scholarly journals Adherence to a Mediterranean-Style Dietary Pattern and Cancer Risk in a Prospective Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4064
Author(s):  
Ioanna Yiannakou ◽  
Martha R. Singer ◽  
Paul F. Jacques ◽  
Vanessa Xanthakis ◽  
R. Curtis Ellison ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Dietary Pattern ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Anthropometric Measures ◽  
Eating Pattern ◽  
Cox Models ◽  
Beneficial Effects ◽  
Total Cancer ◽  
Diet Pattern

A Mediterranean-style diet is a healthy eating pattern that may benefit cancer risk, but evidence among Americans is scarce. We examined the prospective association between adherence to such a diet pattern and total cancer risk. A Mediterranean-style dietary pattern (MSDP) score was derived from a semi-quantitative food frequency questionnaire at exam 5 (1991–1995). Subjects included 2966 participants of the Framingham Offspring Study who were free of prevalent cancer. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for demographic, lifestyle, and anthropometric measures. Cox-models were also used to examine effect modification by lifestyle and anthropometric measures. During 18 years of median follow-up, 259 women and 352 men were diagnosed with cancer. Women with moderate or higher adherence to the MSDP had ≥25% lower risks of cancer than women with the lowest MSDP (HR (moderate vs. lowest): 0.71, 95% CI: 0.52–0.97 and HR (highest vs. lowest): 0.74; 95% CI: 0.55–0.99). The association between MSDP score and cancer risk in men was weaker except in non-smokers. Beneficial effects of the MSDP in women were stronger among those who were not overweight. In this study, higher adherence to MSDP was associated with lower cancer risk, especially among women.

scholarly journals Adherence to Mediterranean Style Dietary Pattern and Total Cancer Risk in the Framingham Offspring Cohort Study (P05-040-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ioanna Yiannakou ◽  
Martha Singer ◽  
Paul Jacques ◽  
Lynn Moore
Keyword(s):  
Cohort Study ◽  
Cancer Risk ◽  
Dietary Pattern ◽  
Protective Effects ◽  
Men And Women ◽  
Beneficial Effects ◽  
Funding Sources ◽  
Total Cancer Risk ◽  
Total Cancer ◽  
Former Smokers

Abstract Objectives This study examines the prospective association between adherence to a Mediterranean style dietary pattern and cancer risk among men and women in the Framingham Offspring (FOS) cohort. Methods The Mediterranean style dietary pattern (MSDP) score was derived from a semi-quantitative food frequency questionnaire taken at examination visit 5 in the prospective FOS cohort. Subjects included 3199 participants (1703 women and 1496 men), aged 30 years old and older, who were free of prevalent cancer. The MSDP score was classified into tertiles and also dichotomized (MSDP score <22 vs. ≥22) used to evaluate the association between the MSDP and cancer risk through the ninth examination cycle. Cox proportional-hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusting for confounding by age, physical activity, body mass Index, and pack-years of cigarette smoking. Factors found not to confound the effects of the MSDP were excluded from final models. Results During a mean follow-up of approximately 11.5 years, 377 and 273 cancer cases were documented among men and women, respectively. Women in the upper two tertiles of the MSDP score had a 25–30% lower cancer risks than women in the lowest tertile [(HR: 0.70, 95% CI:0.52–0.96 (tertile 2); HR, 0.75; 95% CI:0.56–1.00 (tertile 3)]. Effects in men were weaker [HR: 0.94, 95% CI:0.74–1.21 (tertile 2); HR, 0.90; 95% CI:0.68–1.17(tertile 3)]. The protective effects of higher MSDP adherence were stronger among non-smokers and former smokers than among current smokers. Compared with current smokers with a MSDP score < 22, non-smokers and former smokers with higher MSDP scores had approximately 43% and 39% reductions in total cancer risk, respectively (HR: 0.57; 95% CI: 0.43–0.75 for non-smokers with high MSDP; HR: 0.61; 95% CI: 0.47–0.79 for former smokers with high MSDP scores).SDP scores). Conclusions In this large cohort study, higher adherence to MSDP was associated with reduced risk of total cancer, especially among women. Beneficial effects of the MSDP were also stronger among non-smokers and former smokers. Funding Sources N/A.

scholarly journals Estimating cancer risk in relation to tritium exposure from routine operation of a nuclear-generating station in Pickering, Ontario

