Coffee Consumption and the Risk of All-Cause and Cause-Specific Mortality in the Korean Population

BackgroundThere is a dearth of information regarding the association between coffee consumption and its health effects with respect to mortality among Korean people.ObjectiveThe aim of this study was to examine the association between coffee consumption and all-cause mortality and cause-specific mortality risks in the Korean population.DesignThis prospective cohort study had a median follow-up period of 9.1 years.Participants/settingIn total, 173,209 participants aged 40 years and older from the Health Examinees study were enrolled between 2004 and 2013. The analytic sample included 110,920 participants without diabetes, cardiovascular disease (CVD), or cancer at baseline who could be linked with their death information.Main outcome measuresDeaths of participants until December 31, 2018 were ascertained using the death certificate database of the National Statistical Office. Cause of death was classified according to the International Classification of Diseases, 10th Revision.Statistical analyses performedParticipants were categorized according to the amount and type of coffee consumed. Cox proportional hazards regression analysis was performed to estimate the hazard ratio (HR) and 95%CI of all-cause mortality and cause-specific mortality, such as CVD and cancer mortality.ResultsCompared with nonconsumers of coffee, participants who consumed > 3 cups/day had a reduced risk of all-cause mortality (HR 0.79, 95% CI 0.66 to 0.95). Participants who consumed ≤1 cup/day and 1 to 3 cups/day had a reduced risk of CVD mortality (≤1 cup/day: HR 0.58, 95% CI 0.69 to 0.94; 1 to 3 cups/day: HR 0.62, 95% CI 0.41 to 0.96).ConclusionsThis study provides evidence that greater coffee consumption is associated with a decreased risk of all-cause mortality and moderate coffee consumption (approximately 3 cups/day) is associated with a decreased risk of CVD mortality, regardless of the type of coffee, in a Korean population.     

Association Between Frequency of Eating Away-From-Home Meals and Risk of All-Cause and Cause-Specific Mortality

BackgroundDining out is a popular activity worldwide. Evidence on the association between eating meals away from home and long-term health outcomes is still limited.ObjectiveThe objective of this study was to examine the association of frequency of eating meals prepared away from home with all-cause and cause-specific mortality.Participants/settingThis study included 35,084 adults aged 20 years or older from the National Health and Nutritional Examination Survey 1999-2014, who reported their dietary habits including frequency of eating meals prepared away from home in a questionnaire during face-to-face household interviews.Main outcome measuresAll-cause mortality, cardiovascular mortality, and cancer mortality were ascertained by linkage to death records through December 31, 2015.Statistical analyses performedMultivariable Cox proportional hazards models were used to estimate adjusted hazard ratios of mortality from all-cause, cardiovascular, and cancer mortality.ResultsDuring 291,475 person-years of follow-up, 2,781 deaths occurred, including 511 deaths from cardiovascular disease and 638 death from cancer. After adjustment for age, sex, race/ethnicity, socioeconomic status, dietary and lifestyle factors, and body mass index, the hazard ratio of mortality among participants who ate meals prepared away from home very frequently (2 meals or more per day) compared with those who seldom ate meals prepared away from home (fewer than 1 meal/wk) was 1.49 (95% CI 1.05 to 2.13) for all-cause mortality, 1.18 (95% CI 0.55 to 2.55) for cardiovascular mortality, and 1.67 (95% CI 0.87 to 3.21) for cancer mortality.ConclusionsFrequent consumption of meals prepared away from home is significantly associated with increased risk of all-cause mortality. The association of eating meals prepared away from home with cardiovascular mortality and cancer mortality warrants additional investigation.     

Meal Skipping and Shorter Meal Intervals Are Associated with Increased Risk of All-Cause and Cardiovascular Disease Mortality among US Adults

