Health Benefits of Daily Walking on Mortality Among Younger-Elderly Men With or Without Major Critical Diseases in the New Integrated Suburban Seniority Investigation Project: A Prospective Cohort Study

Background

Regular physical activity contributes to the prevention of cancer, cardiovascular disease, and other chronic diseases. However, the frequency of physical activity often declines with age, particularly among the elderly. Thus, we investigated the effects of daily walking on mortality among younger-elderly men (65–74 years) with or without major critical diseases (heart disease, cerebrovascular disease, or cancer).

Methods

We assessed 1239 community-dwelling men aged 64/65 years from the New Integrated Suburban Seniority Investigation Project. We estimated hazard ratios (HRs) of all-cause mortality and 95% confidence intervals (CIs) according to daily walking duration and adjusted for potential confounders, including survey year, marital status, work status, education, smoking and drinking status, BMI, regular exercise, regular sports, sleeping time, medical status, disease history, and functional capacity.

Results

For men without critical diseases, mortality risk declined linearly with increased walking time after adjustment for confounders (P _trend = 0.018). Walking ≥2 hours/day was significantly associated with lower all-cause mortality (HR 0.49; 95% CI, 0.27–0.90). For men with critical diseases, walking 1–2 hours/day showed a protective effect on mortality compared with walking <0.5 hours/day after adjustment for confounders (HR 0.29; 95% CI, 0.06–1.20). Walking ≥2 hours/day showed no benefit on mortality in men with critical diseases, even after adjustment for confounders.

Conclusions

Different duration of daily walking was associated with decreased mortality for younger-elderly men with or without critical diseases, independent of sociodemographic and lifestyle factors, BMI, medical status, disease history, and functional capacity. Incorporating regular walking into daily lives of younger-elderly men may improve longevity and successful aging.Key words: walking, mortality, younger elderly, secondary prevention     

Alcohol intake, smoking, sleeping hours, physical activity and the metabolic syndrome

OBJECTIVE: To evaluate the association between physical activity, sleeping hours, alcohol intake and smoking and metabolic syndrome. METHODS: Social, demographic, personal and family medical histories and behavioral characteristics were collected as self-reported for 2164 participants (1332 women; 832 men), aged 18-92 years old, randomly selected during 1999-2003, among residents in Porto, Portugal, evaluated in the Department of Epidemiology of Porto Medical School. Metabolic syndrome was defined according to the NCEP-ATPIII. Associations between metabolic syndrome and lifestyles factors were computed as odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS: After adjustment, higher total physical activity (OR=0.63 95% CI%: 0.43, 0.94--females; OR=0.55 95% CI: 0.33, 0.91--males) and work activity levels in females (OR=0.55; 95% CI: 0.33, 0.91) were significantly associated with lower prevalence of the metabolic syndrome. More sleeping hours were positively associated with metabolic syndrome (OR=1.25; 95% CI: 1.13, 1.38--females; OR=1.19; 95% CI: 1.04, 1.36--males). Regarding smoking, the only statistically significant association was found in women that smoked less than 10 cigarettes per day (OR=0.32 95% CI: 0.11, 0.92). No statistically significant association was found between ethanol intake and metabolic syndrome. CONCLUSIONS: An association between decreased physical activity, increased sleeping hours and metabolic syndrome was found. No association was found between cigarette smoking, alcohol intake and the metabolic syndrome.     

Association of fewer hours of sleep at 6 months postpartum with substantial weight retention at 1 year postpartum

