Household Density among Undocumented Mexican Immigrants in New York City

Background High household density increases exposure to communicable diseases, psychological distress in adults, and poor long-term health in children. High residential density, which may be a mediator of poor health, is common among immigrants. Methods We used data from a pilot survey among Mexican immigrants in New York City. Respondents were recruited through venue-based sampling in neighborhoods with large Mexican populations. Results Among respondents that reported being undocumented (N = 404), the mean number of people per room (PPR) of residence was 2.2. In multivariate analyses, living in conditions of >2 PPR was positively associated with living with one’s children (OR = 2.3, 95% CI = 1.4–3.9), having experienced food insecurity in the past 6 months (OR = 2.0, 95% CI = 1.1–3.6), and language discrimination (OR = 2.3 compared to other forms of discrimination, 95% CI = 1.2–4.4). Conclusions Undocumented Mexican immigrants, particularly those who are linguistically marginalized and experience food insufficiency, live in conditions of marked household density in NYC.     

Vaginal Douching Among Latina Immigrants

Little is known about vaginal douching among Latina immigrants in the U.S. Understanding factors associated with douching is important due to the negative reproductive outcomes associated with this practice. This study examined demographic and behavioral factors associated with vaginal douching among Latina immigrants. A cross-sectional anonymous survey was administered among a convenience sample of 206 Latina immigrants aged 19–44 years (mean = 28 years) living in the U.S. at least 6 months (mean = 4 years). Demographic and behavioral characteristics, history of regular douching (at least once a month for 6 months), and current regular douching (at least once a month for the last 6 months) were assessed. Adjusted odds ratios (adj. OR) were estimated using multiple logistic regression. Overall, 25% (n = 50) of women reported ever douching regularly and 15% (n = 31) reported current regular douching. Ever douching regularly was significantly associated with a woman’s number of lifetime sex partners (adj. OR = 1.6 per additional partner over one, 95% CI: 1.1–2.5), hormonal contraceptive use (adj. OR = 0.3, 95% CI: 0.1–0.9), and healthcare seeking behavior (adj. OR = 2.3, 95% CI: 1.1–5.2). Regular vaginal douching is a common practice among Latina immigrants. Factors associated with douching in this population vary from those in other U.S. populations and, therefore, it needs to be addressed in a culturally appropriate manner.     

Psychosocial Correlates of Overweight or Obese Status in Latino Adults with Coronary Artery Disease

This study evaluated the psychosocial correlates of being overweight or obese among US born and immigrant Latino adults. Depressive symptoms were measured with the Center for Epidemiological Studies Depression Scale (CES-D10). Of the 177 participants, 64% were either overweight or obese, of which, 51% also had comorbid depressive symptoms. On bivariate analyses, these participants were younger (OR = 2.4, 95% CI = 1.5–5.2), female (OR = 2.5, 95% CI = 1.3–4.6), US born (OR = 6, 95% CI = 1.3–9.0), more likely to have lived in the US 15 or more years (OR = 2.6, 95% CI 1.3–5.1), reported fair or poor health, (OR = 3.8, 95% CI = 1.8–8.0), and were more likely to perceive greater stress (OR = 7.8, 95% CI = 3.4–18.0). On multivariate analysis, only perceived stress remained significant (OR = 6.5, 95% CI = 2.7–15.6). This suggests that interventions designed to reduce the epidemic of overweight and obesity in Latino adults may also need to address their psychosocial health.     

