Fruits and vegetables intake in the SU.VI.MAX study and systolic blood pressure change

BACKGROUND: In intervention studies (DASH), high fruits and vegetables intake lower blood pressure (BP). Less is known on long-term effects of fruits and vegetables intake on BP, especially in European population. OBJECTIVE: To study the relation between fruits and vegetables intake and BP change in the SU.VI.MAX study. METHOD: In the SU.VI.MAX study (1994-2002), BP was measured and information on medical treatment was collected during two clinical examination session in 1995-1996 and 2001-2002. Dietary information came from 24 h dietary records completed every two months, by each volunteer during the first two years of follow-up. We performed a transversal analysis of BP measured at the first clinical examination in 6 427 subjects aged 36-62 years. A longitudinal analysis including subjects without hypertension at baseline was performed on BP change between the two examination (n=2958). RESULTS: At first examination, after adjusting for main confounding factors, subjects reporting high vegetables intake (last quintile) had a lower (-1.6 mmHg, p trend <0.01) systolic BP (SBP) than subjects reporting lower intake (first quintile). High fruits intake was slightly associated with lower SBP (1.1 mmHg, NS). At the end of the follow-up, the mean increase of SBP was of 9.5 mmHg. This increase was 2.2 mmHg lower (p < 0.003) in the last quintile of vegetables intake. No similar relation was observed with fruits intake. CONCLUSION: These results suggest that vegetables intake may be associated with lower BP and a lower increase of BP over years. This last association may have implications for the prevention of hypertension which appears with aging.     

Body composition and fat repartition in relation to structure and function of large arteries in middle-aged adults (the SU.VI.MAX study)

OBJECTIVE: To investigate associations of body composition assessed by bioimpedance analysis and anthropometric indicators of fat repartition with carotid structure and function. DESIGN: Cross-sectional epidemiological study. SUBJECTS: A total of 1014 middle-aged apparently healthy adults participating in the SU.VI.MAX study. MEASUREMENTS: Body composition (fat mass, fat-free mass) was assessed by bioimpedance analysis and anthropometric indicators of fat repartition (waist circumference (WC); waist-hip-ratio (WHR)) were simultaneously collected. Carotid ultrasound examination included measurements of intima-media thickness (IMT) at the common carotid arteries (CCA) and assessment of atherosclerotic plaques in extracranial carotid arteries. Carotid-femoral pulse-wave velocity (PWV) was used as a marker of aortic stiffness.RESULTS:In multivariate analyses adjusted for major known cardiovascular risk factors in addition to age, gender and height, fat-free mass, fat mass (FM), and WC were positively associated with CCA-IMT and lumen diameter. No significant association was found with occurrence of carotid plaques. PWV was only associated with WC. Associations of CCA-IMT and PWV with WC were not significant anymore after further adjustment on body mass index (BMI) or FM. CONCLUSION: WC was the only measurement positively associated with both early atherosclerosis markers such as CCA-IMT and arterial stiffness. Although this association depends on overall adiposity, as assessed by the BMI, it emphasizes the importance of WC in clinical practice and prevention programs as a screening tool for individuals at risk for cardiovascular disease.     

Dairy products, calcium and the risk of breast cancer: results of the French SU.VI.MAX prospective study

The aim was to estimate the association between dairy products (total and their subgroups), calcium intake and the risk of breast cancer. As few studies have considered menopausal status, we also investigated stratified analyses. This analysis included 3,627 women from the French SU.VI.MAX study, among whom 92 developed breast cancer during the follow-up period. Food consumption was assessed based on five 24-hour records completed during the previous 18 months to follow-up. Calcium intake was calculated using an ad-hoc food composition database. Cox proportional hazards models were used to estimate relative risk (RR), comparing 4th quartile vs. 1st quartile, and 95% confidence intervals (95% CI). A lower risk of breast cancer was observed with high total dairy product consumption in the whole population (RR = 0.55, 95% CI = 0.29-1.03, p(trend) = 0.03) and among premenopausal women with a RR of 0.35 (95% CI = 0.12-0.95, p(trend) = 0.01). None of these associations remained after control for calcium intake. Increasing calcium intake was inversely associated with breast cancer risk considering the whole population (RR = 0.50, 95% CI = 0.27-0.91, p(trend) = 0.04) and among the subgroup of premenopausal women (RR = 0.26, 95% CI = 0.10-0.71, p(trend) = 0.01) respectively. Our data support the hypothesis that dairy products, through calcium content or a correlated component, might have a negative association with the risk of breast cancer, particularly among premenopausal women.     