BackgroundPrevious dietary studies and current dietary guidelines have mainly focused on dietary intake and food patterns. Little is known about the association between eating behaviors such as meal frequency, skipping and intervals, and mortality.ObjectiveThe objective was to examine the associations of meal frequency, skipping, and intervals with all-cause and cardiovascular disease (CVD) mortality.DesignThis was a prospective study.Participants/settingA total of 24,011 adults (aged ≥40 years) who participated in the National Health and Nutrition Examination Survey 1999-2014 were included in this study. Eating behaviors were assessed using 24-hour recall. Death and underlying causes of death were ascertained by linkage to death records through December 31, 2015.Main outcome measuresThe outcomes were all-cause and CVD mortality.Statistical analyses performedMultivariable Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) of all-cause and CVD mortality.ResultsDuring 185,398 person-years of follow-up period, 4,175 deaths occurred, including 878 cardiovascular deaths. Most participants ate three meals per day. Compared with participants eating three meals per day, the multivariable-adjusted HRs for participants eating one meal per day were 1.30 (95% CI 1.03 to 1.64) for all-cause mortality, and 1.83 (95% CI 1.26 to 2.65) for CVD mortality. Participants who skipped breakfast have multivariable-adjusted HRs 1.40 (95% CI 1.09 to 1.78) for CVD mortality compared with those who did not. The multivariable-adjusted HRs for all-cause mortality were 1.12 (95% CI 1.01 to 1.24) for skipping lunch and 1.16 (95% CI 1.02 to 1.32) for skipping dinner compared with those who did not. Among participants eating three meals per day, the multivariable-adjusted HR for participants with an average interval of ≤4.5 hours in two adjacent meals was 1.17 (95% CI 1.04 to 1.32) for all-cause mortality, comparing with those having a meal interval of 4.6 to 5.5 hours.ConclusionsIn this large, prospective study of US adults aged 40 years or older, eating one meal per day was associated with an increased risk of all-cause and CVD mortality. Skipping breakfast was associated with increased risk of CVD mortality, whereas skipping lunch or dinner was associated with increased risk of all-cause mortality. Among participant with three meals per day, a meal interval of ≤4.5 hours in two adjacent meals was associated with higher all-cause mortality.     

Soy and fish oil intake and mortality in a Japanese community

The relation between intake of fish and soy products and subsequent all-cause and cause-specific mortality was examined in a cohort of 13,355 male and 15,724 female residents of Takayama, Gifu, Japan. A diet that included soy and fish intake was assessed in 1992 by using a validated semiquantitative food frequency questionnaire. Over 7 years of follow-up, 2,062 participants (1,163 men and 899 women) died. For men, the highest compared with the lowest quintile of total soy product intake was marginally significantly inversely associated with total mortality after adjustment for total energy and nondietary covariates (hazard ratio = 0.83, 95% confidence interval: 0.69, 1.01; p for trend = 0.07). After adjustment for nondietary covariates, a decreased hazard ratio for the highest compared with the lowest quintile of total soy product intake was also observed for women (hazard ratio = 0.83, 95% confidence interval: 0.68, 1.02; p for trend = 0.04). Additional adjustment for dietary factors significantly associated with total mortality did not attenuate these associations. For women but not for men, n-3 fatty acids from fish were significantly inversely associated with total mortality. Results showed that soy intake may have moderate but beneficial effects on total mortality.     

Predicting All-Cause and Cause-Specific Mortality by Static and Dynamic Measurements of Allostatic Load: A 10-Year Population-Based Cohort Study in Taiwan

ObjectiveTo evaluate the role of allostatic load (AL), either static or dynamic measurements, in predicting all-cause and cause-specific mortality of older people in Taiwan.DesignA prospective cohort study.SettingPopulation-based community study.ParticipantsOne thousand twenty-three community-dwelling older people.MeasurementsAllostatic load (calculated by systolic blood pressure, diastolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, triglyceride, glycosylated hemoglobin, fasting glucose, waist-to-hip ratio, body mass index, dehydroepiandrosterone sulfate, insulin-like growth factor-1, 12-hour urine cortisol, 12-hour urine epinephrine, 12-hour urine norepinephrine, 12-hour urine dopamine, white blood cell count, neutrophils, interleukin-6, albumin, creatinine) and all-cause and cause-specific mortality from national death registry.InterventionNone.ResultsAdjusted for age and sex, each 1-point increase in AL score was associated with 20% incremental risk of mortality [hazard ratio 1.20, 95% confidence interval (CI) 1.09–1.31]. This association can be extended to cause-specific mortality in both sexes in general. In addition, the higher AL score quintile was significantly associated with higher risk of 10-year all-cause mortality (P < .0001). This association was consistent across different cause-specific mortality (ie, malignant neoplasm (P = .008), cardiometabolic diseases (P < .0001), infectious diseases (P < .0001), respiratory diseases (P < .0001), and others (P = .0002), respectively. Compared with AL score decliners, adjusted for age, sex, and baseline AL score in 2000, participants with fast increase had significantly higher mortality (HR 2.68, 95% CI 1.23–5.84, P = .01). The effect was stronger in men (HR 2.83, 95% CI 1.1–7.29, P = .03 in slow increase; HR 4.06, 95% CI 1.56–10.6, P = .001 in fast increase group), but it was insignificant in female participants.ConclusionsHigher AL score or rapid increase of AL score significantly increased subsequent mortality risk in older adults, either measured statically or dynamically. AL is predictive of 10-year mortality regardless of cause of death, and rapid increase in AL score is associated with higher subsequent mortality.     

