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.

     

Height and body fatness and colorectal cancer risk: an update of the WCRF–AICR systematic review of published prospective studies

Purpose

There is no published dose–response meta-analysis on the association between height and colorectal cancer risk (CRC) by sex and anatomical sub-site. We conducted a meta-analysis of prospective studies on the association between height and CRC risk with subgroup analysis and updated evidence on the association between body fatness and CRC risk.

Methods

PubMed and several other databases were searched up to November 2016. A random effects model was used to calculate dose–response summary relative risks (RR’s).

Results

47 studies were included in the meta-analyses including 50,936 cases among 7,393,510 participants. The findings support the existing evidence regarding a positive association of height, general and abdominal body fatness and CRC risk. The summary RR were 1.04 [95% (CI)1.02–1.05, I² = 91%] per 5 cm increase in height, 1.02 [95% (CI)1.01–1.02, I² = 0%] per 5 kg increase in weight, 1.06 [95% (CI)1.04–1.07, I² = 83%] per 5 kg/m² increase in BMI, 1.02 [95% (CI)1.02–1.03, I² = 4%] per 10 cm increase in waist circumference, 1.03 [95% (CI)1.01–1.05, I² = 16%] per 0.1 unit increase in waist to hip ratio. The significant association for height and CRC risk was similar in men and women. The significant association for BMI and CRC risk was stronger in men than in women.

Conclusion

The positive association between height and risk of CRC suggests that life factors during childhood and early adulthood might play a role in CRC aetiology. Higher general and abdominal body fatness during adulthood are risk factors of CRC and these associations are stronger in men than in women.

     

Children’s Media Use and Self-Regulation Behavior: Longitudinal Associations in a Nationwide Japanese Study

Objective The effect of media use on child behavior has long been a concern. Although studies have shown robust cross-sectional relations between TV viewing and child behavior, longitudinal studies remain scarce. Methods We analyzed the Longitudinal Survey of Babies, conducted by Japan’s Ministry of Health, Labour and Welfare since 2001. Among 53,575 families, 47,010 responded to the baseline survey; they were followed up every year for 8 years. Complete data were available for longitudinal analysis among 32,439 participants. Daily media use (TV viewing and video game-playing hours at ages 3, 4, and 5 years) was used as the main exposure. We employed an index of the children’s self-regulatory behavior as the outcome variable. Odds ratios and 95 % confidence intervals (CIs) were estimated. Results Among boys, longer TV-viewing times at ages 4 and 5 were related to problematic self-regulatory behavior. Compared with boys who watched just 1–2 h of TV a day, those who watched it 4–5 h had a 1.79-fold greater risk (CI 1.22–2.64) of problematic self-regulatory behavior, according to parental report. Among girls, similar results were evident at ages 4 and 5 (e.g., adjusted odds ratios for 4–5 h daily viewing versus 1–2 h at age 4: 2.59; 95 % CI 1.59–4.22). Video games may have a protective effect on the risk of problematic self-regulatory behavior at ages 3 and 5. Conclusion Longer daily exposure to TV during early childhood (age 4–5) may be associated with subsequent problematic child self-regulatory behavior.     

Associations between food and beverage consumption and different types of sedentary behaviours in European preschoolers: the ToyBox-study

Objective

To examine the association between food and beverage consumption and time spent in different sedentary behaviours such as watching TV and DVDs, playing computer/video games and quiet play/activities in preschoolers.

Methods

A sample of 6431 (51.8 % males) European preschoolers aged 3.5–5.5 years from six survey centres was included in the data analyses. Data on dietary habits and sedentary behaviours [watching TV, playing computer and quiet play (both during weekdays and weekend days)] were collected via standardized proxy-administered questionnaires. One-way analysis of covariance and general linear model (adjusted for sex, maternal education, body mass index and centre) were conducted.