Thyroid hormone levels and thyroid dysfunction of French adults participating in the SU.VI.MAX study

Abnormal thyroid function has important public health consequences. However, the various degrees of thyroid dysfunction remain unsettled. The SU.VI.MAX cohort provided a unique opportunity to conduct a cross-sectional study of abnormal thyroid function in a large representative population of 11256 men and women representing the geographic distribution of the French continental adult population. Thyroid status was measured, in fasting blood samples, at baseline in 1994-1995. Serum thyrotropin (TSH) levels (abnormal < 0.4 mU/l or > or =4.0 mU/l) and free thyroxine (fT4) were both performed in duplicate on the same sample. Subjects with previous or present thyroid diseases or who were taking thyroid hormones or antithyroid drugs (n=920) were excluded (8.1%). Thus, the final study group consisted of 10346 subjects, 4121 men aged 45-60 years (mean +/-SD) (51.8+/-4.7 yrs), 2641 women aged 35-44 years (40.6+/-2.8 yrs), and 3584 women aged 45-60 years (51.4+/-4.4 yrs). Median (2.5th and 97.5th percentiles) for TSH (mU/l) were 1.52 (0.20-4.54) for men, 1.78 (0.22-5.54) for women aged 35-44 years, and 1.96 (0.22-6.80) for women aged 45-60 years. The TSH distribution of women was shifted to the right compared with men. Arithmetic mean fT4 (+/-SD) was 10.7+/-1.7 ng/l (13.8 +/-2.2 pmol/l) for men and 10.9+/-1.8 ng/l (14.0+/-2.3 pmol/l) for women. The prevalence of abnormal TSH values in men, and in women (35-44 yrs and 45-60 yrs) were TSH<0.4 mU/l 7.0%, 5.3% and 4.4%; TSH 4.0-9.9 mU/l 4.0%, 7.2% and 11.1% and TSH > or =10.0 mU/l 0.2%, 0.4% and 0.7%, respectively. Geometric mean serum TSH and arithmetic mean serum fT4 concentrations showed significant overall inter-regional differences for men and women (p<0.0001). There was also an inter-regional difference in the prevalence of thyroid dysfunction for men (p=0.003), and for the older group of women (i.e. > or =45 yrs) (p=0.04) exclusively. Over the age of 45 years, the women: men ratio for unrecognized elevated TSH levels (> or =4.0 mU/l) was 2.82, whereas it was 0.64 for low TSH levels (<0.4 mU/l). In summary, abnormal TSH values and thyroid dysfunction were more prevalent in women than men, increased with age and were significantly associated with environmental factors. A high prevalence of identified thyroid diseases in the French population was confirmed by the high number of subjects in this study with laboratory evidence of abnormal biochemical thyroid function. Further studies are needed to determine the geographical determinants of thyroid dysfunctions, especially regional differences in iodine intakes, and to assess the long-term adverse effects of biochemical thyroid dysfunction on all-cause morbidity.     

Association of physical inactivity with hypertension and low educational level in people living with HIV / AIDS

The aim of this study was to determine the prevalence of physical inactivity and whether it is associated with sociodemographic, lifestyle, clinical, anthropometric, and body composition variables in people living with HIV/AIDS (PLWHA). This study makes use of data from a cohort of 288 adults aged ≥19 years, conducted between October 2009 and July 2011. The variables studied were sex, age, education, income, skin color, tobacco use, alcohol intake, body mass index, body fat percentage, waist circumference, and waist-hip ratio, length of HIV/AIDS diagnosis, use of antiretroviral therapy and length of its use, CD4, hypertension (HT) and diabetes mellitus. Physical inactivity was defined as a score below 600 metabolic equivalent minutes/week according to the International Physical Activity Questionnaire – Short Version. Poisson multiple regression was applied in the multivariate analysis with a significance level of 5%. The prevalence of physical inactivity was 44.1%. Education of ≤4 years of study (prevalence ratio [PR]: 1.71) and HT (PR: 1.49) were associated with physical inactivity. Physical inactivity was highly prevalent in PLWHA and associated with low educational level and HT. We highlight the simultaneous association between two cardiometabolic risk factors, HT and physical inactivity.     

