Abstract P270: Body Size Throughout the Life Course and Risk of Venous Thromboembolism

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Kaitlin A Hagan ◽  
Laura B Harrington ◽  
Jihye Kim ◽  
Francine Grodstein ◽  
Christopher Kabrhel
Keyword(s):  
Body Size ◽  
Venous Thromboembolism ◽  
Waist Circumference ◽  
Early Life ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Hip Circumference ◽  
Adult Body Mass

Introduction: Adult body mass index (BMI) is strongly associated with venous thromboembolism (VTE), however whether earlier-life adiposity or other measures of adult adiposity are associated with VTE risk remains unknown. Hypothesis: Since BMI is a strong risk factor for incident VTE, we hypothesized that early life body size as well as other measures of adult adiposity may also be positively associated with VTE risk. Methods: We evaluated associations of childhood somatotype, BMI at age 18, change in BMI since age 18, and measures of waist and hip circumference with incident VTE among 47,415 women age 40-67 years at baseline from the Nurses’ Health Study (NHS), 47,539 women age 29-48 years from the Nurses’ Health Study II (NHS II), and 32,707 men age 39-76 years from the Health Professionals Follow-Up Study (HPFS) without a prior VTE. We calculated multivariable-adjusted hazard ratios (HR) of VTE using Cox proportional hazards models. Results: Over ≥25 years of follow-up, there were 1,191 incident VTE cases in NHS, 763 cases in NHS II, and 1,350 cases in HPFS. Adult BMI was strongly associated with VTE in all three cohorts (HRs comparing ≥35 kg/m 2 vs. <22.5 kg/m 2 : NHS: 3.03 [95% CI: 2.58, 3.55], NHS II: 3.88 [95% CI: 3.36, 4.48], HPFS: 2.49 [95% CI: 1.83, 3.29]; all P trend< 0.01). Waist circumference, hip circumference, and height were associated with greater VTE risk, even after adjusting for adult BMI (all P trend< 0.01) (Table). Somatotype at ages 5 and 10, BMI at age 18, and change in BMI since age 18 were not significantly associated with VTE risk, after accounting for adult BMI. Conclusions: Adult BMI, waist circumference, hip circumference, and height were independently, positively associated with incident VTE risk. Early life body size was not significantly associated with VTE risk after accounting for adult BMI, indicating that BMI and adiposity are likely more important acutely that cumulatively over time in the etiology of VTE. Clinically, encouraging weight loss in adults

scholarly journals Body Habitus Across the Lifespan and Risk of Pituitary Adenoma

2021 ◽  
Author(s):  
David J Cote ◽  
Timothy R Smith ◽  
Ursula B Kaiser ◽  
Edward R Laws ◽  
Meir J Stampfer
Keyword(s):  
Pituitary Adenoma ◽  
Waist Circumference ◽  
Health Professionals ◽  
Proportional Hazards ◽  
Early Adulthood ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
Health Study ◽  
Body Habitus

Abstract Context No studies have examined the association between body habitus and incidence of pituitary adenoma. Objective To determine if body mass index (BMI), waist circumference, body somatotype, or height are associated with risk of pituitary adenoma. Design Pooled analysis of 3 prospective cohort studies. Setting Population-based study. Participants Participants of the Nurses’ Health Study (NHS), Nurses’ Health Study II (NHSII), and the Health Professionals Follow-Up Study (HPFS), totaling 284 946 American health professionals. Exposures BMI, waist circumference, body somatotype, and height. Outcome Measures Self-reported incident pituitary adenoma. Multivariable (MV)-adjusted hazard ratios (HRs) of pituitary adenoma were estimated using Cox proportional hazards models. Results During 7 350 156 person-years of follow-up, 387 incident pituitary adenomas were reported. Comparing BMI of ≥30 to &lt;25 kg/m2, higher adult BMI was associated with higher risk of pituitary adenoma (MV HR = 1.74; 95% CI, 1.33-2.28), as was higher maximum adult BMI (MV HR = 1.76; 95% CI, 1.34-2.30), higher waist circumference (MV HR = 1.06; 95% CI, 1.04-1.09 per inch), and higher BMI during early adulthood (at age 18 to 21, MV HR = 2.65; 95% CI, 1.56-4.49). Taller adult height was associated with pituitary adenoma (MV HR = 1.05; 95% CI, 1.01-1.09 per inch). Overall findings were similar in women and men, although power was limited in men (n = 62 cases). Sensitivity analyses demonstrated that the association between adult BMI and pituitary adenoma extended to at least 14 years prior to diagnosis and that the results were not affected when analyses were restricted to participants with similar healthcare utilization. Conclusion Higher BMI and waist circumference, from early adulthood to the time of diagnosis, were associated with higher risk of pituitary adenoma.