2013 ◽  
Vol 33 (4) ◽  
pp. 247-256 ◽  
Author(s):  
S Wanigaratne ◽  
E Holowaty ◽  
H Jiang ◽  
TA Norwood ◽  
R Pietrusiak ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Dispersion Model ◽  
Atmospheric Dispersion ◽  
Female Breast Cancer ◽  
Cox Proportional Hazards ◽  
Tritium Concentration ◽  
Cox Models ◽  
Adverse Health Effects ◽  
Increased Risk ◽  
Risk Of Cancer

Introduction Evidence suggests that current levels of tritium emissions from CANDU reactors in Canada are not related to adverse health effects. However, these studies lack tritium-specific dose data and have small numbers of cases. The purpose of our study was to determine whether tritium emitted from a nuclear-generating station during routine operation is associated with risk of cancer in Pickering, Ontario. Methods A retrospective cohort was formed through linkage of Pickering and north Oshawa residents (1985) to incident cancer cases (1985–2005). We examined all sites combined, leukemia, lung, thyroid and childhood cancers (6–19 years) for males and females as well as female breast cancer. Tritium estimates were based on an atmospheric dispersion model, incorporating characteristics of annual tritium emissions and meteorology. Tritium concentration estimates were assigned to each cohort member based on exact location of residence. Person-years analysis was used to determine whether observed cancer cases were higher than expected. Cox proportional hazards regression was used to determine whether tritium was associated with radiation-sensitive cancers in Pickering. Results Person-years analysis showed female childhood cancer cases to be significantly higher than expected (standardized incidence ratio [SIR] = 1.99, 95% confidence interval [CI]: 1.08–3.38). The issue of multiple comparisons is the most likely explanation for this finding. Cox models revealed that female lung cancer was significantly higher in Pickering versus north Oshawa (HR = 2.34, 95% CI: 1.23–4.46) and that tritium was not associated with increased risk. The improved methodology used in this study adds to our understanding of cancer risks associated with low-dose tritium exposure. Conclusion Tritium estimates were not associated with increased risk of radiation-sensitive cancers in Pickering.

scholarly journals Effect of Blood Pressure on Cardiovascular Outcomes: A 15-Year Prospective Cohort Study

2021 ◽  
Author(s):  
Qi Yu ◽  
Qing-Dong Jin
Keyword(s):  
Blood Pressure ◽  
Proportional Hazards ◽  
Positive Association ◽  
Cubic Spline ◽  
Cox Proportional Hazards ◽  
Cardiovascular Outcomes ◽  
Composite Outcome ◽  
Nutrition Survey ◽  
Cox Models ◽  
Diabetes Status

Abstract Objective The association between blood pressure(BP) and cardiovascular outcomes has not been well investigated by large prospective studies on Chinese. We aim to analyze the association of BP with cardiovascular outcomes in Chinese population. Method We included a total of 4,569 adults aged 40–90 years from the China Health and Nutrition Survey (CHNS) cohort. Cox proportional hazards regression models were used to estimate hazard ratios and 95% CIs. Restricted cubic spline analyses were used to explore linear and nonlinear relationships of BP with cardiovascular outcomes. Result With a mean follow-up of 12.1 years, a total of 4,569 individuals were enrolled in our study, of whom 403 developed cardiovascular outcomes. Multivariable adjusted Cox models showed a strong positive association between BP and cardiovascular outcomes. SBP was significantly associated with composite outcome(HR per 10 mmHg 1.23[1.16–1.29]), myocardial infarction(MI)(HR per 10 mmHg 1.17[1.07–1.27]), and stroke(HR per 10 mmHg 1.29[1.21–1.38]). DBP was significantly associated with composite outcome(HR per 10 mmHg 1.32[1.20–1.44]), MI(HR per 10 mmHg 1.26[1.10–1.44]), and stroke(HR per 10 mmHg 1.39[1.25–1.55]). Restricted cubic spline analyses showed linear relationships of either SBP or DBP with composite outcome, MI and stroke. Conclusion Either SBP or DBP is independently and linearly related to the risk of cardiovascular outcomes. These associations are steeper for stroke than for MI, and vary widely by age, use of antihypertensive treatment, and diabetes status.