Effect of supplementation with antioxidants upon long-term risk of hypertension in the SU.VI.MAX study: association with plasma antioxidant levels

OBJECTIVE: To assess the effects of supplementation with a combination of antioxidant vitamins and trace elements, at nutritional doses, upon the 6.5-year risk of hypertension in the SU.VI.MAX trial. To describe the association between baseline plasma antioxidant levels and the same long-term risk using observational data from the study. SETTING: A total of 5086 adults from the SU.VI.MAX trial, a randomized primary prevention trial. RESULTS: Compared with the placebo group, no effect of supplementation upon the 6.5-year risk of hypertension could be detected (odds ratio, 1.04 and 95% confidence interval, 0.87-1.23 in men; and odds ratio, 1.10 and 95% confidence interval, 0.95-1.29 in women). Furthermore, compared with men in the first tertile, those in the second and third tertiles of serum baseline levels of beta-carotene presented a lower risk of hypertension in both the placebo and supplementation groups. Multivariate-adjusted odds ratios (95% confidence interval) were 0.70 (0.44-1.12) and 0.53 (0.33-0.86) in the placebo group, and were 0.59 (0.37-0.94) and 0.67 (0.42-1.07) in the supplementation group. In women, a decreasing trend was observed with vitamin C levels and risk of hypertension in the intervention group. No association could be shown between vitamin E and trace element plasma levels and the risk of hypertension. CONCLUSIONS: Despite an inverse association between baseline plasma levels of beta-carotene in men and the risk of developing hypertension, we could not demonstrate any beneficial effect of low-dose antioxidant supplementation upon the 6.5-year risk of hypertension in the randomized analysis.     

Antioxidant supplements and risk of hypertension in the SU.VI.MAX trial: relationship to plasma antioxidants

The object of this work was to determine the risk of hypertension after 6.5 years'- follow-up of supplementation in vitamins and antioxidant minerals at nutritional doses in the SU.VI.MAX trial. The authors also studied the association with plasma concentrations of antioxidants at inclusion and at long term. This was a randomised nutritional primary prevention study including 5086 adults of the SU.VI.MAX trial. After 6.5 years' follow-up, no effect of supplementation on the risk of developing hypertension could be shown compared with the placebo group: odds ratios (OR IC 95%): 1.04 (0.87-1.23) in men and 1.10 (0.95-1.29) in women. Besides, in the male 2nd and 3rd tertiles of serum beta-carotene levels at inclusion the risk of hypertension was lower [multivariate OR: 0.70 (0.44-1.12) and 0.53 (0.33-0.86) for placebo, and 0.59 (0.37-0.94) and 0.67 (0.42-1.07) for the supplemented groups]. The authors conclude that, despite a reverse relationship in men between the plasma concentrations of beta-carotene and the risk of hypertension, supplementation in antioxidants at nutritional doses had no effect on the risk of developing hypertension after 6.5 years' follow-up.     

Determinants of thyroid volume in healthy French adults participating in the SU.VI.MAX cohort

