Folate, vitamin B6, vitamin B12, and methionine intakes and risk of stroke subtypes in male smokers

The associations of dietary folate, vitamin B(6), vitamin B(12), and methionine intakes with risk of stroke subtypes were examined among 26,556 male Finnish smokers, aged 50-69 years, enrolled in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Dietary intake was assessed at baseline by using a validated food frequency questionnaire. During a mean follow-up of 13.6 years, from 1985 through 2004, 2,702 cerebral infarctions, 383 intracerebral hemorrhages, and 196 subarachnoid hemorrhages were identified from national registers. In analyses adjusting for age and cardiovascular risk factors, a high folate intake was associated with a statistically significant lower risk of cerebral infarction but not intracerebral or subarachnoid hemorrhages. The multivariate relative risk of cerebral infarction was 0.80 (95% confidence interval: 0.70, 0.91; p(trend) = 0.001) for men in the highest versus lowest quintile of folate intake. Vitamin B(6), vitamin B(12), and methionine intakes were not significantly associated with any subtype of stroke. These findings in men suggest that a high dietary folate intake may reduce the risk of cerebral infarction.     

Relations between dietary sodium and potassium intakes and mortality from cardiovascular disease: the Japan Collaborative Cohort Study for Evaluation of Cancer Risks

BACKGROUND: Limited evidence is available about the relations between sodium and potassium intakes and cardiovascular disease in the general population. OBJECTIVE: The objective was to investigate relations between sodium and potassium intakes and cardiovascular disease in Asian populations whose mean sodium intake is generally high. DESIGN: Between 1988 and 1990, a total of 58,730 Japanese subjects (n = 23,119 men and 35,611 women) aged 40-79 y with no history of stroke, coronary heart disease, or cancer completed a lifestyle questionnaire including food intake frequency under the Japan Collaborative Cohort Study for Evaluation of Cancer Risk sponsored by the Ministry of Education, Sports and Science. RESULTS: After 745,161 person-years of follow-up, we documented 986 deaths from stroke (153 subarachnoid hemorrhages, 227 intraparenchymal hemorrhages, and 510 ischemic strokes) and 424 deaths from coronary heart disease. Sodium intake was positively associated with mortality from total stroke, ischemic stroke, and total cardiovascular disease. The multivariable hazard ratio for the highest versus the lowest quintiles of sodium intake after adjustment for age, sex, and cardiovascular disease risk factors was 1.55 (95% CI: 1.21, 2.00; P for trend < 0.001) for total stroke, 2.04 (95% CI: 1.41, 2.94; P for trend < 0.001) for ischemic stroke, and 1.42 (95% CI: 1.20, 1.69; P for trend < 0.001) for total cardiovascular disease. Potassium intake was inversely associated with mortality from coronary heart disease and total cardiovascular disease. The multivariable hazard ratio for the highest versus the lowest quintiles of potassium intake was 0.65 (95% CI: 0.39, 1.06; P for trend = 0.083) for coronary heart disease and 0.73 (95% CI: 0.59, 0.92; P for trend = 0.018) for total cardiovascular disease, and these associations were more evident for women than for men. CONCLUSIONS: A high sodium intake and a low potassium intake may increase the risk of mortality from cardiovascular disease.     

Intake of animal products and stroke mortality in the Hiroshima/Nagasaki Life Span Study