scholarly journals Association of oral contraceptives and tubal ligation with risk of early natural menopause

2021 ◽  
Author(s):  
C R Langton ◽  
B W Whitcomb ◽  
A C Purdue-Smithe ◽  
L L Sievert ◽  
S E Hankinson ◽  
...  
Keyword(s):  
Oral Contraceptives ◽  
Proportional Hazards ◽  
Reproductive Factors ◽  
Cox Proportional Hazards ◽  
Tubal Ligation ◽  
Health Study ◽  
Early Menopause ◽  
Natural Menopause ◽  
Increased Risk

Abstract STUDY QUESTION What is the association of oral contraceptives (OCs) and tubal ligation (TL) with early natural menopause? SUMMARY ANSWER We did not observe an association of OC use with risk of early natural menopause; however, TL was associated with a modestly higher risk. WHAT IS KNOWN ALREADY OCs manipulate hormone levels, prevent ovulation, and may modify the rate of follicular atresia, while TL may disrupt the blood supply to the ovaries. These mechanisms may be associated with risk of early menopause, a condition associated with increased risk of cardiovascular disease and other adverse health outcomes. STUDY DESIGN, SIZE, DURATION We examined the association of OC use and TL with natural menopause before the age of 45 years in a population-based study within the prospective Nurses’ Health Study II (NHSII) cohort. Participants were followed from 1989 to 2017 and response rates were 85-90% for each cycle. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants included 106 633 NHSII members who were premenopausal and aged 25-42 years at baseline. Use, duration and type of OC, and TL were measured at baseline and every 2 years. Menopause status and age were assessed every 2 years. Follow-up continued until early menopause, age 45 years, hysterectomy, oophorectomy, death, cancer diagnosis, or loss to follow-up. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% CIs adjusted for lifestyle, dietary, and reproductive factors. MAIN RESULTS AND THE ROLE OF CHANCE Over 1.6 million person-years, 2579 members of the analytic cohort experienced early natural menopause. In multivariable models, the duration, timing, and type of OC use were not associated with risk of early menopause. For example, compared with women who never used OCs, those reporting 120+ months of OC use had an HR for early menopause of 1.01 (95% CI, 0.87-1.17; P for trend=0.71). TL was associated with increased risk of early menopause (HR = 1.17, 95% CI, 1.06-1.28). LIMITATIONS, REASONS FOR CAUTION Our study population is homogenous with respect to race and ethnicity. Additional evaluation of these relations in more diverse populations is important. WIDER IMPLICATIONS OF THE FINDINGS To our knowledge, this is the largest study examining the association of OC use and TL with early natural menopause to date. While TL was associated with a modest higher risk of early menopause, our findings do not support any material hazard or benefit for the use of OCs. STUDY FUNDING/COMPETING INTEREST(S) The study was sponsored by UO1CA176726 and R01HD078517 from the National Institutes of Health and Department of Health and Human Services. The work was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The authors have no competing interests to report. TRIAL REGISTRATION NUMBER N/A

scholarly journals Meat intake and risk of hepatocellular carcinoma in two large US prospective cohorts of women and men