Results

The results of the generalized linear model showed that the more strong associations in both males and females who were watching TV for > 1 h/day during weekdays were positively associated with increased consumption of fizzy drinks (β = 0.136 for males and β = 0.156 for females), fresh and packed juices (β = 0.069, β = 0.089), sweetened milk (β = 0.119, β = 0.078), cakes and biscuits (β = 0.116, β = 0.145), chocolate (β = 0.052, β = 0.090), sugar-based desserts and pastries (β = 0.234, β = 0.250), salty snacks (β = 0.067, β = 0.056), meat/poultry/processed meat (β = 0.067, β = 0.090) and potatoes (β = 0.071, β = 0.067), and negative associations were observed for the consumption of fruits (β = ?0.057, β = ?0.099), vegetables (β = ?0.056, β = ?0.082) and fish (β = ?0.013, β = ?0.013). During weekend days, results were comparable.

Conclusions

In European preschoolers, sedentary behaviours were associated with consumption of energy-dense foods and fizzy drinks. The present findings will contribute to improve the strategies to prevent overweight, obesity and nutrition-related chronic diseases from early childhood.

     

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.     

Time trends of cause-specific mortality among resettlers in Germany, 1990 through 2009

Resettlers (in German: (Spät-)Aussiedler) form one of the biggest migrant groups in Germany. It is known that migrants have different mortality patterns compared to the autochthon population. In this paper, we combined data from three resettler cohorts and examined differences in mortality from non-communicable diseases among resettlers in Germany and the German population. Furthermore, we investigated time trends of cause-specific mortality for 20 years of follow-up and compared it with the German mortality rates. To assess differences in cause-specific mortality between resettlers and the general German population, we calculated standardized mortality ratios (SMRs). To ascertain mortality trends, cause-specific age-standardized mortality rates were calculated and modeled with Poisson regression and fractional polynomials. During the observation period, the study population accumulated almost 800,000 person-years and 5572 deaths were observed. All-cause mortality among resettlers was lower (SMR = 0.91, 95% CI = 0.89–0.94) compared to the general German population, as well as cardiovascular diseases (CVD) mortality (SMR = 0.82, 95% CI = 0.79–0.86). Results for cancer mortality varied considerably by cancer site. Analyses of time trends showed that all-cause and CVD mortality were decreasing over time in resettlers, as well as in the general German population. Lower all-cause mortality among resettlers is mainly explained by lower CVD mortality. Cancer-site specific mortality showed different results. Converging mortality rates may indicate an adaption of lifestyle behavior. However, there are no data on individual risk factors in this study.     

Mortality risk and perceived quality of life as a function of waking time in discretionary movement-based behaviors: isotemporal substitution effects

Objective

Previous research has examined associations of sedentary behavior (SB), light-intensity physical activity (LIPA) and moderate-to-vigorous physical activity (MVPA) with health-related quality of life (HRQOL) and mortality. However, most of these studies have been limited to examining their potential “independent” effects, as opposed to whether mortality risk and HRQOL vary as a function of waking time in these discretionary movement-related behaviors, which was this study’s purpose.

Methods

Data from the 2003–2006 NHANES were employed, with follow-up mortality assessed through 2011 (5377 adults 20–85 years). HRQOL was assessed via survey, with physical activity assessed using an accelerometer over a 7-day monitoring period. Isotemporal substitution analyses were employed.

Results

Participants engaged in little MVPA during their monitored waking time and higher mortality risk appeared to cluster more so among those spending a greater proportion of their day in SB with less LIPA engagement. Substituting 30 min/day of SB with MVPA would be expected to reduce mortality risk by 81 % (HR_adjusted = 0.19; 95 % CI: 0.06–0.60; P = 0.006) and reduce worse HRQOL by 72 % (OR = 0.28; 95 % CI: 0.13–0.58; P = 0.001).

Conclusions

Allocation of waking time in movement-based behaviors is associated with all-cause mortality and HRQOL. Thus, clinicians should encourage their patients to substitute SB with reasonable amounts of LIPA and MVPA.