Stress-Associated Poor Health Among Adult Immigrants with a Language Barrier in the United States

The healthy migrant hypothesis supported by the ‘Hispanic paradox’ suggests that immigrants are healthier than non-immigrants. To test the generalizability of this hypothesis, we studied the stress-associated health status of adult immigrants with a language barrier in the USA. Three stress-related conditions (Unhappiness, Depression, and Anxiety) and self-reported health status were ascertained from participants of the Community Tracking Study Health Survey conducted in 2003. The associations between these conditions as well as the immigrants’ length of time living in the USA and health were assessed. Our results demonstrated that the three stress-related conditions were significantly associated with a dramatically elevated poor health status (Unhappiness: OR = 5.22, 95% CI: 4.43–6.14; Depression: OR = 3.03, 95% CI: 2.31–3.98; Anxiety: OR = 5.12, 95% CI: 3.53–7.41). Compared to US citizens without a language barrier, immigrants with a language barrier were more likely to report poor health (OR = 2.15, 95% CI: 1.66–2.78). After adjustment for stressors, the likelihood of reporting poor health among immigrants with a language barrier decreased significantly (OR = 1.75, 95% CI: 1.05–2.91). In addition, these immigrants were more likely to report poor health within the first 10 years of their living in the USA (≤5 years: OR = 2.79, 95% CI: 1.94–4.02; 6–10 years: OR = 2.68, 95% CI: 1.86–3.86). In summary, immigrants who have a language barrier were generally more stressed, especially at the beginning of their lives as immigrants. The combined effect of stress and a language barrier led to poorer health in these immigrants. Thus, the healthy migrant hypothesis may not be generalizable to this population.     

Negative Acculturation in Sleep Duration Among Mexican Immigrants and Mexican Americans

Negative acculturation, the increase in high-risk profiles as immigrants live longer in the U.S., is found for a range of health behaviors and outcomes among Latino populations. Yet it has never been explored with regard to sleep duration. Using the National Health Interview Survey, we investigate Mexican immigrant and U.S.-born Mexican-American sleep durations. U.S.-born Mexican Americans are around 40% (P < 0.05) more likely to be short sleepers than Mexican immigrants after adjusting for demographic characteristics. These relationships are attenuated with the addition of health behavior variables (OR = 1.25, n.s.). This is explained because U.S.-born Mexican Americans have higher rates of smoking and stress levels, both of which are associated with increased risks of short sleeping. Because chronic partial sleep deprivation may increase health risks directly and indirectly through impaired judgment, sleep may be a mechanism through which health disparities between Mexican immigrants and U.S.-born Mexican Americans emerge.     

Prevalence and Risk Factors for Female Sexual Dysfunction Among Turkish Women Attending a Maternity and Gynecology Outpatient Clinic

Female sexual dysfunction is a common health problem for many women all over the world. This study was constructed to determine risk factors and prevalence of female sexual dysfunction among Turkish women, in Ordu province of Turkey between May 2008 and December 2008. Four hundred and twenty-five married women, between 18 and 56 years of age, who consented to participate, were included in the study. Data was collected by using a questionnaire form and the Female Sexual Function Index. The prevalence of female sexual dysfunction was 52.2%. The risk factors for female sexual dysfunction were, low education level of the woman (odds ratio [OR] = 1.830, 95% confidence interval [CI] = 1.088–3.078), low education level of the husband (OR = 1.734, 95% CI = 1.094–2.750), being brought up by parents with restrictive attitudes (OR = 1.558, 95% CI = 1.001–2.424), and having genital infections or symptoms (OR = 1.925, 95% CI = 1.213–3.055).     

Healthy Start Program and Feto-Infant Morbidity Outcomes: Evaluation of Program Effectiveness