Dietary Patterns and Total Mortality in a Mediterranean Cohort: The SUN Project

BackgroundDifferent dietary patterns have been associated with several health outcomes, including morbidity and mortality. There is little evidence on the association between empirically derived dietary patterns and all-cause mortality in Southern European populations.ObjectiveThe aim of our study was to prospectively evaluate the association between an empirically derived dietary pattern and all-cause mortality.DesignThe Seguimiento Universidad de Navarra (SUN) Project is an ongoing, multipurpose, prospective and dynamic Spanish cohort.Participants/settingParticipants were a prospective cohort of 16,008 middle-aged Spanish adults. All of them were university graduates (alumni) (59.6% women, mean age 38 years). Usual diet was assessed at baseline with a validated semiquantitative food frequency questionnaire.Main outcome measuresDeaths were confirmed by review of medical records and of the National Death Index.Statistical analysisDietary patterns were ascertained through a factor (principal component) analysis based on 30 predefined food groups. Participants were classified according to tertiles of adherence to the three main dietary patterns identified with factor analysis. Cox regression models were fitted to estimate multivariable-adjusted hazard ratios and 95% CIs for mortality.ResultsThree major dietary patterns were identified. They were labelled Western dietary pattern (rich in red and processed meat, potatoes, and fast food), Mediterranean dietary pattern (rich in vegetables, fish and seafood, fruits, and olive oil), and alcoholic beverages dietary pattern. During follow-up, 148 deaths were reported (mean age at death 54.5 years). After adjustment for potential confounders, the lowest risk of all-cause mortality was found in the tertile of highest adherence to the Mediterranean dietary pattern (adjusted hazard ratio for third vs first tertile 0.53, 95% CI 0.34 to 0.84) (P for trend <0.01). The Western dietary pattern and alcoholic beverages dietary pattern showed no significant association with mortality.ConclusionsGreater adherence to an empirically derived dietary pattern approaching the traditional Mediterranean diet was associated with a reduction in the risk of all-cause mortality among middle-aged Mediterranean adults.     

Predicting cause-specific mortality of older men living in the veterans home by handgrip strength and walking speed: a 3-year, prospective cohort study in Taiwan

ObjectiveTo determine prognostic value of handgrip strength (HGS) and walking speed (WS) in predicting the cause-specific mortality for older men.DesignProspective cohort study.SettingBanciao Veterans Care Home.Participants558 residents aged 75 years and older.MeasurementsAnthropometric data, lifestyle factors, comorbid conditions, biomarkers, HGS, and WS at recruitment; all-cause and cause-specific mortality at 3 years after recruitment.ResultsDuring the study period, 99 participants died and the baseline HGS and WS were significantly lower than survivors (P both <.001). Cox survival analysis showed that subjects with slowest quartile of WS were at significantly higher risk of all-cause mortality and cardiovascular mortality (hazard ratio [HR] 3.55, 95% confidence interval [CI] 1.69–7.43; HR 11.55, 95% CI 2.30–58.04, respectively), whereas the lowest quartile of HGS significantly predicted a higher risk of infection-related death (HR 5.53, 95% CI 1.09–28.09). Participants in the high-risk status with slowest quartile for WS but not those in the high-risk status with weakest quartile for HGS had similar high risk of all-cause mortality with the group with combined high-risk status (HR 2.96, 95% CI 1.68–5.23; HR 2.58, 95% CI 1.45–4.60, respectively) compared with the participants without high-risk status (reference group).ConclusionsSlow WS predicted all-cause and cardiovascular mortality, whereas weak HGS predicted a higher risk of infection-related death among elderly, institutionalized men in Taiwan. Combining HGS with WS simultaneously had no better prognostic value than using WS only in predicting all-cause mortality.     