BACKGROUND: To determine whether intake of animal products was associated with a reduced risk of stroke mortality in a large-scale population-based cohort in Japan. METHODS: A self-administered questionnaire, including questions on dietary habits, was mailed to the members of the Life Span Study, a cohort of people exposed and non-exposed to atomic bomb radiation, who were alive as of 1 September 1979. Animal products included frequency intake of beef/pork, chicken, ham/sausage, milk, dairy products, eggs, fish, and broiled fish. Responses were obtained from 40 349 people (72%): 15 350 men (mean age 54 years) and 24 999 women (mean age 58 years). The subjects were followed for 16 years, and deaths were ascertained by linkage to the nationwide family registration system of Japan. The associations between diet and stroke mortality were examined using a Cox proportional hazard model. RESULTS: During the follow-up period, 1462 stroke deaths occurred. Four animal products comprising eggs, dairy products, fish, and broiled fish were independently associated with a decreased risk of stroke mortality; while beef/pork, chicken, ham/ sausage, and milk consumption were not associated with stroke death. A composite measure of eggs, dairy products, fish, and broiled fish intake was calculated, and the highest tertile was significantly inversely associated with total stroke mortality (Hazards Ratio [HR] = 0.80, 95% CI: 0.68, 0.93) compared with the lowest tertile. The protective effect of animal product intake on total stroke death was largely confined to intracerebral haemorrhage death; the RH of intracerebral haemorrhage death for the highest tertile of consumption was 0.72 (95% CI: 0.53-0.98) compared with the lowest tertile; animal products intake was not related to cerebral infarction mortality (HR = 0.84; 95% CI: 0.67-1.06). CONCLUSIONS: Intake of animal products such as eggs, dairy products, and fish may be protective against intracerebral haemorrhage, but is not related to cerebral infarction mortality.     

Nutrient intake and use of beverages and the risk of kidney stones among male smokers.

High intakes of calcium, potassium, and fluids have been shown to be associated with lowered risk of kidney stones. The authors studied the associations between diet and risk of kidney stones in a cohort of 27,001 Finnish male smokers aged 50-69 years who were initially free of kidney stones. All men participated in the Alpha-Tocopherol, Beta-Carotene Lung Cancer Prevention Study and completed a validated dietary questionnaire at baseline. After 5 years of follow-up (1985-1988), 329 men had been diagnosed with kidney stones. After data were controlled for possible confounders, the relative risk of kidney stones for men in the highest quartile of magnesium intake was 0.52 (95% confidence interval (CI) 0.32-0.85) as compared with men in the lowest quartile. Intake of fiber was directly associated with risk (relative risk (RR) = 2.06, 95% CI 1.39-3.03). Calcium intake was not associated with the risk of kidney stones. Beer consumption was inversely associated with risk of kidney stones; each bottle of beer consumed per day was estimated to reduce risk by 40% (RR = 0.60, 95% CI 0.47-0.76). In conclusion, the authors observed that magnesium intake and beer consumption were inversely associated and fiber intake was directly associated with risk of kidney stones.     

Alcohol and stroke: a community case-control study in Asturias, Spain.

The relationship between alcohol consumption and stroke is uncertain. Heavy alcohol consumption has been associated with an increased risk of stroke, while light drinking appears to be protective. However, the evidence is not uniform. We sought to examine the relationship between alcohol consumption and stroke, according to stroke type. We performed a population-based case-control study from September 1990 to December 1991. The study comprised 467 incident cases of stroke and 477 controls aged between 40 and 85. Case was defined following WHO criteria and control was randomly selected from the study base population. Alcohol exposure was obtained by medical interview. We found that consumption of less than 30 g/day of alcohol was protective against all stroke types combined, the multivariated adjusted odds ratio (OR) was 0.58 (95% confidence interval [CI], 0.41-0.83). Moderate alcohol drinking is also protective against all cerebral infarction combined (OR = 0.53; 95% CI, 0.35-0.80) and cortical infarction (OR = 0.40; 95% CI, 0.18-0.86). Drinking up to 30 g/day of alcohol has a borderline protective effect on deep cerebral infarction (OR = 0.40; 95% CI, 0.16-1.02) and has no effect on intracerebral hemorrhage (OR = 0.88; 95% CI, 0.44-1.74). Heavy alcohol drinking, over 140 g/day, is a risk factor for all stroke types combined (OR = 3.2; 95% CI, 1.1-9.7), all cerebral infarction combined (OR = 5.0; 95% CI, 1.5-16.3), small deep cerebral infarction (OR = 9.7; 95% CI, 2.6-36.7), intracerebral hemorrhage (OR = 6.2; 95% CI, 1.3-24.0), and is marginally associated with superficial cerebral infarction (OR = 4.6; 95% CI, 1.0-20.6). The relationship between alcohol and stroke depends on the alcohol dose and the pathology of the disease. Atherosclerosis of the large and medium cerebral arteries is found mainly in superficial cerebral infarction, and this type of stroke shows a J-shaped relationship with alcohol similar to that found in coronary heart disease, suggesting that they are similar diseases. On the other hand, arteriosclerosis of the penetrating arteries has been found in deep cerebral infarction and intracerebral hemorrhage, while atherosclerosis is not prominent. This may explain why alcohol does not have a protective effect on cerebral hemorrhage whereas heavy drinking is a strong risk factor in these two types of stroke.     

Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women.

Low B-vitamin intake may increase risk of breast cancer through decreased DNA repair capacity. Alcohol intake increases risk for breast cancer, with evidence from prospective studies of an interaction between alcohol and folate. We explored dietary intake of folate and other B vitamins with risk of breast cancer in a cohort study of 34,387 postmenopausal women. To measure diet, we mailed a food frequency questionnaire; we estimated nutrient intakes and categorized them into four levels: <10th, 11th-30th, 31st-50th, and >50th percentiles. Through 12 years of follow-up, we identified 1,586 cases of breast cancer in the cohort at risk. We estimated relative risks (RRs) and 95% confidence intervals (CIs) through Cox regression models adjusted for age, energy, and other risk factors. Women in the lowest 10th percentile of folate intake from diet alone were at modestly increased risk of breast cancer relative to those above the 50th percentile: RR = 1.21 (95% CI = 0.91--1.61). We examined the joint association of folate intake and alcohol use on risk of breast cancer, with the reference group defined as women with high folate (>50th percentile) and no alcohol use. The RRs of breast cancer associated with low dietary folate intake were 1.08 (95% CI = 0.78--1.49) among nondrinkers, 1.33 (95% CI = 0.86--2.05) among drinkers of < or = 4 gm per day, and 1.59 (95% CI = 1.05--2.41) among drinkers of > 4 gm per day. These results suggest that the risks of postmenopausal breast cancer may be increased among women with low intakes of folate if they consume alcohol-containing beverages.     

Higher Intakes of Potassium and Magnesium,but Not Lower Sodium,Reduce Cardiovascular Risk in the Framingham Offspring Study

We explored the dose-response relations of sodium, potassium, magnesium and calcium with cardiovascular disease (CVD) risk in the Framingham Offspring Study, as well as the combined effects of these minerals. Analyses included 2362 30–64 year-old men and women free of CVD at baseline. Cox proportional-hazards models were used estimate adjusted hazard ratios (HR) and 95% confidence intervals (CIs) for mineral intakes and incident CVD. Cox models with restricted cubic spline functions were used to examine dose-response relations, adjusting for confounding by age, sex, body mass index, dietary fiber intake, and time-varying occurrence of hypertension. Lower sodium intake (<2500 vs. ≥3500 mg/d) was not associated with a lower risk of CVD. In contrast, potassium intake ≥3000 (vs. <2500) mg/d was associated with a 25% lower risk (95% CI: 0.59, 0.95), while magnesium intake ≥320 (vs. <240) mg/d led to a 34% lower risk (95% CI: 0.51, 0.87) of CVD. Calcium intake ≥700 (vs. <500) mg/d was associated with a non-statistically significant 19% lower risk. Restricted cubic spline curves showed inverse dose-response relations of potassium and magnesium with CVD risk, but no such associations were observed for sodium or calcium. These results highlight the importance of potassium and magnesium to cardiovascular health.     