2019 ◽  
Author(s):  
Yanan Ma ◽  
Wanshui Yang ◽  
Tricia Li ◽  
Yue Liu ◽  
Tracey G Simon ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Proportional Hazards ◽  
Red Meat ◽  
Cox Proportional Hazards ◽  
Fish Intake ◽  
Health Study ◽  
Meat Intake ◽  
Red Meats ◽  
Processed Red Meat

Abstract Background Epidemiological evidence on the associations between meat intake and risk of hepatocellular carcinoma (HCC) was limited and inconsistent. Methods We prospectively examined the association between consumption of meats and meat mutagens with HCC risk using data from the Nurses’ Health Study and the Health Professionals Follow-up Study. Cox proportional-hazards regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) after adjusting for known liver-cancer risk factors. Results During up to 32 years of follow-up, we documented 163 incident HCC cases. The HRs of HCC for the highest vs the lowest tertile intake levels were 1.84 (95% CI: 1.16–2.92, Ptrend = 0.04) for processed red meats and 0.61 (95% CI: 0.40–0.91, Ptrend = 0.02) for total white meats. There was a null association between unprocessed red meats and HCC risk (HR = 1.06, 95% CI: 0.68–1.63, Ptrend = 0.85). We found both poultry (HR = 0.60, 95% CI: 0.40–0.90, Ptrend = 0.01) and fish (HR = 0.70, 95% CI: 0.47–1.05, Ptrend = 0.10) were inversely associated with HCC risk. The HR for HCC risk was 0.79 (95% CI: 0.61–1.02) when 1 standard deviation of processed red meats was substituted with an equivalent amount of poultry or fish intake. We also found a suggestive positive association of intake of meat-derived mutagenicity or heterocyclic amines with risk of HCC. Conclusions Processed red meat intake might be associated with higher, whereas poultry or possibly fish intake might be associated with lower, risk of HCC. Replacing processed red meat with poultry or fish might be associated with reduced HCC risk.

scholarly journals Prediabetes, Diabetes, and the Risk of All-Cause and Cause-Specific Mortality in a Japanese Working Population: Japan Epidemiology Collaboration on Occupational Health Study

2021 ◽  
Author(s):  
Zobida Islam ◽  
Shamima Akter ◽  
Yosuke Inoue ◽  
Huan Hu ◽  
Keisuke Kuwahara ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
World Health ◽  
Health Study ◽  
Expert Committee ◽  
Risk Of Mortality ◽  
Japanese Workers ◽  
Increased Risk ◽  
Health Organization

<b>Objective:</b> Prediabetes has been suggested to increase mortality risk; however, the definitions of prediabetes that can predict mortality remain elusive. We prospectively investigated the association of multiple definitions of prediabetes with the risk of mortality from all-causes, cardiovascular disease (CVD), and cancer in Japanese workers. <p> </p> <p><b>Research</b> <b>design</b> <b>and</b> <b>methods:</b> The study included 62,785 workers who underwent a health checkup in 2010 or 2011 and were followed up for mortality from 2012 to March 2019. <a>Prediabetes was defined according to fasting plasma glucose (FPG) or glycated hemoglobin (HbA1c) level or a combination of both using the American Diabetes Association (ADA) or World Health Organization (WHO)/International Expert Committee (IEC) criteria. </a>The Cox proportional hazards regression model was used to investigate the associations.</p> <p> </p> <p><b>Results:</b> Over a 7-year follow-up, 229 deaths were documented. <a>Compared with normoglycemia, prediabetes defined according to ADA criteria was associated with a higher risk of all-cause (hazard ratio [HR] 1.53; 95% confidence interval [CI] 1.12–2.09) and cancer (HR 2.37; 95% CI 1.45–3.89) mortality but not with CVD mortality. </a>The results were materially unchanged when prediabetes was defined according to ADA FPG, ADA HbA1c, WHO FPG, or combined WHO/IEC criteria. Diabetes was associated with the risk of all-cause, CVD, and cancer mortality.</p> <p> </p> <p><b>Conclusion:</b> In a cohort of Japanese workers, FPG- and HbA1c-defined prediabetes according to ADA or WHO/IEC was each associated with a significantly increased risk of mortality from all-causes and cancer but not CVD. </p>

scholarly journals Changes in Plant-Based Diet Quality and Total and Cause-Specific Mortality