Shorter sleep duration is linked to obesity, coronary artery disease, and diabetes. Whether sleep deprivation during the postpartum period affects maternal postpartum weight retention remains unknown. This study examined the association of sleep at 6 months postpartum with substantial postpartum weight retention (SPPWR), defined as 5 kg or more above pregravid weight at 1 year postpartum. The authors selected 940 participants in Project Viva who enrolled during early pregnancy from 1999 to 2002. Logistic regression models estimated odds ratios of SPPWR for sleep categories, controlling for sociodemographic, prenatal, and behavioral attributes. Of the 940 women, 124 (13%) developed SPPWR. Sleep distributions were as follows: 114 (12%) women slept < or =5 hours/day, 280 (30%) slept 6 hours/day, 321 (34%) slept 7 hours/day, and 225 (24%) slept > or =8 hours/day. Adjusted odds ratios of SPPWR were 3.13 (95% confidence interval (CI): 1.42, 6.94) for < or =5 hours/day, 0.99 (95% CI: 0.50, 1.97) for 6 hours/day, and 0.94 (95% CI: 0.50, 1.78) for > or =8 hours/day versus 7 hours/day (p = 0.012). The adjusted odds ratio for SPPWR of 2.05 (95% CI: 1.11, 3.78) was twofold greater (p = 0.02) for a decrease in versus no change in sleep at 1 year postpartum. Sleeping < or =5 hours/day at 6 months postpartum was strongly associated with retaining > or =5 kg at 1 year postpartum. Interventions to prevent postpartum obesity should consider strategies to attain optimal maternal sleep duration.     

Information Processing Speed and 8-Year Mortality Among Community-Dwelling Elderly Japanese

Background

Cognitive function is an important contributor to health among elderly adults. One reliable measure of cognitive functioning is information processing speed, which can predict incident dementia and is longitudinally related to the incidence of functional dependence. Few studies have examined the association between information processing speed and mortality. This 8-year prospective cohort study design with mortality surveillance examined the longitudinal relationship between information processing speed and all-cause mortality among community-dwelling elderly Japanese.

Methods

A total of 440 men and 371 women aged 70 years or older participated in this study. The Digit Symbol Substitution Test (DSST) was used to assess information processing speed. DSST score was used as an independent variable, and age, sex, education level, depressive symptoms, chronic disease, sensory deficit, instrumental activities of daily living, walking speed, and cognitive impairment were used as covariates.

Results

During the follow-up period, 182 participants (133 men and 49 women) died. A multivariate Cox proportional hazards model showed that lower DSST score was associated with increased risk of mortality (hazard ratio [HR] = 1.62, 95% CI = 0.97–2.72; HR = 1.73, 95% CI = 1.05–2.87; and HR = 2.55, 95% CI = 1.51–4.29, for the third, second, and first quartiles of DSST score, respectively).

Conclusions

Slower information processing speed was associated with shorter survival among elderly Japanese.Key words: all-cause mortality, cognition, community elderly, information processing speed     

Sleep duration, general and abdominal obesity, and weight change among the older adult population of Spain

BACKGROUND: Short sleep duration is associated with obesity and weight gain among children and young adults. However, there are few studies on the elderly, with conflicting results. OBJECTIVE: We examined the association of habitual sleep duration with obesity and weight change among the population aged > or =60 y in Spain. DESIGN: This prospective study was conducted from 2001 to 2003 on 3576 persons whose habitual sleep duration was self-reported in 2001. The outcomes were obesity [body mass index (BMI; in kg/m(2)) > or =30], severe obesity (BMI > or =35), and abdominal obesity (waist circumference >102 cm in men and >88 cm in women) in 2001 and weight gain > or =5 kg in the period 2001-2003. RESULTS: Compared with subjects who slept 7 h, subjects who slept < or =5 h had a greater frequency of obesity [odds ratio (OR): 1.33; 95% CI: 1.00, 1.77] and severe obesity (OR: 2.08; 95% CI: 1.31, 3.32). In addition, sleeping 8 h was associated with obesity (OR: 1.39; 95% CI: 1.11, 1.75) and severe obesity (OR: 1.82; 95% CI: 1.21, 2.73). Similarly, subjects sleeping 9 h were more likely to have severe obesity (OR: 1.57; 95% CI: 1.00, 2.47). Among women, weight gain > or =5 kg was more frequent among subjects sleeping < or =5 h (OR: 3.41; 95% CI: 1.34, 8.69), 8 h (OR: 3.03; 95% CI: 1.29, 7.12), and 9 h (OR: 3.77; 95% CI: 1.55, 9.17). No association was observed between sleep duration and abdominal obesity. CONCLUSIONS: Among older adults, sleeping < or =5 h and sleeping 8 or 9 h was associated with obesity and with short-term weight gain in women.     