Abstract 13: Adherence to Various Dietary Patterns and Risk of Recurrent Coronary Heart Disease and Mortality in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
James M Shikany ◽  
Monika M Safford ◽  
Joanna Bryan ◽  
PK Newby ◽  
Joshua S Richman ◽  
...  
Keyword(s):  
Racial Differences ◽  
Mediterranean Diet ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Mediterranean Diet Score ◽  
The Mediterranean ◽  
Diet Score

Background: We have shown that the Southern dietary pattern, characterized by added fats, fried foods, organ and processed meats, and sugar-sweetened beverages, is associated with a greater risk of incident CHD in REGARDS, a national, population-based, longitudinal cohort. We sought to determine if the Southern pattern, other dietary patterns, and the Mediterranean diet score were associated with CHD events and mortality in REGARDS participants who previously reported CHD. Methods: REGARDS enrolled white and black adults aged ≥45 years between 2003-2007. Data were analyzed from 3,562 participants with CHD at baseline. Participants completed an FFQ at baseline, from which 5 dietary patterns were derived through factor analysis (Table). The Mediterranean diet score was calculated for each participant. Expert-adjudicated CHD events included myocardial infarction and CHD death. Cox proportional hazards regression was used to model the association of the dietary patterns and score with CHD events and death, adjusting for sociodemographics, lifestyle factors, energy intake, anthropometrics, and medical conditions. Results: Over 7 years of follow-up, there were 581 recurrent CHD events and 1,098 deaths. In fully-adjusted analyses, the highest quartile of adherence to the alcohol/salads pattern and highest group of the Mediterranean diet score were associated with lower risk of recurrent CHD compared to the lowest quartile/group (HR: 0.76; 95% CI: 0.59 – 0.98, HR: 0.78; 95% CI: 0.62 – 0.98, respectively). The highest quartile of adherence to the Southern pattern was associated with higher mortality (HR: 1.57; 95% CI: 1.28 – 1.91), while the highest group of the Mediterranean diet score was associated with lower mortality (HR: 0.80; 95% CI: 0.68 – 0.95). Conclusions: While the Southern dietary pattern was not related to risk of recurrent CHD, it was associated with higher mortality in REGARDS participants with existing CHD. Greater adherence to a Mediterranean diet was associated with lower risk of recurrent CHD and mortality.

scholarly journals Milk Consumption Decreases Risk for Breast Cancer in Korean Women under 50 Years of Age: Results from the Health Examinees Study

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 32 ◽  
Author(s):  
Woo-Kyoung Shin ◽  
Hwi-Won Lee ◽  
Aesun Shin ◽  
Jong-koo Lee ◽  
Daehee Kang
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Epidemiologic Studies ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Milk Consumption ◽  
Korean Women

Epidemiologic studies regarding breast cancer risk related to milk consumption remain controversial. The aim of this study was to evaluate the association between milk consumption and the risk for breast cancer. A total of 93,306 participants, aged 40–69 years, were included in the prospective cohort study in the Health Examinees-Gem (HEXA-G) study between 2004 and 2013. Dietary intake was assessed using a validated food frequency questionnaire. Information on cancer diagnosis in the eligible cohort was retrieved from the Korea Central Cancer Registry through 31 December 2014. The Cox proportional hazards model was used to estimate multivariate hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 359 breast cancer cases were observed over a median follow-up period of 6.3 years. Milk consumption was not associated with decreased risk for breast cancer in the total population (p for trend = 0.0687). In women under 50 years of age, however, milk consumption was inversely associated with breast cancer risk. In the comparison between highest (≥1 serving/day) and lowest (<1 serving/week) intake categories of milk, the multivariate HR (95% CI) was 0.58 (0.35–0.97, p for trend = 0.0195)) among women under 50 years of age. In conclusion, our findings show that milk consumption in Korean women aged 50 or younger is associated with a decreased risk for breast cancer, when compared to those who never or rarely consumed milk. Further studies need to be conducted to assess this relationship and confirm these results.

scholarly journals Dietary Inflammatory Index Is Associated with Risk of All-Cause and Cardiovascular Disease Mortality but Not with Cancer Mortality in Middle-Aged and Older Japanese Adults

2019 ◽  
Vol 149 (8) ◽  
pp. 1451-1459 ◽  
Author(s):  
Emiko Okada ◽  
Toru Shirakawa ◽  
Nitin Shivappa ◽  
Kenji Wakai ◽  
Koji Suzuki ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Dietary Inflammatory Index ◽  
Digestive Cancer ◽  
Inflammatory Index ◽  
Japanese Adults ◽  
Increased Risk ◽  
Total Cancer ◽  
Cvd Mortality