     

Factors Contributing to Background Television Exposure in Low-Income Mexican–American Preschoolers

Objective Background television (TV) exposure is harmful to young children, yet few studies have focused on predictors of exposure. This study’s objectives were to elucidate demographic, environmental, and behavioral correlates of background TV exposure in low-income Mexican–American preschoolers and to explore caregiver beliefs about the impact of such exposure. Methods A convenience sample of low-income Mexican–American female primary caregivers of preschoolers (3–5 years old, n = 309), recruited in safety-net clinics, were surveyed by phone. Caregivers reported the frequency of their child’s exposure to background TV and responded to questions on the home media environment, TV use, and whether they had thought about background TV exposure and its impact on their child. Results Background TV exposure was common; 43 % reported that their child was often, very often, or always exposed to background TV. More hours of TV viewing by the caregiver and greater frequency of TV viewing during meals were associated with an increased frequency of exposure to background TV. Only 49 % of participants had ever thought about the impact of background TV. Believing that background TV is not harmful was associated with higher levels of background TV exposure. Conclusions Findings suggest that background TV exposure is frequent and caregiver awareness of its potential impact is low in low-income Mexican–American families. Beliefs that background TV is not harmful may predict risk of exposure. Potential targets for interventions focused on reducing background TV exposure in this population include increasing caregiver awareness of the potential negative impact of such TV exposure.     

The joint association of self-rated health and diabetes status on 14-year mortality in elderly men and women

Purpose

Low self-rated health (SRH) has been found to be associated with increased risk of type 2 diabetes (T2D) and with mortality. We examined the possible interaction between SRH and diabetic state on all-cause mortality in a large cohort of elderly subjects, followed for 14 years.

Methods

During the years 2000–2004, survivors of the nationwide longitudinal Israel Study of Glucose Intolerance, Obesity and Hypertension were interviewed and examined for the third follow-up. The 1037 participants (mean age 72.4 ± 7.2 years) were asked to rate their health as: excellent, good, fair, poor, or very poor. Glucose categories were as follows: Normoglycemic, Prediabetes, T2D and Undiagnosed diabetes. Survival time was defined as the time from interview to date of death or date of last vital status follow-up (August 1, 2013). Multivariate Cox proportional hazards models were performed in order to assess whether SRH interacts with glycemic state in the association with mortality.

Results

A better SRH was reported by those with undiagnosed than known diabetes, and best for normoglycemic and prediabetic individuals. While all individuals with fair or poor/very poor SRH were at increased risk of mortality compared to those with excellent/good SRH, in the known diabetic individuals a greater hazard was observed in the excellent/good SRH (HR 3.32, 95 % CI 1.71–6.47) than in those with fair or poor/very poor SRH (HR 2.19, 95 % CI 1.25–3.86), after adjusting for age, sex, ethnic origin, marital status, education, BMI, physical activity, CVD, tumors, and creatinine level (p for interaction = 0.01).

Conclusions

Self-rated health is not a sensitive tool for predicting mortality in elderly men and women with known T2D.

     

Dairy intake in relation to cardiovascular disease mortality and all-cause mortality: the Hoorn Study

Purpose

Existing data from prospective cohort studies on dairy consumption and cardiovascular diseases are inconsistent. Even though the association between total dairy and cardiovascular diseases has been studied before, little is known about the effect of different types of dairy products on cardiovascular diseases (CVD). The objective of this study was to examine the relationship between (type of) dairy intake and CVD mortality and all-cause mortality in a Dutch population.

Methods

We examined the relationship between dairy intake and CVD mortality and all-cause mortality in 1956 participants of the Hoorn Study (aged 50–75 years), free of CVD at baseline. Hazard ratios with 95 % CIs were obtained for CVD mortality and all-cause mortality per standard deviation (SD) of the mean increase in dairy intake, with adjustment for age, sex, BMI, smoking, education, total energy intake, alcohol consumption, physical activity, and dietary intakes.