Walking decreased risk of cardiovascular disease mortality in older adults with diabetes

OBJECTIVE: This study examines the association of walking with mortality in persons with type 2 diabetes compared to those with normal glucose tolerance. STUDY DESIGN AND SETTING: This prospective study included community-dwelling adults from the Rancho Bernardo Study aged 50-90 years in 1984-86 who had type 2 diabetes (n=347) or normal glucose tolerance (n=1,317). During the 10-year follow up, Cox proportional hazards modeling was used to model time until death from all causes (n=538), coronary heart disease (CHD, n=143), other cardiovascular disease (non-CHD CVD, n=138), and other causes (n=257) while adjusting for multiple potential confounders. RESULTS: After adjusting for sex, age, smoking, body mass index, alcohol, exercise, history of CHD, and other covariates, adults with diabetes who walked > or =1 mile per day were half as likely to die from all causes combined (hazard ratio [HR]=0.54; 95% confidence interval [CI]: 0.33, 0.88), and less than one-fifth as likely to die from non-CHD CVD (HR=0.19; 95% CI: 0.04, 0.86) compared to adults with diabetes who did not walk. Walking was also protective among adults with normal glucose tolerance (HR=0.55; 95% CI: 0.32, 0.96). CONCLUSION: Results suggest walking > or =1 mile per day may provide strong protection from all-cause and non-CHD CVD mortality in older adults with diabetes.     

Physical Activity and Television Watching in Relation to Risk of Type 2 Diabetes: The Black Women's Health Study

Few modifiable risk factors for type 2 diabetes have been documentedin the high-risk population of US black women. The authors useddata from 45,668 black women aged 21–69 years, followedbiennially from 1995 to 2005 in the Black Women's Health Study,to estimate incidence rate ratios for type 2 diabetes comparingvarious levels of physical activity and television watching.Cox proportional hazards models were used to control confoundingfactors. During 10 years of follow-up, 2,928 incident casesof type 2 diabetes were identified. Vigorous activity was inverselyassociated with type 2 diabetes risk (P_trend < 0.0001); theincidence rate ratio for 7 hours per week was 0.43 (95% confidenceinterval (CI): 0.31, 0.59) relative to no activity. Brisk walkingfor 5 hours per week was associated with reduced type 2 diabetesrisk (incidence rate ratio = 0.67, 95% CI: 0.49, 0.92) relativeto no walking. Television watching was associated with an increasedtype 2 diabetes risk: The incidence rate ratio was 1.86 (95%CI: 1.54, 2.24) for 5 hours relative to <1 hour of televisionper day, independent of physical activity. These observationaldata suggest that black women might reduce their risk of developingtype 2 diabetes by increasing their time spent walking or engagedin vigorous physical activity and by limiting television watching. African continental ancestry group; diabetes mellitus, type 2; exercise; incidence; motor activity; television; walking; women's health     

Androgen receptor gene polymorphisms and increased risk of urologic measures of benign prostatic hyperplasia