Calcium and vitamin D intake and risk of colorectal cancer: the Multiethnic Cohort Study

The associations of intakes of calcium and vitamin D with colorectal cancer risk were examined in the Multiethnic Cohort Study (Hawaii and Los Angeles, California). In 1993-1996, 85,903 men and 105,108 women aged > or =45 years completed a quantitative food frequency questionnaire. A total of 2,110 incident cases of colorectal cancer (1,138 in men and 972 in women) were identified through December 31, 2001. Cox proportional hazards models were used to calculate multivariate-adjusted relative risks and 95% confidence intervals. Total calcium intake (from foods and supplements) was inversely associated with colorectal cancer risk in both men (highest quintile vs. lowest: relative risk (RR) = 0.70, 95% confidence interval (CI): 0.52, 0.93; p for trend = 0.006) and women (RR = 0.64, 95% CI: 0.50, 0.83; p for trend = 0.003). The inverse association was also seen for total vitamin D intake in men (RR = 0.72, 95% CI: 0.51, 1.00; p for trend = 0.03) but not in women. Intake of dairy products was inversely associated with colorectal cancer risk, especially among nonusers of supplemental calcium (men: RR = 0.77, 95% CI: 0.59, 1.01; women: RR = 0.66, 95% CI: 0.49, 0.89). The findings support the hypothesis of protective roles for calcium, vitamin D, and dairy products in the risk of colorectal cancer.     

Folate, vitamin B6, multivitamin supplements, and colorectal cancer risk in women

The authors evaluated associations between intakes of folate and vitamin B(6) and colorectal cancer risk among women enrolled in a randomized trial on aspirin and vitamin E in disease prevention. At baseline (1992-1995), 37,916 US women aged >or=45 years who were free of cancer and cardiovascular disease provided dietary information. During an average of 10.1 years of follow-up (through February 20, 2004), 220 colorectal adenocarcinoma cases were documented. Total folate and vitamin B(6) intakes were not significantly associated with the risk of colorectal cancer. However, dietary intakes of folate and vitamin B(6) were significantly inversely associated with colorectal cancer risk among women who were not taking supplements containing folate and vitamin B(6). Multivariable relative risks among women in the highest quintiles of intake versus the lowest were 1.16 (95% confidence interval (CI): 0.76, 1.79) for total folate, 1.14 (95% CI: 0.77, 1.69) for total vitamin B(6), 0.46 (95% CI: 0.26, 0.81) for dietary folate, and 0.69 (95% CI: 0.41, 1.15) for dietary vitamin B(6). The use of multivitamin supplements was not related to colorectal cancer risk. These findings suggest that higher dietary intakes of folate and vitamin B(6) may reduce the risk of colorectal cancer in women. An alternative explanation is that other factors related to dietary intakes of folate and vitamin B(6) account for the inverse associations.     

Dietary fat intake and risk of coronary heart disease in women: 20 years of follow-up of the nurses' health study

The authors examined the associations of dietary fat and specific types of fat with risk of coronary heart disease (CHD) among 78,778 US women initially free of cardiovascular disease and diabetes in 1980. They documented 1,766 incident CHD cases (including 1,241 nonfatal myocardial infarctions and 525 CHD deaths) during 20 years of follow-up. Polyunsaturated fat intake was inversely associated with CHD risk (multivariate relative risk (RR) for the highest vs. the lowest quintile = 0.75, 95% confidence interval (CI): 0.60, 0.92; p(trend) = 0.004), whereas trans-fat intake was associated with an elevated risk of CHD (RR = 1.33, 95% CI: 1.07, 1.66; p(trend) = 0.01). The associations between intakes of polyunsaturated fat and trans-fat with CHD risk were most evident among women younger than age 65 years (for polyunsaturated fat, RR = 0.66, 95% CI: 0.50, 0.85; p(trend) = 0.002 and for trans-fat, RR = 1.50, 95% CI: 1.13, 2.00; p(trend) = 0.01). The inverse association between polyunsaturated fat intake and CHD risk was strongest among women whose body mass index was >or=25 kg/m(2). Findings continue to support an inverse relation between polyunsaturated fat intake and CHD risk, particularly among younger or overweight women. In addition, trans-fat intake was associated with increased risk of CHD, particularly for younger women.     