Results

During 12.4 years of follow-up, 403 participants died, of whom 116 had a fatal CVD event. Overall dairy intake was not associated with CVD mortality or all-cause mortality. Each SD increase in high-fat dairy intake was associated with a 32 % higher risk of CVD mortality (95 % CI; 7–61 %).

Conclusion

In this prospective cohort study, the intake of high-fat dairy products was associated with an increased risk of CVD mortality.     

Changes in television viewing and computers/videogames use among high school students in Southern Brazil between 2001 and 2011

Objectives

To compare the prevalence of television (TV) watching and of computer/videogame use among high school students (15–19 years) from Southern Brazil between 2001 and 2011 and to identify associated socio-demographic factors.

Methods

Panel studies were conducted with high school students in the state of Santa Catarina, Brazil, in 2001 (n = 5,028) and 2011 (n = 6,529). TV watching and computer/videogame use were collected using questionnaires.

Results

Prevalence of ≥2 h/day of TV watching dropped from 76.8 to 61.5 % and ≥2 h/day of computer/videogame use increased from 37.9 to 60.6 %. In both surveys, those aged 15–16 and those who did not work had higher likelihoods of being exposed to ≥2 h/day of TV watching. Boys, those with higher family income, and those who were living in urban areas had higher likelihoods of ≥2 h/day of computer/videogame use. Older age, studying at night and not working were protective factors to these behaviors.

Conclusions

After a decade, there was a decrease in the prevalence of TV viewing and an increase in computer/videogame use. Socio-demographic factors were differently associated with these behaviors.     

Comparison of the effects of three different <Emphasis Type="Italic">Baccaurea angulata</Emphasis> whole fruit juice doses on plasma,aorta and liver MDA levels,antioxidant enzymes and total antioxidant capacity

Purpose

Baccaurea angulata (common names: belimbing dayak or belimbing hutan) is a Malaysian underutilized fruit. The preliminary work on B. angulata fruit juice showed that it possesses antioxidant properties. Therefore, further work is needed to confirm the efficacy and proper dosage of B. angulata as a potential natural antioxidant. The present study was thus carried out to compare the effects of three different B. angulata whole fruit (WF) juice doses administered at nutritional doses of 0.50, 1.00 and 1.50 ml/kg/day on plasma, aorta and liver malondialdehyde (MDA) levels, antioxidant enzymes (superoxide dismutase, glutathione peroxidase and catalase) as well as total antioxidant capacity in rabbits fed high-cholesterol diet.

Methods

Thirty-five male rabbits of New Zealand strain were randomly assigned to seven groups. For 12 weeks, group CH was fed 1% cholesterol diet only; group C1 was fed 1% cholesterol diet and 0.50 ml/kg/day B. angulata WF juice; group C2 was fed 1% cholesterol diet and 1.00 ml/kg/day B. angulata WF juice; group C3 was fed 1% cholesterol diet and 1.50 ml/kg/day B. angulata WF juice; group N was fed standard pellet only; group N1 was fed standard pellet and 0.50 ml/kg/day B. angulata WF juice; and group N2 was fed standard pellet and 1.00 ml/kg/day B. angulata WF juice.

Results

The three doses reduced the formation of MDA and enhanced the expression of endogenous antioxidant enzymes. The highest dose used (1.50 ml/kg/day) was, however, seen as the most potent.

Conclusion

Higher doses of B. angulata juice exerted better antioxidant activity.

     

Dietary intake and biomarker status of folate in Swedish adults

Purpose

National data on folate status are missing in Sweden, and regional data indicate folate insufficiency in up to more than 25% of the study populations. The objectives were to determine folate intake and status in the adult Swedish population as well as identifying dietary patterns associated with beneficial folate status.

Methods

Folate intake was estimated using a web-based 4-d food record in adults aged 18–80 years (n = 1797). Folate status was measured as erythrocyte (n = 282) and plasma folate concentrations (n = 294). Factor analysis was used to derive a dietary pattern associated with a higher folate status.

