Temporal trends in the healthy soldier effect in a cohort of Royal Norwegian Navy servicemen followed for 67 years

ObjectivesTo investigate temporal trends in the ‘healthy soldier effect’ (HSE) among 28 300 Royal Norwegian Navy servicemen who served during 1950–2004.MethodsStandardised mortality ratios (SMRs) for all causes, diseases and external causes were calculated from national rates for the entire study period (1951–2017), and for seven successive follow-up periods after the first recorded day of Naval service, for the overall cohort and for two subgroups: land-based personnel and vessel crews. Poisson regression, expressed as rate ratios, was used to compare all-cause mortality between the subgroups.ResultsIn the overall cohort, SMRs for all-cause mortality increased steadily during the first six 10-year follow-up periods, from 0.52 to 0.94, which was still lower than national rates. After 60 years, the lower mortality compared with national rates was no longer statistically significant (SMR=0.93). Low non-neoplastic disease mortality contributed most to the longevity of the HSE. For neoplastic diseases, there was a mortality deficit only for the first and third 10-year follow-up periods. External-cause mortality rose to national rates after 40 years. An HSE was present among vessel crews, but their total mortality rate was 24% higher than that among land-based personnel, who also showed a longer-lasting HSE.ConclusionsThe HSE eroded gradually over time but was still present at 60 years of follow-up for all-cause mortality. The effect was strongest and most long-lived for non-neoplastic disease, lasted up to 40 years for external causes, and was relatively short for cancers. Land-based personnel showed stronger and longer-lasting HSE than vessel crews.

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Cognitive Function and Mortality: Results from Kaunas HAPIEE Study 2006–2017

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17072397 ◽

2020 ◽

Vol 17 (7) ◽

pp. 2397

Author(s):

Abdonas Tamosiunas ◽

Laura Sapranaviciute-Zabazlajeva ◽

Dalia Luksiene ◽

Dalia Virviciute ◽

Martin Bobak

Keyword(s):

Cognitive Function ◽

Baseline Survey ◽

Cardiovascular Disease Mortality ◽

Follow Up Study ◽

Kaplan Meier ◽

Disease Mortality ◽

Increased Risk ◽

All Cause Mortality ◽

Cvd Mortality

Background: The purpose of the study is to evaluate the association between cognitive function and risk of all-cause and cardiovascular disease mortality during 10 years of the follow-up. Methods: 7087 participants were assessed in the baseline survey of the Health Alcohol Psychosocial Factors in Eastern Europe (HAPIEE) study in 2006–2008. During 10 years of follow-up, all-cause and CVD mortality risk were evaluated. Results: During 10 years of follow-up, 768 (23%) men and 403 (11%) women died (239 and 107 from CVD). After adjustment for sociodemographic, biological, lifestyle factors, and illnesses, a decrease per 1 standard deviation in different cognitive function scores increased risk for all-cause mortality (by 13%–24% in men, and 17%–33% in women) and CVD mortality (by 19%–32% in men, and 69%–91% in women). Kaplan-Meier survival curves for all-cause and CVD mortality, according to tertiles of cognitive function, revealed that the lowest cognitive function (1st tertile) predicts shorter survival compared to second and third tertiles (p < 0.001). Conclusions: The findings of this follow-up study suggest that older participants with lower cognitive functions have an increased risk for all-cause and CVD mortality compared to older participants with a higher level of cognitive function.

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Tea consumption and the risk of atherosclerotic cardiovascular disease and all-cause mortality: The China-PAR project

European Journal of Preventive Cardiology ◽

10.1177/2047487319894685 ◽

2020 ◽

Vol 27 (18) ◽

pp. 1956-1963 ◽

Cited By ~ 2

Author(s):

Xinyan Wang ◽

Fangchao Liu ◽

Jianxin Li ◽

Xueli Yang ◽

Jichun Chen ◽

...