ABSTRACT Background The Dietary Inflammatory Index (DII) is a comprehensive, literature-derived index for assessing the effect of dietary constituents on inflammatory biomarkers. Several studies have shown an association between DII score and mortality, but there are limited prospective studies in Asian populations. Objectives The aim of this study was to investigate the association between DII score and risk of all-cause, total cardiovascular disease (CVD), stroke, coronary heart disease (CHD), total cancer, digestive cancer, and noncancer/non-CVD mortality in the Japanese population. Methods A total of 58,782 Japanese participants aged 40–79 y who were enrolled in the Japan Collaborative Cohort Study during 1988–1990 were included in the analysis. DII scores were calculated based on a food-frequency questionnaire. HRs and 95% CIs for mortality according to DII quintiles were estimated using Cox proportional hazards models. Results During the median follow-up period of 19.3 y, a total of 11,693 participants died. The multivariable HR for all-cause mortality for the highest compared with the lowest DII quintiles was 1.13 (95% CI: 1.05, 1.21). For CVD mortality, the highest multivariable HRs were 1.30 (95% CI: 1.13, 1.49), 1.29 (95% CI: 1.05, 1.59), and 1.30 (95% CI: 0.96, 1.76) for total CVD, stroke, and CHD, respectively. No significant associations were observed between DII and risk of total cancer, digestive cancer, and noncancer/non-CVD mortality. Conclusion Our findings suggest that a higher DII was associated with an increased risk of all-cause and CVD mortality among Japanese adults.

scholarly journals Serum Lipids and the Risk of Gastrointestinal Malignancies in the Swedish AMORIS Study

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Wahyu Wulaningsih ◽  
Hans Garmo ◽  
Lars Holmberg ◽  
Niklas Hammar ◽  
Ingmar Jungner ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Colon Cancer ◽  
Cancer Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Gastrointestinal Malignancies ◽  
Colon Cancer Risk ◽  
Colon And Rectal Cancer ◽  
Increased Risk ◽  
Lipid Components

Background. Metabolic syndrome has been linked to an increased cancer risk, but the role of dyslipidaemia in gastrointestinal malignancies is unclear. We aimed to assess the risk of oesophageal, stomach, colon, and rectal cancers using serum levels of lipid components.Methods. From the Swedish Apolipoprotein Mortality Risk (AMORIS) study, we selected 540,309 participants (> 20 years old) with baseline measurements of total cholesterol (TC), triglycerides (TG), and glucose of whom 84,774 had baseline LDL cholesterol (LDL), HDL cholesterol (HDL), apolipoprotein B (apoB), and apolipoprotein A-I (apoA-I). Multivariate Cox proportional hazards regression was used to assess glucose and lipid components in relation to oesophageal, stomach, colon, and rectal cancer risk.Results. An increased risk of oesophageal cancer was observed in persons with high TG (e.g. HR: 2.29 (95% CI: 1.42–3.68) for the 4th quartile compared to the 1st) and low LDL, LDL/HDL ratio, TC/HDL ratio, log (TG/HDL), and apoB/apoA-I ratio. High glucose and TG were linked with an increased colon cancer risk, while high TC levels were associated with an increased rectal cancer risk.Conclusion. The persistent link between TC and rectal cancer risk as well as between TG and oesophageal and colon cancer risk in normoglycaemic individuals may imply their substantiality in gastrointestinal carcinogenesis.

Mediterranean dietary pattern and skin cancer risk: A prospective cohort study in French women

2019 ◽  
Vol 110 (4) ◽  
pp. 993-1002 ◽  
Author(s):  
Yahya Mahamat-Saleh ◽  
Iris Cervenka ◽  
Marie Al Rahmoun ◽  
Isabelle Savoye ◽  
Francesca Romana Mancini ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Cancer Risk ◽  
Prospective Cohort ◽  
Proportional Hazards ◽  
Meat Products ◽  
Cox Proportional Hazards ◽  
Skin Cancer Prevention ◽  
Future Research ◽  
Cancer Risk Factors ◽  
Skin Cancer Risk