The association between androgen receptor gene polymorphisms and benign prostatic hyperplasia was investigated among 510 men randomly selected from Olmsted County, Minnesota. From 1990 through 2000, lower urinary tract symptom severity was assessed by the American Urological Association Symptom Index (AUASI), and peak urinary flow rate, prostate volume, and serum prostate-specific antigen level were measured. Androgen receptor CAG and GGN genotyping was performed. A CAG repeat length of <21 was associated with an enlarged prostate (hazard ratio (HR) = 1.4, 95% confidence interval (CI): 1.0, 1.9) and a serum prostate-specific antigen level >1.4 ng/ml (HR = 1.5, 95% CI: 1.1, 2.0). A GGN repeat length of <16 was associated with an AUASI >7 (HR = 1.6, 95% CI: 1.1, 2.3) and a serum prostate-specific antigen level >1.4 ng/ml (HR = 1.5, 95% CI: 1.0, 2.3). Having <21 CAG repeats and <16 GGN repeats compared with having neither was associated with an enlarged prostate (HR = 2.5, 95% CI: 1.5, 4.2), a serum prostate-specific antigen level >1.4 ng/ml (HR = 2.8, 95% CI: 1.6, 4.7), a peak flow rate <12 ml/second (HR = 1.9, 95% CI: 1.1, 3.4), and an AUASI >7 (HR = 1.6, 95% CI: 1.0, 2.7). Androgen receptor gene polymorphisms may have a potential role in the pathogenesis of benign prostatic hyperplasia.     

Can sedentary adults accurately recall the intensity of their physical activity?

BACKGROUND: Physical activity, in particular vigorous activity (i.e., > or =6 METs), lowers mortality from chronic diseases such as cardiovascular disease (CVD). The 7-Day Physical Activity Recall (PAR), a self-administered activity log (LOG), and heart rate monitoring (HR) were used to quantify activity patterns among sedentary adults. We hypothesized that individuals in this population could accurately estimate the duration, but not the intensity, of their activity. METHODS: Sedentary adults (n = 94, 47.8 +/- 7.1 years) completed two PARs 1 week apart and underwent HR monitoring while completing a LOG for 1 day during the PAR assessment interval. RESULTS: The relationship between PARs (kcal. kg(-1). day(-1) ) was significant (r = 0.80, 95% CI 0.68-0.87) among individuals (n = 63) reporting "typical" activity patterns and among all individuals (n = 94) reporting "typical" and "not typical" activity patterns combined (r = 0.44, 95% CI 0.26-0.59). Quantity of moderate activity was greater (P = 0.0001) on PAR and LOG compared to that measured by HR. Quantity of hard (vigorous) activity was also greater (P = 0.019) on LOG compared to that measured by HR. CONCLUSIONS: Sedentary adults tend to overestimate the intensity of their activity, specifically for moderate activity. Furthermore, the aerobic capacity of our sedentary adult sample (about 7.3 METs) suggests that the definition of a threshold intensity level of activity necessary to reduce mortality from CVD should be reexamined, because a value of > or =6 METs appears to be too high in this population.     

BMI,Waist Circumference and All-Cause Mortality in a Middle-Aged and Elderly Chinese Population

Objective

To investigate the association of obesity and all-cause mortality in a sample of middle-aged and elderly population.

Design and Setting

Information of participants was collected in the Dongfeng-Tongji study, a perspective cohort study of Chinese occupational population. The main outcome was risk of death after 8.5 years of follow-up.

Participants and measurements

We examined the association of BMI, waist circumference (WC, and waist–height ratio (WHtR) with all-cause mortality in the Dongfeng-Tongji cohort study (n=26,143). Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for all-cause mortality. Area under the receiver operating characteristic curves and net reclassification improvement (NRI) were used to calculate the power of prediction models.

Results

During a mean of 8.5 years of follow-up, 2,246 deaths were identified. There is a U-shaped association of BMI with all-cause mortality in the middle-aged and elderly Chinese population. Compared with individuals with normal BMI, underweight was positively (HR=2.16, 95% CI: 1.73, 2.69) while overweight (HR=0.75, 95% CI: 0.67, 0.84) and obesity (HR=0.67, 95% CI: 0.56, 0.79) were negatively associated with all-cause mortality after adjustment for potential confounders including WC. In contrast, WC (Q5 vs. Q1, HR=1.55, 95% CI: 1.29, 1.86) and WHtR (Q5 vs.Q1, HR=1.69, 95% CI: 1.40, 2.04) were positively associated with mortality after further adjustment for BMI (P trend < 0.001). Addition of both BMI and WC into the all-cause mortality predictive model significantly increased AUC (P =0.0002) and NRI (NRI = 2.57%, P = 0.0007).