OBJECTIVE: To study the relative importance of determinants of thyroid volume. DESIGN: Cross-sectional study on a sample of subjects issued from the SU.VI.MAX cohort. SUBJECTS: 2987 French subjects (1713 women aged 35-60 years and 1274 men aged 45-60 years). None of them had previous or present thyroid disease. MEASUREMENTS: Thyroid volume was determined by ultrasound. Serum TSH and free thyroxine (fT4) were measured in duplicate. Urinary iodine and urinary thiocyanate were assayed in random morning urine samples. RESULTS: For both sexes, thyroid volume (ml) was positively correlated with weight, height, body mass index and body surface area (P = 0.0001) and negatively with age for females (P = 0.0009). When the urinary iodine concentration was adjusted for urinary thiocyanate concentration and their interaction, the thyroid volume was negatively correlated with urinary iodine (males P = 0.02, females P = 0.006) and positively correlated with urinary thiocyanate (males P = 0.0001, females P = 0.004). Mean thyroid volume was greater among active smokers than non-smokers (males P < 0.0001, females P = 0.0004) and was greater among former smokers than among non-smokers (males P = 0.0001, females = 0.004). Free T4 and thyroid volume were positively correlated for both sexes (P = 0. 0001). TSH was negatively correlated with thyroid volume for both groups (P = 0.0001). Female users of oral contraception (aged 35-45 years) had a smaller thyroid volume than non-users (P = 0.0009). CONCLUSIONS: The state of borderline iodine deficiency observed in France, in association with a slightly goitrogenic environment, may result in sustained stimulation of the thyroid, independently of TSH level, and is of paramount importance in the formation of goitre. Smoking may affect the thyroid, inducing marked long-lasting thyroid enlargement.     

The SU.VI.MAX Study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals

BACKGROUND: It has been suggested that a low dietary intake of antioxidant vitamins and minerals increases the incidence rate of cardiovascular disease and cancer. To date, however, the published results of randomized, placebo-controlled trials of supplements containing antioxidant nutrients have not provided clear evidence of a beneficial effect. We tested the efficacy of nutritional doses of supplementation with a combination of antioxidant vitamins and minerals in reducing the incidence of cancer and ischemic cardiovascular disease in the general population. METHODS: The Supplementation en Vitamines et Mineraux Antioxydants (SU.VI.MAX) study is a randomized, double-blind, placebo-controlled primary prevention trial. A total of 13 017 French adults (7876 women aged 35-60 years and 5141 men aged 45-60 years) were included. All participants took a single daily capsule of a combination of 120 mg of ascorbic acid, 30 mg of vitamin E, 6 mg of beta carotene, 100 mug of selenium, and 20 mg of zinc, or a placebo. Median follow-up time was 7.5 years. RESULTS: No major differences were detected between the groups in total cancer incidence (267 [4.1%] for the study group vs 295 [4.5%] for the placebo group), ischemic cardiovascular disease incidence (134 [2.1%] vs 137[2.1%]), or all-cause mortality (76 [1.2%] vs 98 [1.5%]). However, a significant interaction between sex and group effects on cancer incidence was found (P = .004). Sex-stratified analysis showed a protective effect of antioxidants in men (relative risk, 0.69 [95% confidence interval [CI], 0.53-0.91]) but not in women (relative risk, 1.04 [95% CI, 0.85-1.29]). A similar trend was observed for all-cause mortality (relative risk, 0.63 [95% CI, 0.42-0.93] in men vs 1.03 [95% CI, 0.64-1.63] in women; P = .11 for interaction). CONCLUSIONS: After 7.5 years, low-dose antioxidant supplementation lowered total cancer incidence and all-cause mortality in men but not in women. Supplementation may be effective in men only because of their lower baseline status of certain antioxidants, especially of beta carotene.     

Physical inactivity as a determinant of the physical activity level in the elderly.

OBJECTIVE: To assess the relationship between the mean physical activity level (PAL) and the time spent on activities of three different intensity levels in an elderly population. Data was compared with previously obtained data from a group of younger adults. SUBJECTS: Fourteen elderly women and 14 elderly men (61+/-4 y; 27+/-5 kg/m(2); 33+/-7% body fat), and 14 young women and 16 young men (27+/-5 y, 24+/-2 kg/m(2)). MEASUREMENTS: PAL was determined as average daily metabolic rate (ADMR) combined with a measurement of basal metabolic rate (BMR): PAL=ADMR/BMR. ADMR was measured with the doubly labeled water method. BMR was measured with a ventilated hood system. Time spent on activity and activity intensity was measured by using a tri-axial accelerometer (7x2x0.8 cm, 30 g) over a 2 week interval. RESULTS: Mean PAL was 1.65+/-0.14. PAL was inversely related to the percentage of time spent on low-intensity activity (lying, sitting and standing), r= -0.43; P<0.05. Older subjects spent significantly more time at these activities than 20 to 35-y-old subjects (82+/-7% vs 65+/-7%; P<0.0001). A significant relation was not observed between PAL and the percentage of time spent on moderate (walking) or high (household activities, exercise and sports) intensity activity, or activity monitoring time (14.4+/-1.2 h/day). CONCLUSION: In the elderly, spending relatively more time on low-intensity activities affects the mean PAL negatively. To obtain a higher PAL does not necessarily imply high-intensity activities like sports.     