Circulation ◽  
2019 ◽  
Vol 140 (12) ◽  
pp. 979-991 ◽  
Author(s):  
Megu Y. Baden ◽  
Gang Liu ◽  
Ambika Satija ◽  
Yanping Li ◽  
Qi Sun ◽  
...  
Keyword(s):  
Diet Quality ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Total Mortality ◽  
Cox Proportional Hazards ◽  
Environmental Benefits ◽  
Health Study ◽  
Specific Mortality ◽  
Cvd Mortality

Background: Plant-based diets have been associated with lower risk of type 2 diabetes mellitus and cardiovascular disease (CVD) and are recommended for both health and environmental benefits. However, the association between changes in plant-based diet quality and mortality remains unclear. Methods: We investigated the associations between 12-year changes (from 1986 to 1998) in plant-based diet quality assessed by 3 plant-based diet indices (score range, 18–90)—an overall plant-based diet index (PDI), a healthful PDI, and an unhealthful PDI—and subsequent total and cause-specific mortality (1998–2014). Participants were 49 407 women in the Nurses’ Health Study (NHS) and 25 907 men in the Health Professionals Follow-Up Study (HPFS) who were free from CVD and cancer in 1998. Multivariable-adjusted Cox proportional-hazards models were used to estimate hazard ratios (HRs) and 95% CIs. Results: We documented 10 686 deaths including 2046 CVD deaths and 3091 cancer deaths in the NHS over 725 316 person-years of follow-up and 6490 deaths including 1872 CVD deaths and 1772 cancer deaths in the HPFS over 371 322 person-years of follow-up. Compared with participants whose indices remained stable, among those with the greatest increases in diet scores (highest quintile), the pooled multivariable-adjusted HRs for total mortality were 0.95 (95% CI, 0.90–1.00) for PDI, 0.90 (95% CI, 0.85–0.95) for healthful PDI, and 1.12 (95% CI, 1.07–1.18) for unhealthful PDI. Among participants with the greatest decrease (lowest quintile), the multivariable-adjusted HRs were 1.09 (95% CI, 1.04–1.15) for PDI, 1.10 (95% CI, 1.05–1.15) for healthful PDI, and 0.93 (95% CI, 0.88–0.98) for unhealthful PDI. For CVD mortality, the risk associated with a 10-point increase in each PDI was 7% lower (95% CI, 1–12%) for PDI, 9% lower (95% CI, 4–14%) for healthful PDI, and 8% higher (95% CI, 2–14%) for unhealthful PDI. There were no consistent associations between changes in plant-based diet indices and cancer mortality. Conclusions: Improving plant-based diet quality over a 12-year period was associated with a lower risk of total and CVD mortality, whereas increased consumption of an unhealthful plant-based diet was associated with a higher risk of total and CVD mortality.

Independent effects of waist circumference and physical activity on all-cause mortality in Canadian women

2006 ◽  
Vol 31 (3) ◽  
pp. 271-276 ◽  
Author(s):  
Peter T Katzmarzyk ◽  
Cora L Craig
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Waist Circumference ◽  
Physical Inactivity ◽  
Proportional Hazards ◽  
Leisure Time Physical Activity ◽  
Smoking Status ◽  
Cox Proportional Hazards ◽  
Independent Effects