Dietary Sodium and Potassium Intake and Risk of Non-Fatal Cardiovascular Diseases: The Million Veteran Program

Objective: To examine the association between intakes of sodium and potassium and the ratio of sodium to potassium and incident myocardial infarction and stroke. Design, Setting and Participants: Prospective cohort study of 180,156 Veterans aged 19 to 107 years with plausible dietary intake measured by food frequency questionnaire (FFQ) who were free of cardiovascular disease (CVD) and cancer at baseline in the VA Million Veteran Program (MVP). Main outcome measures: CVD defined as non-fatal myocardial infarction (MI) or acute ischemic stroke (AIS) ascertained using high-throughput phenotyping algorithms applied to electronic health records. Results: During up to 8 years of follow-up, we documented 4090 CVD cases (2499 MI and 1712 AIS). After adjustment for confounding factors, a higher sodium intake was associated with a higher risk of CVD, whereas potassium intake was inversely associated with the risk of CVD [hazard ratio (HR) comparing extreme quintiles, 95% confidence interval (CI): 1.09 (95% CI: 0.99–1.21, p trend = 0.01) for sodium and 0.87 (95% CI: 0.79–0.96, p trend = 0.005) for potassium]. In addition, the ratio of sodium to potassium (Na/K ratio) was positively associated with the risk of CVD (HR comparing extreme quintiles = 1.26, 95% CI: 1.14–1.39, p trend < 0.0001). The associations of Na/K ratio were consistent for two subtypes of CVD; one standard deviation increment in the ratio was associated with HRs (95% CI) of 1.12 (1.06–1.19) for MI and 1.11 (1.03–1.19) for AIS. In secondary analyses, the observed associations were consistent across race and status for diabetes, hypertension, and high cholesterol at baseline. Associations appeared to be more pronounced among participants with poor dietary quality. Conclusions: A high sodium intake and a low potassium intake were associated with a higher risk of CVD in this large population of US veterans.     

Carbohydrate intake, glycemic index, glycemic load, and dietary fiber in relation to risk of stroke in women

The associations of dietary carbohydrate, glycemic index, and glycemic load with stroke risk were examined among 78,779 US women who were free of cardiovascular disease and diabetes in 1980 and completed a food frequency questionnaire. During an 18-year follow-up, 1,020 stroke cases were documented (including 515 ischemic and 279 hemorrhagic). In analyses adjusting for nondietary risk factors and cereal fiber, carbohydrate intake was associated with elevated risk of hemorrhagic stroke when the extreme quintiles were compared (relative risk = 2.05, 95% confidence interval: 1.10, 3.83; p(trend) = 0.02), but not with ischemic stroke. The positive association between carbohydrate intake and stroke risk was most evident among women with a body mass index of > or =25 kg/m(2). Likewise, dietary glycemic load was positively associated with total stroke among only those women whose body mass index was > or =25 kg/m(2). Cereal fiber intake was inversely associated with total and hemorrhagic stroke risk; for total stroke, relative risk = 0.66 (95% confidence interval: 0.52, 0.83; p(trend) = 0.001) and for hemorrhagic stroke, relative risk = 0.51 (95% confidence interval: 0.33, 0.78; p(trend) = 0.01). Findings suggest that high intake of refined carbohydrate is associated with hemorrhagic stroke risk, particularly among overweight or obese women. In addition, high consumption of cereal fiber was associated with lower risk of total and hemorrhagic stroke.     