Objective We evaluate the impact of the Healthy Start intervention program on feto-infant morbidity within a community setting. Methods Prospective data from 2002 to 2007 within the ongoing Federally funded Healthy Start intervention project in Central Hillsborough County were merged with corresponding birth outcomes data from the Florida Department of Health. The impact of the project on the following feto-infant morbidity indices was assessed among service recipients: low birth weight (LBW), very low birth weight (VLBW), preterm, very preterm, small for gestational age (SGA) and a composite feto-infant morbidity outcome. Program effectiveness and impact were measured using odds ratios from logistic regression models and number needed to treat (NNT). Results The risk for low birth weight (OR = 0.7; 95% CI = 0.5–1.0), preterm (OR = 0.7; 95% CI = 0.5–0.9) and the composite feto-infant morbidity outcome (OR = 0.8; 95% CI = 0.6–0.9) was reduced among service recipients (N = 536) as compared to non-recipients (N = 2,815). A clinically important level of risk reduction was also noted for very low birth weight (OR = 0.5; 95% CI = 0.2–1.1) and very preterm (OR = 0.6; 95% CI = 0.3–1.2) although these did not reach statistical significance. The adjusted NNT was lowest for the composite feto-infant morbidity outcome (18), preterm birth (21) and low birth weight (24), and highest for very preterm (86) and very low birth weight (74) events. Conclusions In a disadvantaged community setting, the Healthy Start intervention program was found to reduce the risk for very low birth weight and preterm births by about one-third.     

Efficacy of a Randomized Cell Phone-Based Counseling Intervention in Postponing Subsequent Pregnancy Among Teen Mothers

The purpose of this study is to explore state-level fetal death rates and <24 h infant mortality rates for deliveries less than 500 g in order to estimate outcomes classification differences at the edge of viability. We selected singleton deliveries to US resident mothers born <500 g and >20 weeks gestation from the NCHS live birth-infant death and fetal death files for 1999–2002 (n = 37,813). Infant deaths within 24 h of birth were selected to estimate odds of classification as a fetal death versus a live birth/infant death by state. Logistic regression was used to derive odds of classification as a fetal death and to adjust for maternal characteristics, calculating unadjusted and adjusted odds ratios. We identified 37,813 outcomes from 48 states reporting in this birthweight category. Unadjusted odds of classification of outcomes as a fetal death versus a live birth/death within 24 h by state ranged from OR = 0.38 (95% CI = 0.24–0.59) to OR = 2.93 (95% CI = 2.26–3.78); adjusted for maternal age and race, the range narrowed slightly to a OR = 0.31 (95% CI = 0.20–0.48) to aOR = 2.54 (95% CI = 1.96–3.30). Six states were more likely to classify outcomes as a live birth/infant death, while 14 states were more likely to classify as a fetal death, when compared to a large reference state. The remaining states did not differ significantly in their outcomes. The fraction of outcomes classified as fetal deaths varied by state during the years studied. This study suggests fetal death and early infant death outcomes reported for babies less than 500 g reflect differential classification thus influencing the validity of these vital statistics data at the state level. Further studies are needed to explore the factors that influence these differences.     

Diabetes Self-Efficacy Strongly Influences Actual Control of Diabetes in Patients Attending a Tertiary Hospital in India

A cross-sectional survey of 507 in- and out-patients, with diagnosed Type 2 diabetes mellitus (T2DM) was undertaken to study the relationships between personal, disease and treatment-related factors and diabetes control in a tertiary care hospital. On multivariate logistic regression analysis, self-efficacy (odds ratio (OR) = 2.94; 95% confidence interval (CI) = 1.92–4.54); P < 0.001) was the single most important determinant of current diabetes control (HbA1c ≤ 7%), along with absence of hyperglycemic symptoms in the past year (OR = 1.83; 95% CI = 1.15–2.93, P < 0.01), current treatment with oral medication (OR = 1.77; 95% CI = 1.17–2.66; P < 0.007), and adherence to dietary restrictions (OR = 2.7; 95% CI = 1.28–5.88; P < 0.009). Self-efficacy was itself influenced by educational status, employment, availability of family support, and positive mental attitudes. Our findings suggest that health care delivery inputs, patients’ personal characteristics including education and attitude, and family support for care are complexly processed to determine patients’ ability to manage their disease, which ultimately influences disease outcomes.     