Conclusions

BMI and WC/WHtR were independently associated with all-cause mortality after mutual adjustment. Combination of BMI and WC/WHtR improved the predictive ability of all-cause mortality risk in the middle-aged and elderly population.

     

Association of long working hours with accidents and suicide mortality in Korea

Objectives:The deleterious health effects of long working hours have been previously investigated, but there is a dearth of studies on mortality resulting from accidents or suicide. This prospective study aims to examine the association between working hours and external-cause mortality (accidents and suicide) in Korea, a country with some of the longest working hours in the world.Methods:Employed workers (N=14 484) participating in the Korean National Health and Nutrition Examination Survey (KNHANES) were matched with the Korea National Statistical Office’s death registry from 2007–2016 (person-years = 81 927.5 years, mean weighted follow-up duration = 5.7 years). Hazard ratios (HR) for accident (N=25) and suicide (N=27) mortality were estimated according to weekly working hours, with 35–44 hours per week as the reference.Results:Individuals working 45–52 hours per week had higher risk of total external cause mortality compared to those working 35–44 hours per week [HR 2.79, 95% confidence interval (CI) 1.22–6.40], adjusting for sex, age, household income, education, occupation, and depressive symptoms. Among the external causes of death, suicide risk was higher (HR 3.89, 95% CI 1.06–14.29) for working 45–52 hours per week compared to working 35–44 hours per week. Working >52 hours per week also showed increased risk for suicide (HR 3.74, 95% CI 1.03–13.64). No statistically significant associations were found for accident mortality.Conclusions:Long working hours are associated with higher suicide mortality rates in Korea.     

Alcohol intake, drinking patterns, and risk of prostate cancer in a large prospective cohort study

Alcohol drinking has been extensively studied in relation to prostate cancer, yet findings on the direction of the association are equivocal. Previous studies have not examined drinking patterns. Thus, the authors prospectively evaluated the associations between these factors and risk of incident prostate cancer (n = 2,479) in a cohort study of 47,843 US men (1986-1998). The men completed a questionnaire at baseline that included information on consumption of specific types of alcohol and frequency of use. The authors estimated hazard ratios using Cox proportional hazards regression for average alcohol intake and number of days per week on which alcohol was consumed stratified by average weekly intake (<105 g/week vs. > or = 105 g/week). Compared with nondrinking, the hazard ratio for consumption increased slightly from an average of 5.0-14.9 g/day (hazard ratio (HR) = 1.05, 95% confidence interval (CI): 0.94, 1.18) to 30.0-49.9 g/day (HR = 1.13, 95% CI: 0.96, 1.33), but it was not increased at > or = 50 g/day (HR = 1.00, 95% CI: 0.77, 1.31) after adjustment for recent smoking and other factors. Compared with abstainers, risk was greatest among men who consumed an average of > or = 105 g/week but who drank on only 1-2 days per week (HR = 1.64, 95% CI: 1.13, 2.38). These results suggest that moderate or greater alcohol consumption is not a strong contributor to prostate cancer risk, except possibly in men who consume large amounts infrequently.     

Shift work,long working hours and preterm birth: a systematic review and meta-analysis

Purpose

Specific physical activities or working conditions are suspected for increasing the risk of preterm birth (PTB). The aim of this meta-analysis is to review and summarize the pre-existing evidence on the effect of shift work or long working hours on the risk of PTB.

Methods

We conducted a systematic search in MEDLINE and EMBASE (1990–2013) for observational and intervention studies with original data. We only included articles that met our specific criteria for language, exposure, outcome, data collection and original data that were of at least of moderate quality. The data of the included studies were pooled.

Results

Eight high-quality studies and eight moderate-quality studies were included in the meta-analysis. In these studies, no clear or statistically significant relationship between shift work and PTB was found. The summary estimate OR for performing shift work during pregnancy and the risk of PTB were 1.04 (95 % CI 0.90–1.20). For long working hours during pregnancy, the summary estimate OR was 1.25 (95 % CI 1.01–1.54), indicating a marginally statistically significant relationship but an only slightly elevated risk.