Results

Median folate intake was 246 µg/day (Q ₁ = 196, Q ₃ = 304, n = 1797) and for women of reproductive age 227 µg/day (Q ₁ = 181, Q ₃ = 282, n = 450). As dietary folate equivalents (DFE), median intake was 257 µg/day (Q ₁ = 201, Q ₃ = 323) and for women of reproductive age 239 µg/day (Q ₁ = 185, Q ₃ = 300). Low blood folate concentrations were found in 2% (erythrocyte concentrations <317 nmol/L) and 4% (plasma concentrations <6.8 nmol/L) of the participants, respectively. None of the women of reproductive age had erythrocyte folate concentrations associated with the lowest risk of neural tube defects. Dietary patterns associated with higher folate status were rich in vegetables, pulses and roots as well as cheese and alcoholic beverages, and low in meat.

Conclusions

Prevalence of low erythrocyte folate concentrations was low in this population, and estimated dietary intakes are well above average requirement. However, to obtain a folate status optimal for prevention of neural tube defects major dietary changes are required and folic acid supplements recommended prior to conception.

     

Association of circulating 25-hydroxyvitamin D with mental well-being in a population-based,nationally representative sample of German adolescents

Objective

Numerous studies have linked vitamin D to health-related quality of life (hrQoL) in chronically ill adults or elderly subjects. The aim of this study was to evaluate the association between 25-hydroxyvitamin D (25(OH)D) and hrQoL in a population-based sample of German adolescents.

Methods

A total of n = 5066 study participants from the nationwide, representative German Health Interview and Examination Survey for Children and Adolescents (Kinder- und Jugendgesundheitssurvey) aged 11–17 years were included in this post hoc analysis. HrQoL was measured using the well-validated self- and parent-rated Children’s Quality of Life questionnaires (KINDL-R), while the level of distress was assessed using the self- and proxy version of the Strengths and Difficulties Questionnaire (SDQ). Serum 25(OH)D concentrations were determined using a commercially available chemiluminescence immunoassay.

Results

Bivariate analyses demonstrated a significant positive association between 25(OH)D and hrQoL for both self- [estimate (E) = 0.82, 95 % confidence interval (95 % CI) 0.35–1.30, p = 0.001] and parent ratings (E = 1.33, 95 % CI 0.83–1.83, p < 0.001). In addition, we found negative correlations between 25(OH)D and self- (E = ?0.34, 95 % CI ?0.58 to ?0.11, p = 0.005) and parent-reported total SDQ scores (E = ?0.70, 95 % CI ?1.03 to ?0.37, p < 0.001). Generalized linear models adjusted for age, sex, body mass index, systolic blood pressure, migration background, socio-economic status, and sedentary screen time confirmed that 25(OH)D independently and significantly predicted better hrQoL (p ≤ 0.004).

Conclusions

These findings linking 25(OH)D to better well-being in a nationally representative sample of German children and adolescents suggest beneficial effects of vitamin D on mental health. However, recommendations for vitamin supplementation in healthy children and adolescents are not warranted from our data.

     

Association between dietary zinc intake and mortality among Chinese adults: findings from 10-year follow-up in the Jiangsu Nutrition Study

Purpose

Population studies of the association between zinc intake and mortality yield inconsistent findings. Using data from Jiangsu Nutrition Study, we aimed to assess the association between zinc intake and mortality among Chinese adults.

Methods

We prospectively studied 2832 adults aged 20 years and older with a mean follow-up of 9.8 years. At baseline, food intake was measured by 3-day weighed food record (WFR) between September and December in 2002. Death occurrence was assessed in 2012 during a household visit as well as by data linkage with the regional death registry. Hazard ratios (HRs) and 95% CI were calculated using competing risks regression (CVD and cancer mortality) and Cox proportional hazards analysis (all-cause mortality).