Keyword(s):

Cardiovascular Disease ◽

Disease Incidence ◽

Atherosclerotic Cardiovascular Disease ◽

Tea Consumption ◽

Hazard Ratios ◽

Disease Mortality ◽

All Cause Mortality ◽

Cox Proportional Hazard Regression ◽

Study Participants

Aims The role of tea consumption in the primary prevention of atherosclerotic cardiovascular disease remains unclear in cohort studies. This prospective cohort study aimed to investigate the associations of tea consumption with the risk of atherosclerotic cardiovascular disease and all-cause mortality. Methods We included 100,902 general Chinese adults from the project of Prediction for ASCVD Risk in China (China-PAR) in 15 provinces across China since 1998. Information on tea consumption was collected through standardized questionnaires. Outcomes were identified by interviewing study participants or their proxies, and checking hospital records and/or death certificates. Cox proportional hazard regression models were used to calculate hazard ratios and their corresponding 95% confidence intervals related to tea consumption. Results During a median follow-up of 7.3 years, 3683 atherosclerotic cardiovascular disease events, 1477 atherosclerotic cardiovascular disease deaths, and 5479 all-cause deaths were recorded. Compared with never or non-habitual tea drinkers, the hazard ratio and 95% confidence interval among habitual tea drinkers was 0.80 (0.75–0.87), 0.78 (0.69–0.88), and 0.85 (0.79–0.90) for atherosclerotic cardiovascular disease incidence, atherosclerotic cardiovascular disease mortality, and all-cause mortality, respectively. Habitual tea drinkers had 1.41 years longer of atherosclerotic cardiovascular disease-free years and 1.26 years longer of life expectancy at the index age of 50 years. The observed inverse associations were strengthened among participants who kept the habit during the follow-up period. Conclusion Tea consumption was associated with reduced risks of atherosclerotic cardiovascular disease and all-cause mortality, especially among those consistent habitual tea drinkers.

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Dietary fiber intake and total and cause-specific mortality: the Japan Public Health Center-based prospective study

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa002 ◽

2020 ◽

Vol 111 (5) ◽

pp. 1027-1035 ◽

Cited By ~ 5

Author(s):

Ryoko Katagiri ◽

Atsushi Goto ◽

Norie Sawada ◽

Taiki Yamaji ◽

Motoki Iwasaki ◽

...

Keyword(s):

Public Health ◽

Prospective Study ◽

Dietary Fiber ◽

Large Scale ◽

Total Mortality ◽

Fiber Intake ◽

Dietary Fiber Intake ◽

All Cause Mortality ◽

Specific Mortality

ABSTRACT Background An inverse association has been shown between dietary fiber intake and several noncommunicable diseases. However, evidence of this effect remains unclear in the Asian population. Objective We examined the association between dietary fiber intake and all-cause and cause-specific mortality, as well as the association between fiber intake from dietary sources and all-cause mortality. Methods We conducted a large-scale population-based cohort study (Japan Public Health Center-based prospective study). A validated questionnaire with 138 food items was completed by 92,924 participants (42,754 men and 50,170 women) aged 45–74 y. Dietary fiber intake was calculated and divided into quintiles. HR and 95% CI of total and cause-specific mortality were reported. Results During the mean follow-up of 16.8 y, 19,400 deaths were identified. In multivariable adjusted models, total, soluble, and insoluble fiber intakes were inversely associated with all-cause mortality. The HRs of total mortality in the highest quintile of total fiber intake compared with the lowest quintile were 0.77 (95% CI: 0.72, 0.82; Ptrend <0.0001) in men and 0.82 (95% CI: 0.76, 0.89; Ptrend <0.0001) in women. Increased quintiles of dietary fiber intake were significantly associated with decreased mortality due to total cardiovascular disease (CVD), respiratory disease, and injury in both men and women, whereas dietary fiber intake was inversely associated with cancer mortality in men but not women. Fiber from fruits, beans, and vegetables, but not from cereals, was inversely associated with total mortality. Conclusion In this large-scale prospective study with a long follow-up period, dietary fiber was inversely associated with all-cause mortality. Since intakes of dietary fiber, mainly from fruits, vegetables, and beans were associated with lower all-cause mortality, these food sources may be good options for people aiming to consume more fiber.