Total Physical Activity,Exercise Intensity,and Walking Speed as Predictors of All-Cause and Cause-Specific Mortality Over 7 Years in Older Men: The Concord Health and Aging in Men Project

Objective

The study aimed to examine the contemporaneous temporal association between changes in total physical activity, sports intensity, muscle strengthening exercise, and walking speed as predictors of all-cause, cardiovascular, cancer and other cause-specific mortality in older men.

Lactase persistence,milk intake,and mortality in the Danish general population: a Mendelian randomization study

Meta-analyses have suggested no association between milk intake and mortality. Since only few studies have been conducted, we investigated the association between the lactase persistent genetic variant LCT-13910 C/T (rs4988235), a proxy for long-term low and high intake of milk, and mortality. We used two Danish population-based studies with self-reported intake of milk and genotyping for LCT-13910 C/T. We obtained information on all-cause and cause-specific mortality (cardiovascular and cancer) from the national Danish registries. We used multivariable adjusted Cox regression to assess the association between milk intake and mortality in 74,241 individuals, and both logistic and Cox-regression to assess the association between genetic lactase persistence and mortality in 82,964 individuals using a Mendelian randomization design. We applied per T-allele, co-dominant and dominant models. During a mean follow-up of 7 years, 9759 individuals died, 2166 from cardiovascular disease, and 2822 from cancer. Observationally, there was no association between intake of skimmed milk and all-cause or cardiovascular mortality, and we did not find any associations between intake of semi-skimmed or whole milk with all-cause or cause-specific mortality. Intake of skimmed milk was associated with lower cancer mortality with a hazard ratio of 0.97 (95% CI 0.96–1.00) per doubling in milk intake. Per T-allele, milk intake increased with 0.58 (0.50–0.68) glasses/week. Genetically, we found no associations between the lactase persistent LCT-13910 C/T genotype and all-cause or cause-specific mortality; per T-allele OR (95% CI) for all-cause mortality was 1.02 (0.97–1.06). Our study did not provide strong evidence of observational or genetic associations between milk intake and all-cause or cause-specific mortality.     

饮食摄入种类和体力活动与2型糖尿病患者死亡风险的前瞻性研究

目的 探讨2型糖尿病（T2DM）患者饮食摄入种类和体力活动及其联合作用与全因死亡和特定原因死亡风险的关联。方法 2013年12月至2021年12月,对江苏省常熟市、淮安市清江浦区（原清河区）和淮安区纳入国家基本公共卫生服务管理的T2DM患者19 863人开展前瞻性队列研究。死亡信息和根本死因源于江苏省CDC死亡监测系统。利用Cox比例风险回归模型估计T2DM患者饮食摄入种类、体力活动以及联合作用与全因死亡及特定原因死亡风险的关联强度。结果 截至2021年12月31日,研究对象累计随访150 283人年,中位随访时间8.15年,随访期间共死亡3 293人,其中1 124人死于心血管疾病（CVD）,875人死于肿瘤。Cox比例风险回归模型分析结果显示,与摄入0~1种食物的T2DM患者相比,摄入5~9种食物的患者全因死亡风险降低19%［风险比（HR）=0.81,95%CI：0.70~0.94］,CVD死亡风险降低33%（HR=0.67,95%CI：0.52~0.87）。与体力活动Q₁组的T2DM患者相比,Q₄组全因、CVD和肿瘤死亡风险分别降低50%（HR=0.50,95%CI：0.45~0.56）、50%（HR=0.50,95%CI：0.41~0.61）和27%（HR=0.73,95%CI：0.60~0.88）。联合作用显示,与摄入0~2种食物和低体力活动的T2DM患者相比,摄入4~9种食物和高体力活动的T2DM患者全因、CVD和肿瘤死亡风险分别降低55%（HR=0.45,95%CI：0.38~0.53）、56%（HR=0.44,95%CI：0.32~0.59）和40%（HR=0.60,95%CI：0.44~0.82）。结论 饮食摄入种类和体力活动及其联合作用与T2DM患者死亡风险降低相关。     