Results

During 27,742 person-years of follow-up, there were 184 deaths [63 cancer deaths and 70 cardiovascular disease (CVD) deaths]. Dietary zinc to energy ratio was positively associated with cancer and all-cause mortality. Across quartiles of the zinc to energy ratio from low to high, the HR (95% CI) for all-cause mortality was 1.00, 1.80 (95% CI 1.10–2.95), 1.55 (95% CI 0.96–2.50), and 1.85 (95% CI 1.11–3.07), respectively. Comparing the extreme quartiles of the zinc to energy ratio, the HR for cancer mortality was 2.28 (95% CI 1.03–5.04).

Conclusion

Zinc intake was positively related to all-cause mortality and cancer mortality.

     

Evaluating and establishing national norms for mental wellbeing using the short Warwick–Edinburgh Mental Well-being Scale (SWEMWBS): findings from the Health Survey for England

Purpose

The Warwick–Edinburgh Mental Well-being Scale (WEMWBS), 14 positively worded statements, is a validated instrument to measure mental wellbeing on a population level. Less is known about the population distribution of the shorter seven-item version (SWEMWBS) or its performance as an instrument to measure wellbeing.

Methods

Using the Health Survey for England 2010–2013 (n = 27,169 adults aged 16+, nationally representative of the population), age- and sex-specific norms were estimated using means and percentiles. Criterion validity was examined using: (1) Spearman correlations (ρ) for SWEMWBS with General Health Questionnaire (GHQ-12), happiness index, EQ-VAS (2) a multinomial logit model with SWEMWBS (low, medium and high wellbeing) as the outcome and demographic, social and health behaviours as explanatory variables. Relative validity was examined by comparing SWEMWBS with WEMWBS using: (1) Spearman correlations (continuous data), and (2) the weighted kappa statistic (categorical), within population subgroups.

Results

Mean (median) SWEMWBS was 23.7 (23.2) for men and 23.2 (23.2) for women (p = 0.100). Spearman correlations were moderately sized for the happiness index (ρ = 0.53, P < 0.001), GHQ-12 (ρ = ?0.52, p < 0.001) and EQ-VAS (ρ = 0.40, p < 0.001). Participants consuming <1 portion of fruit and vegetables a day versus ≥5 (odds ratio = 1.43 95% Confidence Interval = (1.22–1.66)) and current smokers versus non-smokers (1.28 (1.15–1.41)) were more likely to have low vs medium wellbeing. Participants who binge drank versus non-drinkers were less likely to have high versus medium wellbeing (0.81 (0.71–0.92)). Spearman correlations between SWEMWBS and WEMWBS were above 0.95; weighted kappa statistics showed almost perfect agreement (0.79–0.85).

Conclusion

SWEMWBS distinguishes mental wellbeing between subgroups, similarly to WEMWBS, but is less sensitive to gender differences.

     

The synergistic effect between the Mediterranean diet and <Emphasis Type="Italic">GSTP1</Emphasis> or <Emphasis Type="Italic">NAT2</Emphasis> SNPs decreases breast cancer risk in Greek-Cypriot women

Purpose

Xenobiotic metabolism is related to the interplay between diet and breast cancer (BC) risk. This involves detoxification enzymes, which are polymorphic and metabolise various dietary metabolites. An important characteristic of this pathway is that chemoprotective micronutrients can act not only as substrates but also as inducers for these enzymes. We investigated whether functional GSTP1 (p.Ile105Val-rs1695), NAT2 (590G>A-rs1799930) SNPs and GSTM1 and GSTT1 deletion polymorphisms could modulate the effect of the Mediterranean diet (MD) on BC risk, in Greek-Cypriot women.

Methods

Genotyping was performed on women from the MASTOS case–control study of BC in Cyprus. A 32-item food-frequency questionnaire was used to obtain dietary intake information. A dietary pattern, which closely resembles the MD (high loadings of vegetables, fruit, legumes and fish), was previously derived with principal component analysis and was used as our dietary variable.