The purpose of this study was to determine the independent effects of waist circumference (WC) and physical inactivity on the risk of mortality in women. This prospective cohort study included 5421 female participants 20-69 years of age in the 1981 Canada Fitness Survey. WC was measured with an anthropometric tape and leisure-time physical activity levels over the previous 12 months were assessed with a questionnaire. Mortality surveillance was conducted by data linkage with the Canadian Mortality Database through 31 December, 1993. The hazard ratios (HR) of mortality were estimated using Cox proportional hazards regression with age, smoking status, and alcohol con sumption included as covariates in all models. A total of 225 deaths occurred over an average of 12.4 years of follow up (67 500 person-years of follow up). Physical activity (HR = 0.78; 95% C.I.: 0.64-0.95) and WC (HR = 1.17; 95% C.I.: 1.05-1.31) were associated with mortality when included in separate regression models. When included in the same model, both physical activity (HR = 0.79; 95% CI: 0.65-0.96) and WC (HR = 1.16; 95% C.I.: 1.04-1.30) remained independent significant predictors of mortality. In conclusion, physical inactivity and high WC have significant independent risks of premature mortality among women.Key words: death, obesity, cohort study, Canada Fitness Survey.

scholarly journals Restricted AccessChanges in Plant-Based Diet Indices and Subsequent Risk of Type 2 Diabetes in Women and Men: Three U.S. Prospective Cohorts

2021 ◽  
Author(s):  
Zhangling Chen ◽  
Jean-Philippe Drouin-Chartier ◽  
Yanping Li ◽  
Megu Y. Baden ◽  
JoAnn E. Manson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Diabetes Risk ◽  
Health Study ◽  
Weight Changes ◽  
Subsequent Risk

<b>Objective</b> <p>We evaluated the associations between changes in plant-based diets and subsequent risk of type 2 diabetes.</p> <p><b>Methods</b></p> <p>We prospectively followed 76,530 women in the Nurses’ Health Study (NHS, 1986-2012), 81,569 women in NHS II (1991-2017), and 34,468 men in the Health Professionals’ Follow-up Study (1986-2016). Adherence to plant-based diets was assessed every 4 years using the overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI). We used multivariable Cox proportional hazards models to estimate hazard ratios (HRs). Results of the three cohorts were pooled using meta-analysis.</p> <p><b>Results</b></p> <p>We documented 12,627 cases of type 2 diabetes during 2,955,350 person-years of follow-up. <a>After adjustment for initial BMI, initial and 4-year changes in alcohol intake, smoking, physical activity, and other factors, </a><a>compared with participants whose indices remained relatively stable (±3%), </a><a>participants with the largest decrease (>10%) in PDI and hPDI over 4 years had a 12%-23% higher diabetes risk in the subsequent 4 years (pooled HR: PDI, 1.12 (95% CI 1.05, 1.20), hPDI, 1.23 (1.16, 1.31)). </a>Each 10% increment in PDI and hPDI over 4 years was associated with a 7%-9% lower risk (PDI, 0.93 (0.91, 0.95), hPDI, 0.91 (0.87, 0.95)). Changes in uPDI were not associated with diabetes risk. Weight changes accounted for 6.0%-35.6% of the associations between changes in PDI and hPDI and diabetes risk. </p> <p><b>Conclusions</b></p> <p>Improving adherence to overall and healthful plant-based diets was associated with a lower risk of type 2 diabetes, whereas decreased adherence to such diets was associated with a higher risk. </p>

scholarly journals Changes in Plant Based Diets and Subsequent Risk of Type 2 Diabetes: Results from 3 Large US Cohorts

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1387-1387
Author(s):  
Zhangling Cheng ◽  
Jean-Philippe Drouin-Chartier ◽  
Yanping Li ◽  
Megu Baden ◽  
JoAnn Manson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Proportional Hazards ◽  
Meta Analysis ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Weight Changes ◽  
Cox Proportional Hazards Models