Frailty Status Predicts All-Cause and Cause-Specific Mortality in Community Dwelling Older Adults

ObjectivesTo examine the relationship between frailty status and risk of all-cause and cause-specific mortality.DesignLongitudinal cohort study with an 11-year follow up.Setting and participantsData from the Survey on Health, Aging and Retirement in Europe (SHARE) were used. In the analysis, we included data from 11 European countries. We included men and women older than 50 years residing in Europe. Overall, 24,634 participants were analyzed with a mean age of 64.2 (9.8), 53.6% female, where 14.7% and 6.9% were found to be prefrail or frail, respectively, at the baseline.MethodsFrailty status was calculated using the SHARE–Frailty Instrument, categorizing the participants as robust, prefrail, and frail. Multivariate Cox regression models were used to estimate the risk of all-cause and cause-specific (stroke, heart attack, other cardiovascular disease, cancer, respiratory illness, infectious, and digestive and other) mortality.ResultsDuring the follow-up, and after adjusting for sex, age, education, body mass index, smoking, alcohol consumption, and number of comorbidities, frailty was associated with a higher risk of all-cause (HR 2.17, 95% CI 1.90-2.48) and mortality due to stroke (HR 2.06, 95% CI 1.37-3.10), heart attack (HR 1.67, 95% CI 1.19-2.34), other cardiovascular disease (HR 2.77, 95% CI 1.87-4.12), cancer (HR 2.11, 95% CI 1.63-2.73), respiratory disease (HR 2.76, 95% CI 1.66-4.60), infectious diseases (HR 1.79, 95% CI 1.03-3.11), and digestive and other causes (HR 2.02, 95% CI 1.51-2.71). Prefrailty was associated with a higher risk of all-cause (HR 1.47, 95% CI 1.31-1.63), heart attack (HR 1.31, 95% CI 1.01-1.72), other cardiovascular disease (HR 2.03, 95% CI 1.46-2.81), respiratory disease (HR 1.70, 95% CI 1.09-2.65), and digestive and other causes (HR 1.50, 95% CI 1.18-1.91) mortality.Conclusions and implicationsBaseline prefrailty and frailty are associated with increased all-cause and cause-specific mortality over an 11-year follow up. Public health policy should include preventive programs aimed at older adults to prevent frailty and reduce mortality.     

Total fat intake is associated with decreased mortality in Japanese men but not in women

Dietary guidelines generally recommend avoiding a high-fat diet. However, the relationship between fat subtypes and mortality remains unclear especially in a population with a relatively low intake of fat. We aimed to prospectively examine the relationship between dietary fat intake and all-cause and cause-specific mortality in a Japanese community. In 1992, a total of 28,356 residents of Takayama, Japan, without cancer, stroke, or coronary heart disease, responded to a validated 169-item FFQ. We identified 4616 deaths during a 16-y follow-up. The HR of mortality according to the percentage of energy from the total and subtypes of fat when substituted for an isoenergic quantity of carbohydrate was calculated after controlling for potential confounders. A high intake of total fat and PUFA was associated with a decrease in all-cause mortality in men; the HR for the highest compared with the lowest quintile were 0.83 (95% CI: 0.70, 0.99; P-trend = 0.048) for total fat and 0.77 (95% CI: 0.62, 0.95; P-trend = 0.05) for PUFA. Both fats were associated with a decrease in mortality from cancer and diseases other than cardiovascular disease. In women, a higher SFA intake was associated with higher all-cause mortality [HR = 1.22 (95% CI: 0.99, 1.49; P-trend = 0.03)]. A favorable effect was suggested for total fat and PUFA intakes on mortality in men except for that from cardiovascular disease, whereas increased SFA intake may be associated with adverse health consequences in women.     

Dietary total antioxidant capacity is inversely associated with all-cause and cardiovascular disease death of US adults

Purpose

Although evidence strongly supports that antioxidant-rich diets reduce risk of chronic disease and mortality, findings from the previous studies on the effect of individual antioxidants on mortality have been inconsistent. The aim of this study was to assess the relationship between dietary total antioxidant capacity (TAC) and all-cause and disease-specific mortality in a representative sample of the US population.

