Increased Risk

Background Previous studies have suggested that sleep timing is associated with cardiovascular risk factors. However, there is no evidence on the relationship between sleep timing and congestive heart failure (CHF). We aimed to examine this relationship in this study. Methods and Results We recruited 4765 participants (2207 men; mean age, 63.6±11.0 years) from the SHHS (Sleep Heart Health Study) database in this multicenter prospective cohort study. Follow‐up was conducted until the first CHF diagnosis between baseline and the final censoring date. Sleep timing (bedtimes and wake‐up times on weekdays and weekends) was based on a self‐reported questionnaire. Cox proportional hazard models were constructed to investigate the association between sleep timing and CHF. During the mean follow‐up period of 11 years, 519 cases of CHF (10.9%) were reported. The multivariable Cox proportional hazards models revealed that participants with weekday bedtimes >12:00 am (hazard ratio [HR], 1.56; 95% CI, 1.15–2.11; P =0.004) and from 11:01 pm to 12:00 am (HR, 1.25; 95% CI, 1.00–1.56; P =0.047) had an increased risk of CHF compared with those with bedtimes from 10:01 pm to 11:00 pm . After stratified analysis, the association was intensified in participants with a self‐reported sleep duration of 6 to 8 hours. Furthermore, wake‐up times >8:00 am on weekdays (HR, 1.53; 95% CI, 1.07–2.17; P =0.018) were associated with a higher risk of incident CHF than wake‐up times ≤6:00 am . Conclusions Delayed bedtimes (>11:00 pm ) and wake‐up times (>8:00 am ) on weekdays were associated with an increased risk of CHF.

Download Full-text

Use of disease-modifying antirheumatic drugs and the subsequent risk of herpes zoster in older adults

Rheumatology ◽

10.1093/rheumatology/keab538 ◽

2021 ◽

Author(s):

Jiahui Qian ◽

Marissa Nichole Lassere ◽

Anita Elizabeth Heywood ◽

Bette Liu

Keyword(s):

Herpes Zoster ◽

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Antiviral Therapies ◽

Cox Proportional Hazards Models ◽

Hazard Ratios ◽

Using Data ◽

Subsequent Risk

Abstract Objectives To examine the association between DMARD use and subsequent risk of herpes zoster in a large, heterogeneous, and prospective population-based cohort. Methods Using data from a cohort of adults (45 and Up Study) recruited between 2006 and 2009 and linked to pharmaceutical, hospital and death data (2004–2015), the effect of DMARD use on zoster risk was analysed using Cox proportional hazards models, adjusting for sociodemographic characteristics, comorbidities and corticosteroid use. Results Among 254 065 eligible participants, over 1,826 311 person-years follow-up, there were 6295 new DMARD users and 17 024 incident herpes zoster events. Compared with non-users, the risk of zoster was higher in those who used bDMARDs, either alone or in combination with csDMARDs than in those who only used csDMARDs (adjusted hazard ratios, aHR 2.53 [95% confidence interval, CI 2.03–3.16]) for bDMARDs vs 1.48 [95%CI 1.33–1.66] for csDMARDs, p-heterogeneity < 0.001; reference: non-users). Among users of csDMARDs, compared with non-users, zoster risks were highest in those using exclusively cyclophosphamide (aHR 2.69 [95%CI 1.89–3.83]), more moderate in those using azathioprine (aHR 1.57 [95%CI 1.07–2.30]) and hydroxychloroquine (aHR 1.43 [95%CI 1.11–1.83]) and not elevated in users of methotrexate (aHR 1.24 [95%CI 0.98–1.57]), sulfasalazine (aHR 1.00 [95%CI 0.71–1.42]) and leflunomide (aHR 0.41 [95%CI 0.06–2.88]). Conclusions The risk of zoster was high among bDMARD and cyclophosphamide users. Also, the risk was increased in those using hydroxychloroquine alone and in combination with methotrexate but not methotrexate alone. Preventative strategies such as zoster vaccination or antiviral therapies should be considered in these populations if not contraindicated.

Download Full-text

The predictive role of sickness absence spell durations in associations with inpatient- and specialized outpatient care among a population-based Swedish twin sample

BMC Health Services Research ◽

10.1186/s12913-021-06310-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Annina Ropponen ◽

Mo Wang ◽

Jurgita Narusyte ◽

Sanna Kärkkäinen ◽

Victoria Blom ◽

...

Keyword(s):

Patient Care ◽

Sickness Absence ◽

Outpatient Care ◽

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Models ◽

Hazard Ratios ◽

Increased Risk ◽

Predictive Role

Abstract Background The associations between a sickness absence spell duration and patient care have been rarely studied. An assumption is that associations would differ by spell duration and by the patient care type, inpatient- or specialized outpatient, due to severity of diseases and/or conditions. We aimed to investigate sickness absence spells in various spell durations as a predictor for subsequent inpatient- and specialized outpatient care separately, and to study if familial confounding plays a role in these associations. Methods We followed a population-based sample of Swedish twins born 1925–90 with national registers from 2001 for first incident sickness absence spell (days to calculate spell duration categorized into ≤30 days, 31–90 days, 91–180 days and ≥ 181 days), or no sickness absence, and for inpatient- and specialized outpatient care until 2013 (n = 24,975). Cox proportional hazards models were applied for hazard ratios (HR) with 95% confidence intervals (CI) while accounting for covariates and familial confounding. Results First incident sickness absence spell across all duration categories was associated with an increased risk of inpatient- (age- and sex adjusted HR 1.28 to 6.05) or specialized outpatient care (HR 1.17–2.50), both in comparison to those without any sickness absence or the shortest sickness absence spell category (1–30 days). The associations remained statistically significant while controlling for covariates or familial confounding. Conclusions First incident sickness absence spell increases the risk of inpatient care or specialized outpatient care regardless of the duration of the sickness absence spell. Hence, incident sickness absence spells should be noted and targeted to actions at workplaces as well as in primary and occupational health care.

Download Full-text