Conclusion

Although in many of the included studies a positive association between long working hours and PTB was seen this did reach only marginal statistical significance. In the studies included in this review, working in shifts or in night shifts during pregnancy was not significantly associated with an increased risk for PTB. For both risk factors, due to the lack of high-quality studies focusing on the risks per trimester, in particular the third trimester, a firm conclusion about an association cannot be stated.     

A Study of the Combined Effects of Physical Activity and Air Pollution on Mortality in Elderly Urban Residents: The Danish Diet,Cancer, and Health Cohort

Background

Physical activity reduces, whereas exposure to air pollution increases, the risk of premature mortality. Physical activity amplifies respiratory uptake and deposition of air pollutants in the lung, which may augment acute harmful effects of air pollution during exercise.

Objectives

We aimed to examine whether benefits of physical activity on mortality are moderated by long-term exposure to high air pollution levels in an urban setting.

Methods

A total of 52,061 subjects (50–65 years of age) from the Danish Diet, Cancer, and Health cohort, living in Aarhus and Copenhagen, reported data on physical activity in 1993–1997 and were followed until 2010. High exposure to air pollution was defined as the upper 25th percentile of modeled nitrogen dioxide (NO₂) levels at residential addresses. We associated participation in sports, cycling, gardening, and walking with total and cause-specific mortality by Cox regression, and introduced NO₂ as an interaction term.

Results

In total, 5,534 subjects died: 2,864 from cancer, 1,285 from cardiovascular disease, 354 from respiratory disease, and 122 from diabetes. Significant inverse associations of participation in sports, cycling, and gardening with total, cardiovascular, and diabetes mortality were not modified by NO₂. Reductions in respiratory mortality associated with cycling and gardening were more pronounced among participants with moderate/low NO₂ [hazard ratio (HR) = 0.55; 95% CI: 0.42, 0.72 and 0.55; 95% CI: 0.41, 0.73, respectively] than with high NO₂ exposure (HR = 0.77; 95% CI: 0.54, 1.11 and HR = 0.81; 95% CI: 0.55, 1.18, p-interaction = 0.09 and 0.02, respectively).

Conclusions

In general, exposure to high levels of traffic-related air pollution did not modify associations, indicating beneficial effects of physical activity on mortality. These novel findings require replication in other study populations.

Citation

Andersen ZJ, de Nazelle A, Mendez MA, Garcia-Aymerich J, Hertel O, Tjønneland A, Overvad K, Raaschou-Nielsen O, Nieuwenhuijsen MJ. 2015. A study of the combined effects of physical activity and air pollution on mortality in elderly urban residents: the Danish Diet, Cancer, and Health cohort. Environ Health Perspect 123:557–563; http://dx.doi.org/10.1289/ehp.1408698     

A dose-response relationship between short sleeping hours and childhood obesity: results of the Toyama Birth Cohort Study

BACKGROUND: Short sleeping hours could cause obesity through increased sympathetic activity, elevated cortisol secretion and decreased glucose tolerance. The aim of this study was to clarify parental and lifestyle factors, particularly sleeping habits, associated with obesity in Japanese children. METHODS: Between June and July 1996, 8274 children (4194 males and 4080 females) aged 6-7 years living in Toyama prefecture, Japan, were investigated by questionnaire survey and the collection of anthropometric data. Subjects with a body mass index (BMI; weight in kg divided by square of height in m) greater than the age- and sex-specific cut-off points linked to adulthood overweight (BMI of 25 kg/m2 or more) were defined as obese subjects. Parental obesity was defined as a BMI of 25 kg/m2 or more. Logistic regression analysis was performed to evaluate the strength of the relationships between parental obesity or lifestyle factors and childhood obesity, adjusted for possible confounding factors. RESULTS: Parental obesity, long hours of TV watching and physical inactivity were significantly associated with childhood obesity. Although wake-up time was not related to obesity, there was a significant dose-response relationship between late bedtime or short sleeping hours and childhood obesity. Compared with children with 10 or more hours of sleep, the adjusted odds ratio was 1.49 (95% confidence interval 1.08-2.14) for those with 9-10 h sleep, 1.89 (1.34-2.73) for those with 8-9 h sleep and 2.87 (1.61-5.05) for those with <8 h sleep, after adjustment for age, sex, parental obesity and other lifestyle factors. CONCLUSION: A strong inverse association was observed in the relationship between sleeping hours and childhood obesity. Longitudinal research will be required to confirm this causality.     