Results

GSTT1 null genotype increased BC risk compared with the homozygous non-null GSTT1 genotype (OR 1.21, 95 % CI 1.01–1.45). Increasing adherence to the MD reduced BC risk in women with at least one GSTP1 Ile allele (OR for Ile/Ile = 0.84, 95 % CI 0.74–0.95, for Ile/Val = 0.73, 95 % CI 0.62–0.85) or one NAT2 590G allele (OR for 590 GG = 0.73, 95 % CI 0.63–0.83, for 590 GA = 0.81, 95 % CI 0.70–0.94). p interaction values were not, however, statistically significant.

Conclusion

The homozygous null GSTT1 genotype could be a risk allele for BC among Greek-Cypriot women. The anticarcinogenic effects of the high adherence to MD against BC risk could also be further enhanced when combined with the wild-type alleles of the detoxification GSTP1 or NAT2 SNPs.

     

Factors associated with illicit opioid use in methadone maintenance treatment clients in 5 Provinces,China

Objectives

To investigate factors associated with illicit opioid use among methadone maintenance treatment (MMT) population.

Methods

Participants were recruited from Beijing (2 clinics), Shanghai (2 clinics), Guangdong (2 clinics), Chongqing (2 clinics) and Gansu (1 clinic) provinces. Information about heroin use and MMT was obtained from a self-reported questionnaire, illicit opioid use was obtained from monthly medical records. Binary logistic regression was used to investigate factors associated with illicit opioid use.

Results

Five hundred ninety-eight eligible MMT participants were used for data analysis. Variables such as age, gender, route of heroin use and daily MMT dosages were associated with illicit opioid use. Compared with MMT participants aged <40 years, participants aged 40–44 years (P = 0.027, OR = 0.57, 95 % CI 0.35–0.94), 45–49 years (P < 0.001, OR = 0.41, 95 % CI 0.24–0.67) and ≥50 years (P = 0.008, OR = 0.52, 95 % CI 0.33–0.85) were more likely not to have illicit opioid use. Compared with male participants, females were more likely to have illicit opioid use (P = 0.044, OR = 1.53, 95 % CI 1.01–2.32). Compared with inhalation heroin abusers, abusers with route of inhalation + injection heroin use were more likely to have illicit opioid use (P = 0.009, OR = 2.00, 95 % CI 1.19–3.36). Compared with daily MMT dosages <60 mg participants, participants with daily MMT dosages >80 mg were more likely to have illicit opioid use (P = 0.003, OR = 2.37, 95 % CI 1.35–4.15).

Conclusions

Age, gender, route of heroin use and daily MMT dosages were associated with illicit opioid use. A tailored intervention is needed for a promotion of MMT.

     

Systematic viewing in radiology: seeing more,missing less?

To prevent radiologists from overlooking lesions, radiology textbooks recommend “systematic viewing,” a technique whereby anatomical areas are inspected in a fixed order. This would ensure complete inspection (full coverage) of the image and, in turn, improve diagnostic performance. To test this assumption, two experiments were performed. Both experiments investigated the relationship between systematic viewing, coverage, and diagnostic performance. Additionally, the first investigated whether systematic viewing increases with expertise; the second investigated whether novices benefit from full-coverage or systematic viewing training. In Experiment 1, 11 students, ten residents, and nine radiologists inspected five chest radiographs. Experiment 2 had 75 students undergo a training in either systematic, full-coverage (without being systematic) or non-systematic viewing. Eye movements and diagnostic performance were measured throughout both experiments. In Experiment 1, no significant correlations were found between systematic viewing and coverage, r = ?.10, p = .62, and coverage and performance, r = ?.06, p = .74. Experts were significantly more systematic than students F _2,25 = 4.35, p = .02. In Experiment 2, significant correlations were found between systematic viewing and coverage, r = ?.35, p < .01, but not between coverage and performance, r = .13, p = .31. Participants in the full-coverage training performed worse compared with both other groups, which did not differ between them, F _2,71 = 3.95, p = .02. In conclusion, the data question the assumption that systematic viewing leads to increased coverage, and, consequently, to improved performance. Experts inspected cases more systematically, but students did not benefit from systematic viewing training.