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Dietary fats and mortality among patients with type 2 diabetes: analysis in two population based cohort studies

BMJ ◽

10.1136/bmj.l4009 ◽

2019 ◽

pp. l4009 ◽

Cited By ~ 8

Author(s):

Jingjing Jiao ◽

Gang Liu ◽

Hyun Joon Shin ◽

Frank B Hu ◽

Eric B Rimm ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Fatty Acids ◽

Linoleic Acid ◽

Saturated Fatty Acids ◽

Total Mortality ◽

Cardiovascular Disease Mortality ◽

Disease Mortality

AbstractObjectiveTo assess the association of dietary fatty acids with cardiovascular disease mortality and total mortality among patients with type 2 diabetes.DesignProspective, longitudinal cohort study.SettingHealth professionals in the United States.Participants11 264 participants with type 2 diabetes in the Nurses’ Health Study (1980-2014) and Health Professionals Follow-Up Study (1986-2014).ExposuresDietary fat intake assessed using validated food frequency questionnaires and updated every two to four years.Main outcome measureTotal and cardiovascular disease mortality during follow-up.ResultsDuring follow-up, 2502 deaths including 646 deaths due to cardiovascular disease were documented. After multivariate adjustment, intake of polyunsaturated fatty acids (PUFAs) was associated with a lower cardiovascular disease mortality, compared with total carbohydrates: hazard ratios comparing the highest with the lowest quarter were 0.76 (95% confidence interval 0.58 to 0.99; P for trend=0.03) for total PUFAs, 0.69 (0.52 to 0.90; P=0.007) for marine n-3 PUFAs, 1.13 (0.85 to 1.51) for α-linolenic acid, and 0.75 (0.56 to 1.01) for linoleic acid. Inverse associations with total mortality were also observed for intakes of total PUFAs, n-3 PUFAs, and linoleic acid, whereas monounsaturated fatty acids of animal, but not plant, origin were associated with a higher total mortality. In models that examined the theoretical effects of substituting PUFAs for other fats, isocalorically replacing 2% of energy from saturated fatty acids with total PUFAs or linoleic acid was associated with 13% (hazard ratio 0.87, 0.77 to 0.99) or 15% (0.85, 0.73 to 0.99) lower cardiovascular disease mortality, respectively. A 2% replacement of energy from saturated fatty acids with total PUFAs was associated with 12% (hazard ratio 0.88, 0.83 to 0.94) lower total mortality.ConclusionsIn patients with type 2 diabetes, higher intake of PUFAs, in comparison with carbohydrates or saturated fatty acids, is associated with lower total mortality and cardiovascular disease mortality. These findings highlight the important role of quality of dietary fat in the prevention of cardiovascular disease and total mortality among adults with type 2 diabetes.

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Abstract P224: Higher Fruit and Vegetable Intake Was Associated With Lower Total and Cause-Specific Mortality in a Nonlinear Dose-Response Manner

Circulation ◽

10.1161/circ.137.suppl_1.p224 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Dong D Wang ◽

Shilpa N Bhupathiraju ◽

Yanping Li ◽

Bernard A Rosner ◽

Qi Sun ◽

...

Keyword(s):