Television, walking, and diet: associations with postpartum weight retention

BACKGROUND: For many women, pregnancy begets long-term weight gain. Modifiable behaviors that contribute to postpartum weight retention have not been well studied. METHODS: Prospective cohort study of 902 women enrolled in Project Viva, examining associations of postpartum television viewing, walking, and trans fat intake with weight retention equal to or greater than 5 kg at 12 months postpartum. Data were collected in 1999-2003 and analyzed in 2005-2006. RESULTS: At 6 months postpartum, women reported a mean (SD) of 1.7 (1.3) hours of television viewing, 0.7 (0.7) hours of walking, and 1.1% (0.5) of energy intake from trans fat per day. At 1 year, participants retained a mean of 0.6 kg (range: -17.3 to 25.5), and 12% retained at least 5 kg. In multivariate logistic regression models, adjusting for maternal sociodemographics, parity, prepregnancy body mass index, gestational weight gain, breastfeeding, and smoking, the odds ratio of retaining at least 5 kg was 1.24 (95% confidence interval [CI]: 1.06-1.46) per daily hour of television viewing, 0.66 (95% CI: 0.46-0.94) per daily hour of walking, and 1.33 (95% CI: 1.09-1.62) per 0.5% increment in daily energy intake from trans fat. Women who watched less than 2 hours of television, walked at least 30 minutes, and consumed trans fat below the median had an odds ratio of 0.23 (95% CI: 0.08-0.66) of retaining at least 5 kg. CONCLUSIONS: Postpartum television viewing, walking, and trans fat intake were associated with weight retention. Interventions to modify these behaviors may help reduce excess postpartum weight gain and prevent obesity among women.     

Long working hours and risk for hypertension in Japanese male white collar workers

STUDY OBJECTIVE: To evaluate the association of long working hours with the risk for hypertension. DESIGN: A five year prospective cohort study. SETTING: Work site in Osaka, Japan. PARTICIPANTS: 941 hypertension free Japanese male white collar workers aged 35-54 years were prospectively examined by serial annual health examinations. Men in whom borderline hypertension and hypertension were found during repeated surveys were defined as incidental cases of borderline hypertension and hypertension. MAIN RESULTS: 336 and 88 men developed hypertension above the borderline level and definite hypertension during the 3940 and 4531 person years, respectively. After controlling for potential predictors of hypertension, the relative risk for hypertension above the borderline level, compared with those who worked < 8.0 hours per day, was 0.63 (95% confidence intervals (CI): 0.43, 0.91) for those who worked 10.0-10.9 hours per day and 0.48 (95% CI: 0.31, 0.74) for those who worked > or = 11.0 hours per day. The relative risk for definite hypertension, compared with those who worked < 8.0 hours per day, was 0.33 (95% CI: 0.11, 0.95) for those who worked > or = 11.0 hours per day. The multivariate adjusted slopes of diastolic blood pressure (DBP) and mean arterial blood pressure (MABP) during five years of follow up decreased as working hours per day increased. From the multiple regression analyses, working hours per day remained as an independent negative factor for the slopes of systolic blood pressure, DBP, and MABP. CONCLUSIONS: These results indicate that long working hours are negatively associated with the risk for hypertension in Japanese male white collar workers.     

Moderate alcohol consumption predicts long-term mortality in elderly subjects with chronic heart failure

Objective

Moderate alcohol consumption is related to a reduction of mortality. However, this phenomenon is not well established in the elderly, especially in the presence of chronic heart failure (CHF). The aim of the study was to verify the effect of moderate alcohol consumption on 12-year mortality in elderly community-dwelling with and without CHF.