Inequalities in smoking profiles in Morocco: the role of educational level

BACKGROUND: Cigarette smoking is increasingly associated with lower socio-economic status, indicated by lower educational levels. This association has never been investigated in Morocco. OBJECTIVE: The MARTA survey was undertaken to assess tobacco use in the Moroccan population according to level of education and other socio-demographic characteristics. METHODS: A cross-sectional survey based on a representative sample of the Moroccan population was conducted in 2005-2006. The survey questionnaire gathered socio-demographic information, educational level and smoking status. chi(2) analyses were performed to determine whether the smoking outcome variables differed significantly between different educational levels in relation to demographic variables. Multiple logistic regression analysis was used to calculate the adjusted odds ratio for smoking status according to educational level. RESULTS: A total of 9195 subjects were included in the study; 52% were men and 17.9% illiterate. The overall prevalence of current smoking was 18.0% (95%CI 17.2-18.8): 31.5% (95%CI 30.2-32.9) in males and 3.3% (95%CI 2.8-3.8) in females. The prevalence of current smoking was inversely associated with level of education in men and increased with educational level in women. Illiterate males tended to have a higher probability of being current smokers than males with university-level education (OR 1.93, 95%CI 1.51-2.46). CONCLUSION: These results indicate a need for tobacco control to reach all sectors of society, and especially the illiterate population.     

Body mass index, physical inactivity and low level of physical fitness as determinants of all-cause and cardiovascular disease mortality--16 y follow-up of middle-aged and elderly men and women

OBJECTIVE: To investigate the independent associations and the possible interaction of body mass index (BMI), leisure time physical activity (LTPA) and perceived physical fitness and functional capability with the risk of mortality. DESIGN: Prospective 16y follow-up study. SUBJECTS: A regionally representative cohort of 35-63-y-old Finnish men (n= 1,090) and women (n= 1,122). MEASUREMENTS: All-cause, cardiovascular disease (CVD) and coronary heart disease (CHD) mortality were derived from the national census data until the end of September 1996 while the initial levels of BMI, LTPA, physical fitness and function were determined from self-administered questionnaires. RESULTS: After adjustment for age, marital and employment status, perceived health status, smoking and alcohol consumption, the Cox proportional hazards model showed that BMI was not associated with the risk of death among the men or the women. Compared with the most active subjects the men and women with no weekly vigorous activity had relative risks of 1.61 (95% confidence interval, CI, 0.98-2.64) and 4.68 (95% CI, 1.41-15.57), respectively, for CVD mortality, and for the men there was a relative risk of 1.66 (95% CI, 0.92-2.99) for CHD mortality. When compared with the men who perceived their fitness as better than their age-mates, the men with the 'worse' assessment had a relative risk of 3.29 (95% CI, 1.80-6.02) for all-cause mortality and 4.37 (95% CI, 1.80-10.6) for CVD mortality. Men with at least some difficulty in walking a distance of 2 km had a relative risk of 1.62 (95% CI, 1.05-2.50) for all-cause mortality when compared with those who had no functional difficulties. In addition, in the comparison with subjects with no functional difficulties, the men and women who had some difficulty climbing several flights of stairs had relative risks of 1.47 (95% CI, 0.97-2.23) and 2.39 (95% CI, 1.25-4.60) for all-cause mortality, respectively. For CVD mortality the relative risks were 1.85 (95% CI, 1.04-3.30) and 3.38 (1.22-9.41), respectively. CONCLUSIONS: Although BMI did not prove to be an independent risk factor for mortality from CVD, CHD or from all causes combined, perceived physical fitness and functional capability did. An increase in LTPA seems to have a similar beneficial effect on the mortality risk of obese and nonobese men and women, and the effect also seems to be similar for fit and unfit subjects.     