Fat and protein intakes and risk of intraparenchymal hemorrhage among middle-aged Japanese

The authors examined the relation between low intakes of saturated fat and animal protein and risk of intraparenchymal hemorrhage in a 14-year prospective study (ending in 1997) of 4,775 Japanese aged 40-69 years who undertook a single 24-hour dietary recall. Compared with the highest quartile of energy-adjusted saturated fat intake (median, 17 g/day), multivariate relative risks, after adjustment for age, sex, community, total energy intake, and known cardiovascular risk factors, were 0.77 (95% confidence interval (CI): 0.42, 1.42) for the second quartile (12 g/day), 0.66 (95% CI: 0.34, 1.25) for the third quartile (8 g/day), and 0.30 (95% CI: 0.12, 0.71) for the lowest quartile (5 g/day); p for trend = 0.005. An inverse relation was observed among both hypertensives and nonhypertensives; the respective relative risks with a one standard deviation increase in saturated fat intake (15.4 g/day) were 0.72 (95% CI: 0.52, 1.00) and 0.36 (95% CI: 0.14, 0.95). Intake of animal protein tended to correlate inversely with risk; the relative risk with a one standard deviation increase in animal protein intake (17.6 g/day) was 0.79 (95% CI: 0.61, 1.02); p = 0.07. Results are similar to those recently reported for US women and together help to explain the high rate of this stroke subtype in Asian countries, where intakes of these nutrients are low.     

Association between dietary fiber, water and magnesium intake and functional constipation among young Japanese women

OBJECTIVE: Most research on constipation has focused on dietary fiber intake. Here, we examined the intake of water and magnesium, nutrients possibly associated with constipation, as well as that of dietary fiber in relation to constipation. DESIGN: Cross-sectional study. SUBJECTS: A total of 3835 female Japanese dietetic students aged 18-20 years from 53 institutions in Japan. METHODS: Dietary intake was estimated with a validated, self-administered diet history questionnaire. Functional constipation was defined using the Rome I criteria. RESULTS: The prevalence of functional constipation was 26.2%. Neither dietary fiber intake (mean=6.4 g/4186 kJ) nor intakes of total water and water from fluids were associated with constipation. Conversely, low intake of water from foods was associated with an increasing prevalence of constipation. In comparison with women in the first (lowest) quintile, the multivariate adjusted odds ratio (OR) (95% confidence interval (CI)) for women in the second, third, fourth, and fifth quintiles were 0.72 (0.57, 0.90), 0.78 (0.62, 0.98), 0.71 (0.56, 0.89), and 0.77 (0.61, 0.97), respectively (P for trend=0.04). Additionally, low magnesium intake was associated with increasing prevalence of constipation. Compared with women in the first quintile, the multivariate adjusted OR (95% CI) for women in the second, third, fourth and fifth quintiles were 0.70 (0.56, 0.88), 0.75 (0.60, 0.95), 0.73 (0.58, 0.92) and 0.79 (0.63, 0.996), respectively (P for trend=0.09). CONCLUSIONS: Low intakes of water from foods and magnesium are independently associated with an increasing prevalence of functional constipation among a population whose dietary fiber intake is relatively low.     

Dietary intakes of fat and risk of Parkinson's disease

Previous epidemiologic studies have generated inconsistent results regarding the associations between fat intakes and risk of Parkinson's disease. The authors investigated these associations in two large, prospective US cohorts. They documented 191 incident cases of Parkinson's disease in men (1986-1998) and 168 in women (1980-1998) during the follow-up. Overall, intakes of total fat or major types of fat were not significantly associated with the risk. The relative risks comparing the highest quintile of animal fat intake with the lowest were 1.42 for men (95% confidence interval (CI): 0.91, 2.20; p for trend = 0.1) and 0.65 for women (95% CI: 0.36, 1.16; p for trend = 0.3). For men, but not women, replacement of polyunsaturated fat with saturated fat was associated with a significantly increased risk (5% of energy intake, relative risk (RR) = 1.83, 95% CI: 1.10, 3.03). Of the individual polyunsaturated fatty acids, arachidonic acid tended to be inversely associated with the risk (pooled RR between extreme quintiles = 0.65, 95% CI: 0.46, 0.91; p for trend = 0.05). Results do not support an important role of overall fat intake in the pathogenesis of Parkinson's disease, but a possible adverse effect of saturated fat for men could not be excluded.     