Dose Response ◽

Fruits And Vegetables ◽

Vegetable Intake ◽

Total Mortality ◽

Fruit And Vegetable Intake ◽

Fruit And Vegetable ◽

Dose Response Relationship ◽

Disease Mortality ◽

Specific Mortality

Introduction: The strength and dose-response relationship between fruit and vegetable intake and mortality are still subjects of debate. Hypothesis: We hypothesized that higher fruit and vegetable intake was associated with lower total and cause-specific mortality in a nonlinear dose-response manner. Methods: We followed 66,719 women from the Nurses’ Health Study (1984-2012) and 42,016 men from the Health Professionals Follow-up Study (1986-2012) who were free from cardiovascular disease (CVD), cancer and diabetes at baseline. Diet was assessed using food frequency questionnaires at baseline and updated every 2 to 4 years. Results: Our study documented 28,333 deaths during follow-up. The 3rd quintile of fruit and vegetable intake was associated with the lowest hazard ratio (HR) of total mortality (HR, 0.87, 95% CI, 0.83-0.90, P nonlinear <0.001) compared to the 1st quintile. The nonlinear dose-response relationship plateaued at about 5 servings/day (svg/d), but above that level, higher intake was not associated with additional risk reduction. We found similar nonlinear associations for CVD, cancer and respiratory disease mortality. Compared to fruit and vegetable intake <1.5 svg/d, the intake level ≥5 svg/d was associated with HRs (95% CI) of 0.84 (0.75-0.93), 0.82 (0.72-0.93) and 0.55 (0.44-0.67) for cancer, CVD and respiratory disease mortality, respectively. Among individual fruits and vegetables, the associations of intakes with mortality were heterogeneous. Higher intakes of most fruit and vegetable subgroups were associated with lower total mortality, whereas higher intake of starchy vegetable such as peas and corn was not associated with total mortality. Conclusions: Higher fruit and vegetable intake was associated with lower mortality; the lowest mortality was observed among those who consumed 5 servings of fruit and vegetables per day (2 servings of fruit and 3 servings of vegetables daily). Our findings also suggest the presence of heterogeneity in the health benefits of individual fruits and vegetables.

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Low-density lipoprotein cholesterol and all-cause mortality: findings from the China health and retirement longitudinal study

BMJ Open ◽

10.1136/bmjopen-2020-036976 ◽

2020 ◽

Vol 10 (8) ◽

pp. e036976

Author(s):

Liang Zhou ◽

Ying Wu ◽

Shaobo Yu ◽

Yueping Shen ◽

Chaofu Ke

Keyword(s):

Longitudinal Study ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Total Mortality ◽

Low Density ◽

Low Density Lipoprotein Cholesterol ◽

Middle Aged ◽

Elderly Chinese ◽

All Cause Mortality

ObjectivesTo investigate the relationship between low-density lipoprotein cholesterol (LDL-C) and all-cause mortality among middle-aged and elderly Chinese population.DesignProspective cohort study.SettingThis study used data from the China Health and Retirement Longitudinal Study.ParticipantsMiddle-aged and elderly participants with complete data were enrolled for a 4-year follow-up of total mortality and plasma levels of LDL-C, including 4981 male respondents and 5529 female respondents.ResultsDuring a 4-year follow-up, there were 305 and 219 deaths in men and women, respectively. Compared with the first quintile (Q1) of LDL-C, the adjusted HRs (95% CIs) were 0.818 (0.531 to 1.260) for Q2, 0.782 (0.507 to 1.208) for Q3, 0.605 (0.381 to 0.962) for Q4 and 0.803 (0.506 to 1.274) for Q5 in men. The results from restricted cubic spine (RCS) showed that when the 20th percentile of LDL-C levels (84 mg/dL) was used as the reference, a lower LDL-C concentration (<84 mg/dL) was associated with a higher 4-year all-cause mortality risk. By contrast, both quintile analysis and RCS analysis did not show a statistically significant association in women.ConclusionsCompared with moderately elevated LDL-C (eg, 117–137 mg/dL), a lower plasma level of LDL-C (eg, ≤84 mg/dL) was associated with an increased risk of 4-year all-cause mortality in middle-aged and elderly Chinese men. The results suggest the potential harmful effect of a quite low level of LDL-C on total mortality.

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Associations of total nut and peanut intakes with all-cause and cause-specific mortality in a Japanese community: the Takayama study

British Journal Of Nutrition ◽

10.1017/s0007114521002257 ◽

2021 ◽

pp. 1-23

Author(s):

Michiyo Yamakawa ◽

Keiko Wada ◽

Sachi Koda ◽

Takahiro Uji ◽

Yuma Nakashima ◽

...