Smoking in non-student Mexican adolescents with asthma: relation with family structure, educational level, parental approval of smoking, parents who smoke, and smoking friends

Introduction

The association between some factors of the familial and social environment with smoking in non-student adolescents with asthma has not been explored. The aim of the study was to determine the association between family structure, educational level, parental approval of smoking, parents who smoke, and smoking friends with smoking in non-student adolescents with asthma.

Subjects and methods

In a cross-sectional study, data were obtained by means of a structured questionnaire applied to 4,778 non-student adolescents aged 13–18 years. Diagnosis of asthma was performed using a questionnaire based on the International Study of Asthma and Allergy in Childhood questionnaire. The smoking habit was determined by application of a self-administered questionnaire. Odds ratios (OR) were determined for smoking using logistic regression.

Results

From the total sample, asthma prevalence was 6.6% and of active smoking, 34.2%. Age at initiation of asthma symptoms was 5.15 ± 3.52 years, and that of active smoking was 13.65 ± 2.07 years. Percentage of non-intact family (40.1 vs. 32.7%) was greater in the group of adolescents with asthma. Logistic regression models show that parental approval of smoking (adjusted OR = 5.57; 95% confidence interval = 2.48–12.51) and smoking friends (adjusted OR = 2.92; 95% confidence interval = 1.04–8.19) are associated with smoking in non-student adolescents with asthma.

Conclusion

In this study, parental approval of smoking and having friends who smoke appear to be associated with smoking among non-student adolescents with asthma.     

The role of C-reactive protein,adiponectin and leptin in the association between abdominal adiposity and insulin resistance in middle-aged individuals

Background and aimsIn the present study, we assessed the extent of mediation by low-grade systemic inflammation and adipokines in the association between abdominal adiposity and insulin resistance.Methods and resultsIn this cross-sectional analysis of baseline measurements of the Netherlands Epidemiology of Obesity study, total body fat (TBF) was measured in all (n = 5772) participants who did not have missing data and neither used glucose-lowering medication, and abdominal subcutaneous adipose tissue (aSAT) and visceral adipose tissue (VAT) were assessed by MRI in a random subgroup (n = 2448). C-reactive protein (CRP), adiponectin, and leptin were considered as potential mediators, and insulin resistance was assessed by Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). Mediation by CRP, adiponectin, and leptin was studied by including the mediators to the fully adjusted linear regression model. Participants had a mean (SD) age of 56 (6) years, TBF of 36 (9) %, VAT of 119 (61) cm² and aSAT of 300 (111) cm². Per SD of TBF, VAT and aSAT, HOMA-IR was 64% (95% confidence interval [CI]: 59–70), 33% (95%CI: 28–42) and 20% (95%CI: 14–26) higher, respectively. The association between aSAT and HOMA-IR fully disappeared after adjustment for leptin; the association between VAT and HOMA-IR attenuated after adjustment for leptin (22%) and adiponectin (15%). No mediation was observed by CRP, and mediation estimates were similar in men and women.ConclusionWhere leptin fully explained the aSAT-HOMA-IR association, the VAT-HOMA-IR association was only partly explained by leptin and adiponectin similarly in men and women.     

Multiple exposures to smoking, alcohol, physical inactivity and overweight: Prevalences according to the Canadian Community Health Survey Cycle 1.1

The objective of this study was to calculate the prevalence of multiple exposures to four modifiable risk factors (smoking, alcohol, physical inactivity and overweight) and to establish whether there are more Canadians with multiple risk factor exposures than those with singular ones. Weighted estimates of the prevalence of mutually exclusive risk factor clusters were calculated according to the Canadian Community Health Survey, Cycle 1.1 (2000). Confidence limits were estimated by bootstrap techniques. Findings indicate that 21.0 percent of Canadians have no risk factor exposures, 53.5 percent are physically inactive, 21.5 percent currently smoke, 44.8 percent are overweight, and 6.0 percent are high-risk drinkers. Compared to females, males are less physically inactive but more likely to smoke, have high alcohol intake and be overweight, across all age groups. At least one risk factor was present in 79.0 percent of Canadians and 39.0 percent have at least two coexistent exposures. The distribution of risk factor prevalences differed significantly by age, most peaking among those between age 35 and 64, with the exception of physical inactivity. Those who smoke and are physically inactive account for the highest proportion of the population with two or more coexistent risk factors. Canadians who are free of the four risk factors for chronic disease examined in this paper constitute the minority. Future studies are recommended to examine other risk factors, as well as interactions of multiple exposures in association with chronic disease.     