A Longitudinal Study of WIC Participation on Household Food Insecurity

We examined the association between women’s/children’s duration of WIC participation and household food security status. For mothers (n = 21,863) and their children (n = 57,377) participating in WIC (2001–2006), longitudinal measures of household food security status were collected using a subscale of the USDA Food Security Module. Using logistic regression, household food security status at the last WIC visit was associated with measures of WIC duration (number of trimesters on WIC for pregnant women, and number of WIC visits for children). Among women with prenatal household food insecurity with hunger, odds of any post-partum household food insecurity was reduced with first (AOR = 0.67, 95% CI = 0.48–0.94) or second trimester of entry (AOR = 0.64, 95% CI = 0.45–0.90) versus third. Among children with initial household food insecurity without hunger, an additional WIC visit reduced the odds of any household food insecurity (AOR = 0.92, 95% CI = 0.90–0.94) and of household food insecurity with hunger (AOR = 0.94, 95% CI = 0.89–0.98) at the last visit. Among those with initial household food insecurity with hunger, an additional WIC visit reduced the odds of any household food insecurity (AOR = 0.96, 95% CI = 0.92–0.99) and of household food insecurity with hunger (AOR = 0.88, 95% CI = 0.83–0.94) at the last visit. Earlier and longer WIC participation may improve household food security status, particularly of vulnerable groups.     

Risk Factors for Sub-Clinical and Major Postpartum Depression Among a Community Cohort of Canadian Women

Objectives To identify prenatal and perinatal factors that predict women at risk of sub-clinical and major postpartum depression among a cohort of low medical risk pregnant women in Canada. Methods Data from 1,403 women who completed a randomized controlled trial of supplementary support during pregnancy was analyzed to identify risk factors for sub-clinical and major postpartum depression. The Edinburgh Postnatal Depression Scale (EPDS), completed at eight weeks postpartum, was used to classify each woman’s depression symptom severity. Demographic, obstetric, behavioral risk, mental health and psychosocial factors were considered. Multiple logistic regression analyses were used to identify risk factors most predictive of sub-clinical and major postpartum depression. Results After adjustment for other covariates, variables that increased the risk of sub-clinical postpartum depression included a history of depression (OR = 2.27, CI = 1.42–3.63), anxiety symptoms during pregnancy (OR = 2.12, CI = 1.09–4.11), being born outside Canada (OR = 1.87, CI = 1.17–3.00), and low parenting self-efficacy (OR = 1.65, CI = 1.06–2.55). Variables that increased the risk of major postpartum depression included a history of depression (OR = 2.78, CI = 1.56–4.97), being born outside Canada (OR = 2.97, CI = 1.70–5.17), depressive symptoms during pregnancy (OR = 2.83, CI = 1.29–6.19) and not breastfeeding at eight weeks postpartum (OR = 2.12, CI = 1.21–3.70). Conclusions A history of depression and being born outside Canada predicted women who were at an increased risk of sub-clinical and major postpartum depression. The remaining risk factors specific to sub-clinical and major postpartum depression suggest some differences between women vulnerable to sub-clinical compared to major depressive symptoms in the postpartum period, which may have implications for targeted screening and intervention strategies.     

A Health Behaviour Cross-Sectional Study of Immigrants and Non-immigrants in a Swiss Urban General-Practice Setting

Background Little is known about smoking, unhealthy use of alcohol, and risk behaviours for sexually transmitted diseases (STDs) in immigrants from developed and developing countries. Method We performed a cross-sectional study of 400 patients who consulted an academic emergency care centre at a Swiss university hospital. The odds ratios for having one or more risk behaviours were adjusted for age, gender, and education level. Results Immigrants from developing countries were less likely to use alcohol in an unhealthy manner (OR = 0.35, 95% CI 0.22–0.57) or practise risk behaviours for STDs (OR = 0.31, 95% CI 0.13–0.74). They were also less likely to have any of the three studied risk behaviours (OR = 2.5, 95% CI 1.5–4.3). Discussion In addition to the usual determinants, health behaviours are also associated with origin; distinguishing between immigrants from developing and developed countries is useful in clinical settings. Surprisingly, patients from developing countries tend to possess several protective characteristics.     