Keyword(s):

Epidemiological Studies ◽

Population Based ◽

Disease Mortality ◽

Risk Of Mortality ◽

All Cause Mortality ◽

Specific Mortality ◽

The Mean ◽

Nut Intake ◽

Reduced Risk

Abstract Numerous epidemiological studies have suggested that nut intake is associated with a reduced risk of mortality. Although diets and lifestyles differ by regions or races/ethnicities, few studies have investigated the associations among non-white, non-Western populations. We evaluated the associations of total nut and peanut intakes with all-cause and cause-specific mortality in a population-based prospective cohort in Japan. Participants (age: ≥35 years at baseline in 1992; n = 31,552) were followed up until death or the end of follow-up in 2008. Those with cancer, coronary heart disease, or stroke at baseline were excluded. Dietary intake was assessed only at baseline by using a validated food frequency questionnaire. In total, 2901 men died during 183,299 person-years and 2438 women died during 227,054 person-years. The mean intakes of total nuts were 1.8 and 1.4 g/day in men and women, respectively. Although peanut intake accounted for approximately 80% of the total nut intake, total nut and peanut intakes were inversely associated with all-cause mortality in men after adjusting for all potential confounders. For example, compared with the lowest quartile category, the adjusted hazard ratio (95% confidence interval) of total nut intake for all-cause mortality in men of the highest quartile category was 0.85 (0.75–0.96) (P for trend = 0.034). Peanut intake was inversely associated with digestive disease mortality in men and cardiovascular disease mortality in women. Total nut and peanut intakes, even in low amounts, were associated with a reduced risk of mortality particularly in men.

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Prognostic impact of right ventricular overload in patients with acute coronary syndrome

European Heart Journal ◽

10.1093/ehjci/ehaa946.1535 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

T Sato ◽

Y Ogihara ◽

T Kurita ◽

H Mizutani ◽

A Takasaki ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Right Ventricular ◽

Laboratory Data ◽

Prognostic Impact ◽

Entire Study ◽

Poor Prognostic Factor ◽

Coronary Syndrome ◽

Increased Risk ◽

All Cause Mortality

Abstract Background Right ventricular (RV) overload is associated with adverse outcome in patients with chronic heart failure. However, its prognostic value in acute coronary syndrome (ACS) patients remains unknown. Purpose The purpose of this study was to investigate the prevalence and prognostic impact of right ventricular overload in ACS patients. Methods We studied 2797 ACS patients from Mie ACS registry, a prospective and multicenter registry in Japan. They were divided into 4 subgroups according to the severity of RV overload and the extent of Left Ventricle Ejection Fraction (LVEF) assessed by echocardiography before hospital discharge. High RV overload was defined as trans-tricuspid pressure gradient (TRPG) ≥40mmHg and preserved LVEF was defined as ≥50%. The primary outcome was defined as 2-year all-cause mortality. Median follow up duration was 730 days (1–2215 days). Results High RV overload was detected in 76 patients (2.7%). In basic patients characteristics, high RV overload patients were significantly older and higher killip classification than low RV overload patients (P<0.01, respectively). Laboratory data in high RV overload patients showed lower hemoglobin level and higher serum creatinine level than those in low RV overload patients (P<0.01, respectively). Echocardiographic findings in high RV overload represented lower LVEF, higher rate of moderate or severe mitral regurgitation and left atrial enlargement than those in low RV overload patients (P<0.01, respectively). During the follow-up periods (median 730 days), 260 (9.3%) patients experienced all-cause death. Multivariate cox hazard regression analysis for all-cause mortality demonstrated that high RV overload was an independent poor prognostic factor in the entire study population. Among patients with preserved LVEF, high RV overload resulted in an increased risk of all-cause mortality compared to low RV overload (P<0.0001). Conclusion In ACS patients, high RV overload strongly contributes to worsening of prognosis regardless of the extent of LVEF. Kaplan-Meier survival curve Funding Acknowledgement Type of funding source: None

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Association between psychological distress and mortality: the case of Israel

Journal of Epidemiology & Community Health ◽

10.1136/jech-2017-210356 ◽

2018 ◽

Vol 72 (8) ◽

pp. 726-732 ◽

Cited By ~ 1

Author(s):

Alexander Michael Ponizovsky ◽

Ziona Haklai ◽

Nehama Goldberger

Keyword(s):