Association of dietary calcium,magnesium, sodium,and potassium intake and hypertension: a study on an 8-year dietary intake data from the National Health and Nutrition Examination Survey

BACKGROUND/OBJECTIVESThere has been an increased interest in determining calcium magnesium, sodium, and potassium''s distinct effects on hypertension over the past decade, yet they simultaneously regulate blood pressure. We aimed at examining the association of dietary calcium, magnesium, sodium, and potassium independently and jointly with hypertension using National Health and Nutrition Examination Survey data from 2007 to 2014.MATERIALS/METHODSThe associations were examined on a large cross-sectional study involving 16684 US adults aged>20 years, using multivariate analyses with logistical models.RESULTSSodium and calcium quartiles assessed alone were not associated with hypertension. Potassium was negatively associated with hypertension in the highest quartile, 0.64 (95% confidence interval [CI], 0.48–0.87). When jointly assessed using the high and low cut-off points, low sodium and corresponding high calcium, magnesium, and potassium intake somewhat reduced the odds of hypertension 0.39 (95% CI, 0.20–0.76). The sodium-to-potassium ratio was positively associated with hypertension in the highest quartile1.50 (95% CI, 1.11–2.02). When potassium was adjusted for sodium intake and sodium-to-potassium ratio assessed among women, increased odds of hypertension were reported in the highest quartile as 2.02 (95% CI, 1.18–3.34) and 1.69 (95% CI, 1.12–2.57), respectively. The association of combined minerals on hypertension using dietary goals established that men meeting the reference intakes for calcium and exceeding for magnesium had reduced odds of hypertension 0.51 (95% CI, 0.30–0.89). Women exceeding the recommendations for both calcium and magnesium had the lower reduced odds of 0.30 (95% CI, 0.10–0.69).CONCLUSIONSOur results suggest that the studied minerals'' association on hypertension is stronger when jointly assessed, mostly after gender stratification. As compared to men, women increased their risk of hypertension even with a low sodium intake. Women would also reasonably reduce their risk of developing hypertension by increasing calcium and magnesium intake. In comparison, men would somewhat be protected from developing hypertension with calcium intake meeting the dietary goals and magnesium exceeding the nutritional goals.     

Serum ascorbic acid and cardiovascular disease prevalence in U.S. adults: the Third National Health and Nutrition Examination Survey (NHANES III).

PURPOSE: To examine the relation between serum ascorbic acid concentration, which reflects dietary and supplement intake, and the prevalence of cardiovascular disease. METHODS: We analyzed data from 7658 men and women enrolled in the Third National Health and Nutrition Examination Survey (NHANES III). We calculated odds ratios and 95% confidence intervals (CI) to estimate the relative prevalence of cardiovascular disease, defined as self-reported angina, myocardial infarction, or stroke. Because we detected an interaction between serum ascorbic acid concentration and alcohol intake, we performed analyses stratified by drinking status. RESULTS: Among participants who reported no alcohol consumption, serum ascorbic acid concentrations were not independently associated with cardiovascular disease prevalence. Among participants who consumed alcohol, serum ascorbic acid concentrations consistent with tissue saturation (1.0-3.0 mg/dl) were associated with a decreased prevalence of angina (multivariate odds ratio (OR): 0.48; 95% CI: 0.23% to 1.03; p for trend = 0.06), but were not significantly associated with myocardial infarction or stroke prevalence. CONCLUSIONS: These results suggest the possibility of a biologic interaction between ascorbic acid and alcohol and that higher intakes of ascorbic acid may be associated with a decreased risk of angina among drinkers.     