Lifetime total physical activity and prostate cancer risk: a population-based case–control study in Sweden

The etiologic role of physical activity in prostate cancer development is unclear. We assessed the association between lifetime total physical activity and prostate cancer risk in a Swedish population-based case–control study comprising 1,449 incident prostate cancer cases and 1,118 unaffected population controls. Information regarding physical activity was obtained via a self-administered questionnaire assessing occupational, household, and recreational activity separately at various ages throughout an individual’s lifetime. Clinical data (TNM-classification, Gleason sum and PSA) was obtained from linkage to the National Prostate Cancer Registry. Overall, we observed no association between lifetime total physical activity and prostate cancer risk (odds ratio [OR] = 1.04, 95% confidence interval [CI] = 0.77–1.41 for ≥49.7 vs. <41.9 metabolic equivalent-hours per day). There was a significantly increased risk of prostate cancer in the most active men compared with the least active men in household (OR = 1.44, 95% CI = 1.08–1.92) and recreational physical activity (OR = 1.56, 95% CI = 1.16–2.10). Comparing the most active with the least active men, total physical activity was not associated with either localized disease (OR = 0.95, 95% CI = 0.67–1.34) or advanced disease (OR = 1.19, 95% CI = 0.83–1.71). These findings do not support the hypothesis that physical activity uniformly protects against prostate cancer development.     

Is the high mortality risk in sentenced offenders independent of previous imprisonment?

The mortality in prisoners is high. However, our knowledge about the mortality in convicted offenders, irrespective of incarceration history, is limited. Our aim was to investigate possible predictors for over-all and cause specific mortality in a nation-wide study of convicted offenders with and without previous imprisonment. This case–control study drew random samples of deceased and living offenders (N = 1,112) from four complete cohorts of convicted offenders, two male (born 1967 and 1977, respectively), and two female (born 1967–70 and 1977–80, respectively). All criminal records were systematized and information about date and cause of death was collected on those deceased. Multivariable analyses demonstrated that age at first court conviction (OR = 0.88, 95% CI = 0.84–0.93), drug related crimes (OR = 1.99, 95% CI = 1.23–3.22), and crime diversity (1.51, 95% CI = 1.07–2.13) were significant predictors of premature death in males. In females, age at first court conviction (OR = 0.92, 95% CI = 0.88–0.97), drug related crimes (OR = 2.24, 95% CI = 1.37–3.69) and belonging to the oldest cohort (OR = 2.10, 95% CI = 1.35–3.26) were significant predictors of premature death. Age at first court conviction remained a significant predictor for death in all cause specific multivariable mortality analyses. In addition, having committed drug related crimes and high crime diversity were strong predictors for substance related deaths. Males did more often die in accidents or commit suicide. Somatic deaths were most often encountered in the oldest cohort. Incarceration did not remain a significant predictor for premature death in any of the multivariable analyses. Measures intended to prevent premature death in convicted offenders should target wider populations than hitherto acknowledged.     

Physical Abuse Around the Time of Pregnancy Among Women With Disabilities

Women with disabilities are at greater risk for physical abuse than women without disabilities. However, no previous population-based studies have examined physical abuse against women with disabilities around the time of pregnancy, a critical period for mother and child. The objective of this study was to describe the prevalence of physical abuse before and during pregnancy among a representative sample of Massachusetts women with and without disabilities. Data from the 2007–2008 Massachusetts Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed in 2010. Disability prevalence was 4.9% (95% CI = 3.9–6.2) among Massachusetts women giving birth during 2007–2008. The prevalence of physical abuse during the 12-months before pregnancy among women with disabilities was 13.6% (95% CI = 7.2–24.0) compared to 2.8% for women without disabilities (95% CI = 2.1–3.7). Similarly, 8.1% (95% CI = 4.0–15.7) of women with disabilities compared to 2.3% (95% CI = 1.7–3.1) of women without disabilities experienced physical abuse during pregnancy. Multivariate analyses indicated that women with disabilities were more likely to report physical abuse before pregnancy (OR = 4.3, 95% CI = 1.9–9.7), during pregnancy (OR = 2.8, 95% CI = 1.1–7.1), or during either time period (OR = 3.2, 95% CI = 1.4–7.1) than women without disabilities while controlling for maternal age, education, race/Hispanic ethnicity, marital status and household poverty status. No difference was observed by disability status in the likelihood of prenatal-care providers talking to women about physical abuse. These analyses reveal disproportionate prevalence of physical abuse before and during pregnancy among women with disabilities. Screening for physical abuse and timely referral of women in need of assistance are critical to optimize health outcomes for both mother and child.     