Methods

A total of 23,595 US adults aged 30 years and older in NHANES 1988–1994 and 1999–2004 were selected for this study. Dietary TAC was calculated from 1-day 24-h diet recall data at baseline and all-cause, cancer and cardiovascular disease (CVD) mortality was assessed through December 31, 2011.

Results

During a mean follow-up of 13 years, deaths from all-cause, cancer and CVD were 7157, 1578, and 2155, respectively. Using cause-specific Cox proportional hazards models, inverse associations and linear trends were observed between dietary TAC and all-cause mortality [highest quartile (Q4) versus Q1 ref. HR 0.78; 95% CI 0.71–0.86], cancer mortality (Q4 versus Q1 ref. HR 0.75; 95% CI 0.60–0.93), and CVD mortality (Q4 versus Q1 ref. HR 0.83; 95% CI 0.69–0.99), respectively, after adjusting for age, sex, ethnicity, and total energy intake. The inverse association and linear trend still remained between dietary TAC and all-cause mortality (Q4 versus Q1 ref. HR 0.79; 95% CI 0.71–0.87) and CVD mortality (Q4 versus Q1 ref. HR 0.74; 95% CI 0.61–0.89) when further adjusted for relevant covariates.

Conclusions

These findings support that antioxidant-rich diets are beneficial to reducing risk of death from all-cause and CVD.

     

Association Between Sugar-Sweetened Beverage Intake and Mortality Risk in Women: The California Teachers Study

BackgroundThe evidence linking sugar-sweetened beverage (SSB) intake and mortality risk is conflicting, and associations between various SSB subtypes and mortality remain unclear.ObjectiveTo examine the association between baseline SSB intake, subtypes of SSB intake, and mortality risk in women.DesignProspective cohort study.Participants/settingParticipants of the California Teachers Study (n = 100,314; median age = 53 years) free of cardiovascular disease, cancer, and diabetes at baseline (1995-1996) were followed from 1995 to 2015. Baseline SSB intake was defined as caloric soft drinks (regular soft drinks, not diet soda), sweetened bottled waters or teas, and fruit drinks; and was derived from a self-administered food frequency questionnaire.Main outcome measureMortality was ascertained via annual linkage with state- and nationwide mortality records and the National Death Index over 20 years.Statistical analysisMultivariable-adjusted Cox proportional hazards models were used to generate hazard ratios (HRs) and 95% CIs for assessing associations between SSB intake and mortality. Rare/never consumers were the comparator group.ResultsThere were a total of 14,143 deaths over 20 years (30.5% from cardiovascular disease; 29.2% from cancer). In women who consumed ≥ 7 servings/week of SSBs at baseline (4% of participants), the multivariable-adjusted HRs were not significant for all-cause, cardiovascular disease-specific, or cancer-specific mortality. Consuming ≥ 7 servings/week of baseline caloric soft drink was associated with a higher risk of all-cause (HR = 1.26, 95% CI 1.10 to 1.46; P for trend = 0.02) and cancer-specific (HR = 1.33, 95% CI 1.08 to 1.63; P for trend = 0.08) mortality. In secondary analyses, consuming ≥ 1.5 c/day of baseline SSBs was associated with all-cause mortality (HR = 1.12, 95% CI 1.02 to 1.24; P for trend = 0.01).ConclusionsAlthough the baseline frequency of total SSB intake was not significantly associated with mortality, consuming ≥ 7 servings/week of caloric soft drinks was associated with higher risk of all-cause and cancer-specific mortality. Findings support public health efforts to reduce caloric soft drink consumption.     

Optimal Dairy Intake Is Predicated on Total,Cardiovascular, and Stroke Mortalities in a Taiwanese Cohort

Objective: Dairy foods help achieve essential nutrient adequacy. This role may be conflicted where so-called chronic diseases prevail. We have examined associations between dairy intake and mortality where dairy foods have not been traditional.

Methods: A representative Taiwanese cohort of 3810 subjects, aged 19–64 years, derived from the Nutrition and Health Survey in Taiwan (NAHSIT, 1993–1996) was linked to death registration (1993–2008). Participants were categorized by 4 dairy weekly intake frequencies from 0 to >7 times. Mortality hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox proportional-hazards models.