Settings

community-dwelling from 5 regions of Italy.

Participants

A cohort of 1332 subjects aged 65 and older.

Measurement

Mortality after 12-year follow-up in elderly subjects (≥65 years old) with and without CHF was studied. Moderate alcohol consumption was considered ≤250 ml/day (drinkers).

Results

In the absence of CHF (n=947), mortality was 42.2% in drinkers vs. 53.7% in non-drinker elderly subjects (p=0.021). In contrast, in the presence of CHF (n=117), mortality was 86.5% in drinkers vs. 69.7% in non-drinker elderly subjects (p=0.004). Accordingly, Cox regression analysis shows that a moderate alcohol consumption is protective of mortality in the absence (HR=0.79; CI 95% 0.66–0.95; p<0.01) but it is predictive of mortality in the presence of CHF (HR=1.29; CI 95% 1.05–1.97; p<0.05).

Conclusions

Our data demonstrates that moderate alcohol consumption is associated with an increased long-term mortality risk in the elderly in the presence of CHF.     

Coffee Consumption and Incidence of Subarachnoid Hemorrhage: The Jichi Medical School Cohort Study

Background

Previous studies on the association between coffee consumption and subarachnoid hemorrhage (SAH) have provided inconsistent results. We examine the risk of SAH from coffee consumption in a Japanese population.

Methods

Our analyses were based on the Jichi Medical School Cohort Study, a large-scale population-based prospective cohort study. A total of 9941 participants (3868 men and 6073 women; mean age 55 years) with no history of cardiovascular disease or carcinoma were examined. Participants were asked to choose one of five options to indicate their daily coffee consumption: none, less than 1 cup a day, 1–2 cups a day, 3–4 cups a day, or 5 or more cups a day. The incidence of SAH was assessed independently by a diagnostic committee. Cox proportional hazards models were used to calculate hazard ratios (HRs) and their 95% confidence intervals (CI) after adjustment for age and sex (HR1) and for additional potential confounders (HR2).

Results

During 10.7 years of follow-up, SAH occurred in 47 participants. When compared with the participants who consumed less than 1 cup of coffee a day, the HR of SAH was significantly higher in the group who consumed 5 or more cups a day in both models (HR1 4.49; 95% CI, 1.44–14.00; HR2 3.79; 95% CI, 1.19–12.05).

Conclusions

The present community-based cohort study showed that heavy coffee consumption was associated with an increased incidence of SAH after adjusting for age, sex, and multiple potential cardiovascular confounders.Key words: coffee consumption, subarachnoid hemorrhage, community-based cohort study     

Association between reduced sleep and weight gain in women

Physiologic studies suggest that sleep restriction has metabolic effects that predispose to weight gain. The authors investigated the association between self-reported usual sleep duration and subsequent weight gain in the Nurses' Health Study. The 68,183 women who reported habitual sleep duration in 1986 were followed for 16 years. In analyses adjusted for age and body mass index, women sleeping 5 hours or less gained 1.14 kg (95% confidence interval (CI): 0.49, 1.79) more than did those sleeping 7 hours over 16 years, and women sleeping 6 hours gained 0.71 kg (95% CI: 0.41, 1.00) more. The relative risks of a 15-kg weight gain were 1.32 (95% CI: 1.19, 1.47) and 1.12 (95% CI: 1.06, 1.19) for those sleeping 5 and 6 hours, respectively. The relative risks for incident obesity (body mass index: >30 kg/m(2)) were 1.15 (95% CI: 1.04, 1.26) and 1.06 (95% CI: 1.01, 1.11). These associations remained significant after inclusion of important covariates and were not affected by adjustment for physical activity or dietary consumption. These data suggest that short sleep duration is associated with a modest increase in future weight gain and incident obesity. Further research is needed to understand the mechanisms by which sleep duration may affect weight.