ABSTRACT Background The Mediterranean diet (MD) has been reported to be associated with lower cancer risk. However, while previous studies explored major single components of the MD, only 1 previous study has investigated adherence to the MD in relation to melanoma risk. Objective The aim of this study was to explore the relations between adherence to the MD and the risk of skin cancer, including melanomas, basal cell carcinomas (BCCs), and squamous cell carcinomas (SCCs). Design Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale (E3N) is a prospective cohort of 98,995 French women aged 40–65 y in 1990. Dietary data were collected via a validated food questionnaire in 1993. Adherence to the MD was assessed using a 9-unit dietary score that incorporates intakes of fruit, vegetables, legumes, cereal products, olive oil, fish, dairy products, meat products, and alcohol. We used Cox proportional hazards regression models to compute HRs and 95% CIs adjusted for age and main known skin cancer risk factors. Results From 1993 to 2008, a total of 2003 skin cancer cases were ascertained among 67,332 women, including 404 melanomas, 1367 BCCs, and 232 SCCs. Score of adherence to the MD was associated with lower risk of skin cancer (HR: 0.83; 95% CI: 0.73, 0.93 for high compared with low score, Ptrend = 0.001). MD score was also inversely and linearly associated with risks of melanoma (HR: 0.72; 95% CI: 0.54, 0.96; Ptrend = 0.02) and BCC (HR: 0.77; 95% CI: 0.66, 0.90; Ptrend = 0.0006) but not SCC (HR: 1.08; 95% CI: 0.75, 1.55; Ptrend = 0.68), although with no heterogeneity across skin cancer types (Pheterogeneity = 0.23). Conclusion These findings suggest that adherence to the MD is associated with a lower skin cancer risk in women, particularly melanoma and BCC. If confirmed in future research, these findings may have important implications in skin cancer prevention.

scholarly journals Obesity and risk of infections: results from men and women in the Swedish National March Cohort

2019 ◽  
Author(s):  
Francesca Ghilotti ◽  
Rino Bellocco ◽  
Weimin Ye ◽  
Hans-Olov Adami ◽  
Ylva Trolle Lagerros
Keyword(s):  
Proportional Hazards ◽  
Cox Model ◽  
Normal Weight ◽  
Cox Proportional Hazards ◽  
Event Analysis ◽  
Obese Women ◽  
Cox Models ◽  
Increased Risk ◽  
Repeated Events ◽  
Tract Infections

Abstract Background Previous studies have shown an association between body mass index (BMI) and infections, but the literature on type-specific community acquired infections is still limited. Methods We included 39 163 Swedish adults who completed a questionnaire in September 1997 and were followed through record-linkages until December 2016. Information on BMI was self-reported and infections were identified from the Swedish National Patient Register using International Classification of Diseases (ICD), Tenth Revision (ICD-10) codes. We fitted multivariable Cox proportional hazards models for time-to-first-event analysis, and we used extensions of the standard Cox model when repeated events were included. Results During a 19-year follow-up 32% of the subjects had at least one infection requiring health care contact, leading to a total of 27 675 events. We found an increased incidence of any infection in obese women [hazard ratio (HR) = 1.22; 95% confidence interval (CI) = 1.12; 1.33] and obese men (HR = 1.25; 95% CI = 1.09; 1.43) compared with normal weight subjects. For specific infections, higher incidences were observed for skin infections in both genders (HR = 1.76; 95% CI = 1.47; 2.12 for obese females and HR = 1.74; 95% CI = 1.33; 2.28 for obese males) and gastrointestinal tract infections (HR = 1.44; 95% CI = 1.19; 1.75), urinary tract infections (HR = 1.30; 95% CI = 1.08; 1.55) and sepsis (HR = 2.09; 95% CI = 1.46; 2.99) in obese females. When accounting for repeated events, estimates similar to the aforementioned ones were found. Conclusions Obesity was associated with an increased risk of infections in both genders. Results from multiple-failure survival analysis were consistent with those from classic Cox models.

Proportionally Difficult: Testing for Nonproportional Hazards in Cox Models

2010 ◽  
Vol 18 (2) ◽  
pp. 189-205 ◽  
Author(s):  
Luke Keele
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Model ◽  
Standard Test ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Cox Models ◽  
Nonproportional Hazards ◽  
Specification Errors ◽  
Hazards Model

The Cox proportional hazards model is widely used to model durations in the social sciences. Although this model allows analysts to forgo choices about the form of the hazard, it demands careful attention to the proportional hazards assumption. To this end, a standard diagnostic method has been developed to test this assumption. I argue that the standard test for nonproportional hazards has been misunderstood in current practice. This test detects a variety of specification errors, and these specification errors must be corrected before one can correctly diagnose nonproportionality. In particular, unmodeled nonlinearity can appear as a violation of the proportional hazard assumption for the Cox model. Using both simulation and empirical examples, I demonstrate how an analyst might be led astray by incorrectly applying the nonproportionality test.

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