Effect of Maternal Birthplace on Gestational Diabetes Prevalence in Colorado Hispanics

(1) Describe gestational diabetes mellitus (GDM) prevalence time trends in USborn (USWH) and Mexico-born (MWH), white Hispanic Colorado women and (2) Determine effect of maternal birthplace on GDM prevalence. Retrospective population-based study of 1995–2004 Colorado birth certificate data for live, singleton births to white, Hispanic mothers estimated prevalence, trends, and association of GDM and maternal birthplace. Univariate, bivariate and logistic regression analyses were conducted. GDM prevalence in 154,957 births increased in both USWH (1.77–2.53%, P < 0.0001) and MWH (2.38–3.08%, P < 0.0001). Over study years, MWH had higher crude odds (OR = 1.30; 95% CI = 1.22–1.38) for developing GDM than USWH. Adjustment for maternal age and maternal education reduced GDM risk by birth country (OR = 1.05; 95% CI = 0.98–1.13, P = ns). GDM prevalence increased in both US-born and Mexico-born, white, Hispanic Colorado women. Mexico-born immigrant women may have increased risk for GDM compared with their USborn counterparts. Lower education attainment may be determinant of disease risk.     

Implications of black immigrant health for U.S. racial disparities in health

This paper contributes to a growing understanding of U.S. black-white health disparities by using national-level data to disaggregate the health status of black Americans into the following subgroups: U.S.-born blacks, black immigrants from Africa, black immigrants from the West Indies, and black immigrants from Europe. Using new data on the 2000 and 2001 National Health Interview Surveys (NHIS), the authors compare the status of U.S.- and foreign-born blacks to that of U.S.-born whites on three measures of health. The analysis finds that U.S.-born and European-born blacks have worse self-rated health, higher odds of activity limitation, and higher odds of limitation due to hypertension compared to U.S.-born whites. In contrast, African-born blacks have better health than U.S.-born whites on all three measures, while West Indian-born blacks have poorer self-rated health and higher odds of limitation due to hypertension but lower odds of activity limitation. These findings suggest that grouping together foreign-born blacks misses important variations within this population. Rather than being uniform, the black immigrant health advantage varies by region of birth and by health status measure. The authors conclude by exploring the implications of these findings for researchers, health professionals, and public policy.     

Anxiety and depression symptoms in arterial hypertension: the influence of antihypertensive treatment. The HUNT study, Norway

Antihypertensive drugs have been suggested to modulate symptoms of depression and anxiety. It is disputed whether this is due to the hypertension per se, its treatment, or both. The aim of this study was to investigate these associations in a large population sample. 55,472 participants in the Nord-Tr?ndelag Health Study (HUNT 2, 1995–1997), Norway, who completed the Hospital Anxiety and Depression rating Scale, were divided into 3 groups according to their diastolic blood pressure and antihypertensive treatment status. A cut-off of ≥90 mmHg diastolic blood pressure was used to identify hypertensive status. Differences in anxiety and depression symptom levels in untreated and treated hypertensives (all treatments) versus the normotensive reference group were explained by differences in age and gender distribution in the three groups in this study. However, the receipt of two or more antihypertensive drugs was associated with depressive symptoms alone (OR = 1.40, 95% CI = 1.03–1.90), but not with symptoms of anxiety (OR = 1.14, 95% CI = 0.83–1.57) or mixed anxiety and depression (OR = 1.19, 95% CI = 0.82–1.72) in the fully adjusted model, compared to untreated hypertension. Antihypertensive monotherapy (all agents) nor any single antihypertensive drug class were associated with symptoms of depression, anxiety, or mixed anxiety and depression. There may be a positive association between multi antihypertensive drug use and symptoms of depression, whereas this was not found in persons with symptoms of anxiety or mixed anxiety and depression. This might reflect poor antihypertensive treatment adherence leading to polypharmacy, or other unfavorable health behaviors in people with symptoms of pure depression.     