Interaction of apolipoprotein E genotype with smoking and physical inactivity on coronary heart disease risk in men and women

ObjectiveApolipoprotein E genotype (APOE) polymorphism affects lipid levels and coronary heart disease (CHD) risk. However, these associations may be modified by lifestyle factors. Therefore, we studied whether smoking, physical inactivity or overweight interact with APOE on cholesterol levels and CHD risk.MethodsCombining two Swedish case-control studies yielded 1735 CHD cases and 4654 population controls (3747 men, 2642 women). Self-reported questionnaire lifestyle data included smoking (ever [current or former regular] or never) and physical inactivity (mainly sitting leisure time). We obtained LDL cholesterol levels and APOE genotypes. CHD risk was modelled using logistic regression to obtain odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for relevant covariates.ResultsSmoking interacted with APOE on CHD risk; adjusted ORs for ever versus never smoking were 1.45 (95% CI 1.00–2.10) in ?2 carriers, 2.25 (95% CI 1.90–2.68) in ?3 homozygotes and 2.37 (95% CI 1.85–3.04) in ?4 carriers. Female ?4 carriers had OR 3.62 (95% CI 2.32–5.63). The adjusted ORs for physical inactivity were 1.09 (95% CI 0.73–1.61), 1.34 (95% CI 1.12–1.61), and 1.79 (95% CI 1.38–2.30) in ?2, ?3?3 and ?4 groups, respectively. No interaction was seen between overweight and APOE for CHD risk, or between any lifestyle factor and APOE for LDL cholesterol levels.ConclusionThe APOE ?2 allele counteracted CHD risk from smoking in both genders, while the ?4 allele was seen to potentiate this risk mainly in women. Similar ?2 protection and ?4 potentiation was suggested for CHD risk from physical inactivity.     

Prevalence of overweight, obesity and physical inactivity in 20- to 29-year-old, Danish men. Relation to sociodemography, physical dysfunction and low socioeconomic status: the Odense Androgen Study

OBJECTIVE: To assess the prevalence of overweight, obesity and physical inactivity in 20- to 29-year-old men and to analyze whether sociodemography, physical dysfunction and low socioeconomic status are independent correlates of obesity and physical inactivity. DESIGN: Population-based, cross-sectional study. SUBJECTS: Seven hundred and eighty-three Caucasian, Danish men, aged 20-29 years recruited from 2042 respondents in a questionnaire survey of 3000 men, randomly drawn from the Danish Civil Registration System. METHODS: Questionnaire, interview and physical examination. RESULTS: The 783 included men and the 2042 questionnaire respondents matched the background population demographically. The 783 men matched the questionnaire respondents as regards BMI, physical activity, chronic disease, medication, smoking, sociodemography and socioeconomic status. The prevalence of overweight and obesity was 31.7 and 7.9%, respectively (World Health Organization criteria). Using waist circumference (WC) cutoffs of 94 and 102 cm, the prevalence was 16.2 and 10.6%, respectively; 24.4% were physically inactive. BMI and WC increased significantly from age 20 to 29 years. Physical activity decreased significantly with age and correlated inversely with WC, but not with BMI. Occupation, geography, partner status, fatherhood and tobacco exposure were independently related with obesity and physical inactivity. Obesity was also related to musculoskeletal complaints, whereas chronic diseases and low educational level were associated with physical inactivity. Age was not independently related with either outcome. CONCLUSION: In affluent societies, sociodemographic changes may partly explain the age-related decrease in physical activity and the parallel increase in WC and BMI.