Results: Nonconsumers of dairy products included 30.7% of the men and 22.1% of the women. Adverse sociodemographic and personal behaviors were generally significantly associated with lower dairy consumption. After adjustment for covariates, together with body mass index (BMI) and supplement use, those with 3–7 times/week intakes had an HR (95% CI) for all-cause mortality of 0.61 (0.39–0.96) with a significant dose–response trend (p = 0.043). Similarly, the HR for cardiovascular disease (CVD) mortality with dairy weekly intake frequency >7 was 0.14 (0.02–0.97) with a significant linear trend (p = 0.007). For stroke, the corresponding HR (95% CI) was 0.03 (0.00–0.28) with a linear trend. By age and with adjustment for dietary quality, food, and calcium or vitamin D intake, significance and dose–response relationships remained. Dairy intake and cancer mortality were not associated.

Conclusion: In a Chinese food culture, a dairy foods intake in adults up to 7 times a week does not increase mortality and may have favorable effects on stroke.     

Dietary fiber intake in relation to coronary heart disease and all-cause mortality over 40 y: the Zutphen Study

BACKGROUND: Little is known about the effects of dietary fiber intake on long-term mortality. OBJECTIVE: We aimed to study recent and long-term dietary fiber intake in relation to coronary heart disease and all-cause mortality. DESIGN: The effects of recent and long-term dietary fiber intakes on mortality were investigated in the Zutphen Study, a cohort of 1,373 men born between 1900 and 1920 and examined repeatedly between 1960 and 2000. During that period, 1,130 men died, 348 as a result of coronary heart disease. Hazard ratios were obtained from time-dependent Cox regression models. RESULTS: Every additional 10 g of recent dietary fiber intake per day reduced coronary heart disease mortality by 17% (95% CI: 2%, 30%) and all-cause mortality by 9% (0%, 18%). The strength of the association between long-term dietary fiber intake and all-cause mortality decreased from age 50 y (hazard ratio: 0.71; 95% CI: 0.55, 0.93) until age 80 y (0.99; 0.87, 1.12). We observed no clear associations for different types of dietary fiber. CONCLUSIONS: A higher recent dietary fiber intake was associated with a lower risk of both coronary heart disease and all-cause mortality. For long-term intake, the strength of the association between dietary fiber and all-cause mortality decreased with increasing age.     

Dietary Patterns and Osteoporosis Risk in Postmenopausal Korean Women

ObjectivesThe prevalence of osteoporosis and related fractures has increased rapidly in Korean women. Proper nutrition intake is associated with the prevention of osteoporosis. We analyzed the association between dietary patterns and the risk of osteoporosis during a 4-year follow-up in postmenopausal Korean women.MethodsPostmenopausal women (n = 1,725) who participated in the Korean Genome and Epidemiology Study were enrolled. Food intake was assessed using a validated semiquantitative food frequency questionnaire, and a quantitative ultrasound device was used to measure the speed of sound at the radius and tibia.ResultsThree major dietary patterns were identified using factor analysis based on baseline intake data: traditional (high intake of rice, kimchi, and vegetables), dairy (high intake of milk, dairy products, and green tea), and western (high intake of sugar, fat, and bread). Multivariate Cox proportional hazards models were used to estimate relative risk for osteoporosis. An inverse association was detected between the dairy dietary pattern and the osteoporosis incidence [relative risk (RR): 0.63, 95% confidence interval (CI): 0.42–0.93, p-trend = 0.055 in radius; RR: 0.56, 95% CI: 0.35–0.90, p-trend = 0.048 in tibia]. Individuals in the highest quintile for the traditional dietary pattern (p-trend = 0.009 in tibia) and western dietary pattern (p-trend = 0.043 in radius) demonstrated a higher risk of osteoporosis incidence than those in the lowest quintile.ConclusionThese results suggested that high consumption of milk, dairy products, and green tea may reduce the risk of osteoporosis in postmenopausal Korean women.     