Very Preterm Birth is Reduced in Women Receiving an Integrated Behavioral Intervention: A Randomized Controlled Trial

This study examines whether an integrated behavioral intervention with proven efficacy in reducing psycho-behavioral risks (smoking, environmental tobacco smoke exposure (ETSE), depression, and intimate partner violence (IPV)) in African-Americans is associated with improved pregnancy outcomes. A randomized controlled trial targeting risks during pregnancy was conducted in the District of Columbia. African-American women were recruited if reporting at least one of the risks mentioned above. Randomization to intervention or usual care was site and risk specific. Sociodemographic, health risk and pregnancy outcome data were collected. Data on 819 women, and their singleton live born infants were analyzed using an intent-to-treat approach. Bivariate analyses preceded a reduced logistical model approach to elucidate the effect of the intervention on the reduction of prematurity and low birth weight. The incidence of low birthweight (LBW) was 12% and very low birthweight (VLBW) was 1.6%. Multivariate logistic regression results showed that depression was associated with LBW (OR = 1.71, 95% CI = 1.12–2.62). IPV was associated with preterm birth (PTB) and very preterm birth (VPTB) (OR 1.64, 95% CI = 1.07–2.51, OR = 2.94, 95% CI = 1.40–6.16, respectively). The occurrence of VPTB was significantly reduced in the intervention compared to the usual care group (OR = 0.42, 95% CI = 0.19-0.93). Our study confirms the significant associations between multiple psycho-behavioral risks and poor pregnancy outcomes, including LBW and PTB. Our behavioral intervention with demonstrated efficacy in addressing multiple risk factors simultaneously reduced VPTB within an urban minority population.     

Genetic polymorphisms of phase I metabolizing enzyme genes,their interaction with lifetime grilled and smoked meat intake,and breast cancer incidence

PurposeTo examine associations between 22 CYP single nucleotide polymorphisms (SNPs) and breast cancer incidence and their interactions with grilled–smoked meat intake, a source of polycyclic aromatic hydrocarbons.MethodsWhite women with first primary in situ or invasive breast cancer (n = 988) and frequency-matched controls (n = 1021) from a population-based study were interviewed to assess lifetime grilled–smoked meat intake. SNPs with minor allele frequencies of greater than 0.05 were selected because of their links to carcinogenesis. We used multivariable unconditional logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsBreast cancer was inversely associated with CYP1A1 rs104C8943 AG + GG genotype (OR = 0.71, 95% CI = 0.50–0.99; vs. AA genotype) and positively associated with CYP1B1 rs10175338 TT genotype (OR = 1.59, 95% CI = 1.12–2.26; vs. GG genotype) and the CYP3A4 rs2242480 CT + TT genotype (OR = 1.25, 95% CI = 1.00–1.56; vs. CC genotype). The sum of the number of “at-risk” alleles for the CYP SNPs was positively associated with breast cancer incidence (4–6 “at-risk” alleles OR = 2.33, 95% CI = 1.37–3.99 vs. 0-1 alleles; P_Trend < .01). We observed multiplicative and additive interactions (P < .05) between grilled–smoked meat intake (low vs. high) with CYP1A1 rs1048943 and CYP1B1 rs10175338 SNPs.ConclusionsPhase I metabolizing enzyme gene SNPs may play a role in breast cancer development and may modify the grilled–smoked meat intake–breast cancer association.