Psychological Distress ◽

Linear Trend ◽

General Health Questionnaire ◽

Total Mortality ◽

National Health Survey ◽

Reverse Causality ◽

Israeli Population ◽

All Cause Mortality ◽

Causes Of Mortality

BackgroundPrevious studies have demonstrated the association between psychological distress (measured by the 12-item General Health Questionnaire, GHQ-12) and risks of all-cause mortality and deaths from cardiovascular, cancer and other causes. We hypothesised that in the Israeli population permanently exposed to war/terror stressors, this relationship is absent.MethodsWe performed an analysis of data from participants in the Israel National Health Survey conducted in 2003–2004, who died during the follow-up decade. Subjects were assigned to groups based on GHQ-12 score: 0–10 (asymptomatic), 11–14 (subclinically symptomatic), 15–19 (symptomatic) and 20–36 (highly symptomatic). Data were weighted to the total population.ResultsWe analysed data from 4843 individuals, median age 40.5 (IQR 28–54); 473 participants died during the follow-up. We found a significant increase in total mortality, cardiovascular and other causes of mortality (but not cancer deaths) with increase in GHQ-12 score (P for linear trend of ungrouped GHQ scores <0.0001, 0.0015 and <0.0001, respectively). The age–sex-adjusted HR for the highest GHQ-12 compared with the lowest asymptomatic category was 2.1 (95% CI 1.6 to 2.7) for all-cause deaths, 2.3 (95% CI 1.3 to 4.1) for cardiovascular disease deaths and 2.7 (95% CI 1.9 to 3.9) for other deaths. The HR remained significant after adjustment for education, smoking, alcohol consumption and diabetes. The HR even increased after excluding participants with baseline cardiovascular diseases and cancer.ConclusionContrary to our hypothesis, psychological distress was associated with all-cause and cardiovascular but not cancer mortality. The absence of reverse causality provides evidence for the direct deleterious effects of psychological distress on mortality outcomes.

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Flavonoid intake and all-cause mortality

American Journal of Clinical Nutrition ◽

10.3945/ajcn.113.073106 ◽

2015 ◽

Vol 101 (5) ◽

pp. 1012-1020 ◽

Cited By ~ 73

Author(s):

Kerry L Ivey ◽

Jonathan M Hodgson ◽

Kevin D Croft ◽

Joshua R Lewis ◽

Richard L Prince

Keyword(s):

Cardiovascular Disease ◽

Vascular Diseases ◽

Food Composition ◽

Total Flavonoid ◽

Disease Mortality ◽

Risk Of Mortality ◽

All Cause Mortality ◽

Flavonoid Intake ◽

Study Population

ABSTRACT Background: Flavonoids are bioactive compounds found in foods such as tea, chocolate, red wine, fruit, and vegetables. Higher intakes of specific flavonoids and flavonoid-rich foods have been linked to reduced mortality from specific vascular diseases and cancers. However, the importance of flavonoids in preventing all-cause mortality remains uncertain. Objective: The objective was to explore the association between flavonoid intake and risk of 5-y mortality from all causes by using 2 comprehensive food composition databases to assess flavonoid intake. Design: The study population included 1063 randomly selected women aged >75 y. All-cause, cancer, and cardiovascular mortalities were assessed over 5 y of follow-up through the Western Australia Data Linkage System. Two estimates of flavonoid intake (total flavonoidUSDA and total flavonoidPE) were determined by using food composition data from the USDA and the Phenol-Explorer (PE) databases, respectively. Results: During the 5-y follow-up period, 129 (12%) deaths were documented. Participants with high total flavonoid intake were at lower risk [multivariate-adjusted HR (95% CI)] of 5-y all-cause mortality than those with low total flavonoid consumption [total flavonoidUSDA: 0.37 (0.22, 0.58); total flavonoidPE: 0.36 (0.22, 0.60)]. Similar beneficial relations were observed for both cardiovascular disease mortality [total flavonoidUSDA: 0.34 (0.17, 0.69); flavonoidPE: 0.32 (0.16, 0.61)] and cancer mortality [total flavonoidUSDA: 0.25 (0.10, 0.62); flavonoidPE: 0.26 (0.11, 0.62)]. Conclusions: Using the most comprehensive flavonoid databases, we provide evidence that high consumption of flavonoids is associated with reduced risk of mortality in older women. The benefits of flavonoids may extend to the etiology of cancer and cardiovascular disease.

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