Association of vegetable, fruit, and grain intakes with colorectal cancer: the Multiethnic Cohort Study

BACKGROUND: It is uncertain whether or not vegetables, fruit, or grains protect against colorectal cancer. OBJECTIVE: In a large prospective study, we investigated the association of vegetable, fruit, and grain intakes with colorectal cancer risk. DESIGN: Between 1993 and 1996, 85 903 men and 105 108 women completed a quantitative food-frequency questionnaire that included approximately 180 foods and beverages in the Multiethnic Cohort Study. A diagnosis of colorectal cancer was made in 1138 men and 972 women after an average follow-up of 7.3 y. Cox proportional hazards models were used to calculate multivariate-adjusted relative risks and 95% CIs for colorectal cancer. RESULTS: In men, multivariate adjustment for energy intake, dietary, and nondietary variables resulted in relative risks in the highest quintile group of 0.74 (95% CI: 0.59, 0.93; P for trend = 0.02) for vegetables and fruit combined, 0.80 (95% CI: 0.64, 0.99; P for trend = 0.09) for fruit alone, and 0.85 (95% CI: 0.69, 1.05; P for trend = 0.05) for vegetables alone. When colon and rectal cases were separated among men, the inverse associations were stronger for colon than for rectal cancer. In women, none of the associations with vegetables, fruit, or vegetables and fruit combined were significant. Grain intake was not associated with colorectal cancer for either men or women. CONCLUSION: The intake of vegetables and fruit was inversely related to colorectal cancer risk among men but not among women. The association appears stronger for colon than for rectal cancer.     

Joint association of magnesium and iron intake with anemia among Chinese adults

OBJECTIVE: Inflammation and iron deficiency are two important causes of anemia. Magnesium intake is inversely associated with inflammation. However, little is known as to whether magnesium intake is related to anemia. We assessed the joint association of magnesium and iron intake with anemia among Chinese adults. METHODS: A cross-sectional household survey of 2849 men and women 20 y of age or older was conducted in 2002. Nutrient intakes were assessed by 3-d weighed food records. Serum ferritin and hemoglobin concentrations were measured. RESULTS: The prevalence of anemia was 18.3% in men and 31.5% in women. Magnesium and iron intakes were positively associated with hemoglobin levels and inversely related to the prevalence of anemia. The risks of anemia were reduced by 26% (P for trend = 0.03) and 52% (P < 0.01), respectively, for iron and magnesium intake comparing the fourth quartile with the first with adjustment for potential confounders. The lowest risk of anemia was observed among participants with the highest intakes of magnesium and iron (odds ratio 0.46, 95% confidence interval 0.31-0.68). The inverse association of iron intake and anemia but not the association of magnesium intake and anemia was modified by serum ferritin levels. The observed relations were not appreciably modified by gender. CONCLUSION: This study suggests that magnesium is a potent predictor of anemia in Chinese adults.     

Water, other fluids, and fatal coronary heart disease: the Adventist Health Study

Whole blood viscosity, plasma viscosity, hematocrit, and fibrinogen are considered independent risk factors for coronary heart disease and can be elevated by dehydration. The associations between fatal coronary heart disease and intake of water and fluids other than water were examined among the 8,280 male and 12,017 female participants aged 38-100 years who were without heart disease, stroke, or diabetes at baseline in 1976 in the Adventist Health Study, a prospective cohort study. A total of 246 fatal coronary heart disease events occurred during the 6-year follow-up. High daily intakes of water (five or more glasses) compared with low (two or fewer glasses) were associated with a relative risk in men of 0.46 (95% confidence interval (CI): 0.28, 0.75; p trend = 0.001) and, in women, of 0.59 (95% CI: 0.36, 0.97). A high versus low intake of fluids other than water was associated with a relative risk of 2.47 (95% CI: 1.04, 5.88) in women and of 1.46 (95% CI: 0.7, 3.03) in men. All associations remained virtually unchanged in multivariate analysis adjusting for age, smoking, hypertension, body mass index, education, and (in women only) hormone replacement therapy. Fluid intake as a putative coronary heart disease risk factor may deserve further consideration in other populations or using other study designs.