Abstract Objectives Plant-based diets may lower type 2 diabetes (T2D) risk. Whether changes in adherence to plant-based diets are associated with subsequent T2D risk remains unknown. We aimed to evaluate the associations between 4 year changes in plant based diets and subsequent 4 year risk of T2D. Methods We prospectively followed 76,530 women in the Nurses’ Health Study (NHS, 1986–2012), 81,586 women in NHS II (1991–2017), and 34,468 men in the Health Professionals’ Follow-up Study (1986–2016). Diet was assessed every 4 years using validated food-frequency questionnaires. Adherence to plant-based diets was assessed using previously developed indices – the overall plant-based diet index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI). Self reported T2D cases were validated by supplementary questionnaires. We used multivariable time dependent Cox proportional hazards models to estimate hazard ratios (HR) and 95% CIs for T2D associated with 4 year changes in adherence to plant based diets. Results of the three cohorts were pooled using an inverse variance-weighted meta-analysis. Results We documented 12,016 cases of T2D during 2818,485 person-years of follow-up. After adjustment for initial BMI, initial and 4-year changes in lifestyle and other factors, compared with participants whose indices remained relatively stable (±3%), participants with the largest 4-year decrease (&gt;10%) in PDI and hPDI had a 12%-23% higher T2D risk in the subsequent 4 years (HR for PDI, 1.12 (95% CI 1.05, 1.20), HR for hPDI, 1.23 (1.16, 1.31)). Conversely, each 10% incremental increase in PDI and hPDI over 4 years was associated with a 7%–9% lower T2D risk in subsequent 4 years (HR for PDI, 0.93 (0.90, 0.95), HR for hPDI, 0.91 (0.87, 0.95)). Changes in uPDI were not associated with T2D risk. Further adjustment for concurrent changes in body weight, a potential mediator, modestly attenuated the associations but results remained significant. We estimated that body weight changes explained 6.0%–36% of the associations between 4 year changes in PDI and hPDI and subsequent T2D risk. Conclusions Improving adherence to overall and healthful plant based diets over a 4 year period was associated with a lower T2D risk, whereas decreased adherence to overall and healthful plant based diets was associated with a higher T2D risk. Funding Sources Nutricia Research Foundation/NIH.

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

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.

scholarly journals No association between dietary sodium intake and the risk of multiple sclerosis

Neurology ◽  
2017 ◽  
Vol 89 (13) ◽  
pp. 1322-1329 ◽  
Author(s):  
Marianna Cortese ◽  
Changzheng Yuan ◽  
Tanuja Chitnis ◽  
Alberto Ascherio ◽  
Kassandra L. Munger
Keyword(s):  
Multiple Sclerosis ◽  
Fixed Effects ◽  
Proportional Hazards ◽  
Sodium Intake ◽  
Cox Proportional Hazards ◽  
Dietary Sodium ◽  
Health Study ◽  
Cox Proportional Hazards Models ◽  
Using Data

Objective:To prospectively investigate the association between dietary sodium intake and multiple sclerosis (MS) risk.Methods:In this cohort study, we assessed dietary sodium intake by a validated food frequency questionnaire administered every 4 years to 80,920 nurses in the Nurses' Health Study (NHS) (1984–2002) and to 94,511 in the Nurses' Health Study II (NHSII) (1991–2007), and calibrated it using data from a validation study. There were 479 new MS cases during follow-up. We used Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the effect of energy-adjusted dietary sodium on MS risk, adjusting also for age, latitude of residence at age 15, ancestry, body mass index at age 18, supplemental vitamin D intake, cigarette smoking, and total energy intake in each cohort. The results in both cohorts were pooled using fixed effects models.Results:Total dietary intake of sodium at baseline was not associated with MS risk (highest [medians: 3.2 g/d NHS; 3.5 g/d NHSII] vs lowest [medians: 2.5 g/d NHS; 2.8 g/d NHSII] quintile: HRpooled 0.98, 95% CI 0.74–1.30, p for trend = 0.75). Cumulative average sodium intake during follow-up was also not associated with MS risk (highest [medians: 3.3 g/d NHS; 3.4 g/d NHSII] vs lowest [medians: 2.7 g/d NHS; 2.8 g/d NHSII] quintile: HRpooled 1.02, 95% CI 0.76–1.37, p for trend = 0.76). Comparing more extreme sodium intake in deciles yielded similar results (p for trend = 0.95).Conclusions:Our findings suggest that higher dietary sodium intake does not increase the risk of developing MS.

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