Successful Aging and Mortality Risk: The Korean Longitudinal Study of Aging (2006-2014)

ObjectivesThe aim of this study is to examine the association of successful aging with mortality and further find gender differences in the effect of components of successful aging on mortality risks.DesignRetrospective cohort study.Setting and participantsA total of 3848 adults aged 65 and older from the Korean Longitudinal Study of Aging (2006-2014) data.MeasuresSuccessful aging was defined as success in the following 7 components: absence of major disease, no depression, no freedom from disability, high cognitive and physical function, active social engagement, and satisfaction with life. All-cause mortality was measured by death certificate and family interview.ResultsIn both genders, the mortality rate was higher in the older adults who did not achieve successful aging than in their counterparts (men: hazard ratio [HR] = 1.69, 95% confidence interval [CI] 1.18-2.43; and women: HR = 2.37, 95% CI 1.21-4.63). All components of no successful aging were associated with an increased risk of mortality except for no satisfaction with life in females. Mortality rates were predominant in major disease (HR = 1.86, 95% CI 1.54-2.25) and depressive symptoms (HR = 1.62, 95% CI 1.26-2.10) in males, and disability (HR = 2.08, 95% CI 1.68-2.57) and low physical functioning (HR = 2.31, 95% CI 1.79-2.98) were predominant in females.Conclusion/ImplicationWe found that older Koreans who did not achieve successful aging had a higher risk of all-cause mortality than successful agers. There were gender differences in mortality risks across all components of successful aging.     

Ventilatory Function in Young Adults and Dietary Antioxidant Intake

Dietary antioxidants may protect against poor ventilatory function. We assessed the relation between ventilatory function and antioxidant components of diet in young Chileans. Forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), and the ratio FEV₁/FVC were measured in 1232 adults aged 22–28 years, using a Vitalograph device. Dietary intake was ascertained with a food frequency questionnaire (FFQ) designed for this study, from which nutrient and flavonoid intakes were estimated. Dietary patterns were derived with Principal Component Analysis (PCA). After controlling for potential confounders, dietary intake of total catechins was positively associated with FVC (Regression coefficient (RC) of highest vs. lowest quintile of intake 0.07; 95% CI 0.01 to 0.15; p per trend 0.006). Total fruit intake was related to FVC (RC of highest vs. lowest quintile 0.08; 95% CI 0.003 to 0.15; p per trend 0.02). Intake of omega 3 fatty acids was associated with a higher FEV₁ (RC for highest vs. lowest quintile 0.08; 95% CI 0.01 to 0.15 L; p per trend 0.02) and with FVC 0.08 (RC in highest vs. lowest quintile of intake 0.08, 95% CI 0.001 to 0.16; p per trend 0.04). Our results show that fresh fruits, flavonoids, and omega 3 fatty acids may contribute to maintain ventilatory function.     

The association of calcium and vitamin D with risk of colorectal adenomas

The Polyp Prevention Trial (PPT) was a multicenter randomized clinical trial designed to determine the effects of a high-fiber, high-fruit and vegetable, low-fat diet on the recurrence of adenomatous polyps in the large bowel. Detailed dietary intake and supplement use data were collected at baseline and at each of 4 annual study visits. Adenoma recurrence was ascertained by complete colonoscopy at baseline and after 1 and 4 y. Recurrence was found in 754 of the 1905 trial participants. We evaluated the association between calcium and vitamin D intake and adenomatous polyp recurrence after adjusting for intervention group, age, gender, nonsteroidal anti-inflammatory drug use, total energy intake, and the interaction of gender and intervention group. Vitamin D models were also adjusted for the location of the clinic site. Dietary variables were adjusted for total energy intake via the residual method. There were no overall significant associations between adenoma recurrence and dietary calcium intake [odds ratio (OR) for the 5th compared with the lowest quintile = 0.91; 95% CI = 0.67-1.23; P-trend = 0.68], total calcium intake (OR = 0.86; 95% CI = 0.62-1.18; P-trend = 0.20), or dietary vitamin D intake (OR = 0.93; 95% CI = 0.69-1.25; P-trend = 0.43) averaged over follow-up. Total vitamin D intake was weakly inversely associated with adenoma recurrence (OR = 0.84; 95% CI = 0.62-1.13; P-trend = 0.03). Supplemental calcium and vitamin D use during follow-up also were inversely associated with adenoma recurrence (OR for any compared with no use = 0.82; 95% CI = 0.68-0.99; and OR = 0.82; 95% CI = 0.68-0.99; for calcium and vitamin D, respectively). Slightly stronger associations were noted for the prevention of multiple recurrences. Our analyses did not suggest a significant effect modification between total calcium and total vitamin D intake (P = 0.14) on risk for adenoma recurrence. This trial cohort provides some evidence that calcium and vitamin D may be inversely associated with adenoma recurrence.