Early age at menarche associated with increased all-cause mortality

The objective was to examine the association between age at menarche and all-cause mortality. A population-based prospective study involving 55,128 Japanese women aged 40–79 years in 1988–1990 and followed up to December 2006 was used. A total of 6,967 deaths occurred during the follow-up. Hazard ratios (HR) and 95% confidence intervals (CI) adjusted for age, smoking and drinking status, exercise, sleeping hours, parity, menopausal status, and body mass index at baseline were calculated by Cox proportional hazards model. The HRs (95% CI) of all-cause mortality were 1.16 (1.01–1.32), 1.01 (0.92–1.11), 1.00, 0.97 (0.90–1.05), 0.98 (0.91–1.05), 0.92 (0.84–1.01), and 1.05 (0.96–1.14) for women with menarche aged 9–12, 13, 14 (referent), 15, 16, 17, 18–20 years, respectively, indicating an inverse J-shaped association (P for quadratic trend <.01). Moreover, women with menarche aged ≤12 years have a significantly high risk of all-cause mortality compared with those with menarche aged ≥13 years (HR 1.17, 95% CI 1.03–1.33). Comparing between women with menarche aged ≤13 years and ≥14 years, those with earlier age at menarche had borderline significantly high risk of all-cause mortality in both comparisons (HR 1.07, 95% CI 0.99–1.15, P = .082). Japanese women with early age at menarche of ≤12 years were associated with increased risk of all-cause mortality and those with late age at menarche of ≥18 years also had a slightly higher mortality risk. These associations were independent of lifestyle, anthropometric, and reproductive factors.     

Obesity but not overweight is associated with increased mortality risk

The association between body mass index (BMI) and survival has been described in various populations. However, the results remain controversial and information from low-prevalence Western countries is sparse. Our aim was to examine this association and its public health impact in Switzerland, a country with internationally low mortality rate and obesity prevalence. We included 9,853 men and women aged 25–74 years who participated in the Swiss MONICA (MONItoring of trends and determinants in CArdiovscular disease) study (1983–1992) and could be followed up for survival until 2008 by using anonymous record linkage. Cox regression models were used to calculate mortality hazard ratios (HRs) and to estimate excess deaths. Independent variables were age, sex, survey wave, diet, physical activity, smoking, educational class. After adjustment for age and sex the association between BMI and all-cause mortality was J shaped (non-smokers) or U shaped (smokers). Compared to BMI 18.5–24.9, among those with BMI ≥ 30 (obesity) HR for all-cause mortality was 1.41 (95% confidence interval: 1.23–1.62), for cardiovascular disease (CVD) 2.05 (1.60–2.62), for cancer 1.29 (1.04–1.60). Further adjustment attenuated the obesity-mortality relationship but the associations remained statistically significant. No significant increase was found for overweight (BMI 25–29.9). Between 4 and 6.5% of all deaths, 8.8–13.7% of CVD deaths and 2.4–3.9% of cancer deaths could be attributed to obesity. Obesity, but not overweight was associated with excess mortality, mainly because of an increased risk of death from CVD and cancer. Public health interventions should focus on preventing normal- and overweight persons from becoming obese.     

Weight loss and all-cause mortality: A propensity score matching cohort study

BackgroundWeight loss was supposed to help with decreasing risk of premature mortality. However, results on this topic remain debatable and limited by study design.ObjectiveThe present study aimed to investigate the association between weight loss and all-cause mortality among US adults with overweight or obesity in a national cohort study by using propensity score matching (PSM) analysis.MethodsA total of 5486 pairs of participants were matched in the National Health and Nutrition Examination Survey (NHANES, 2003–2015) after PSM. Hazard ratios (95% confidence intervals) (HRs (95% CIs)) were employed to evaluate the association between weight loss indicated by long-term weight loss (LTWL) and all-cause mortality by using Cox proportional hazards regression models.ResultsDuring a median follow-up of 6.8 years, 674 participants died from all-cause mortality. In each PSM match, compared with participants with LTWL < 5%, the HRs (95% CIs) for participants with LTWL of 5–9.9% (2877 pairs), 10–14.9% (1315 pairs), and ≥ 15% (1294 pairs) were 1.18 (0.83–1.68) (P = 0.366), 1.65 (1.17–2.34) (P = 0.005), and 1.91 (1.21–3.00) (P = 0.006), respectively. The significant increased risk of all-cause mortality for LTWL ≥ 15% remained among male, female, participants aged ≥ 65 years, without weight loss intention, with non-communicable diseases, and without exceeding estimated energy requirement.ConclusionWeight loss especially for being ≥ 15% should be cautious for US adults with overweight or obesity.     

Individual-level measures of social capital as predictors of all-cause and cardiovascular mortality: a population-based prospective study of men and women in Finland

Individual-level social capital was assessed for prediction of mortality in a nationally representative study population aged 30–99 years at the baseline. A total of 90% of the original sample had participated in a comprehensive health examination (Mini-Finland Health Survey) in 1978–1980. After the first 5 years of the 24-year follow-up period, 1,196 of 3,014 men and 1,280 of 3,689 women died. Individual-level social capital was determined by factor analysis that revealed three factors: residential stability, leisure participation and interpersonal trust. Factor analysis showed a gender difference in leisure social participation. All-cause mortality and cardiovascular mortality were analyzed using Cox proportional hazard models. Adjusted for demographic, life style and biological risk factors, and for health and socio-economic status, leisure participation was associated with reduced all-cause mortality in men (hazard ratio, HR: 0.94; 95% confidence interval, CI: 0.89–1.00). This association seems to be related to economic status in men. Age modifies the effect of interpersonal trust on all-cause mortality in men. In women, leisure participation (HR: 0.96; 95% CI: 0.91–1.00) and interpersonal trust (HR: 0.69; 95% CI: 0.51–0.93) predicted all-cause mortality, and the latter also cardiovascular mortality (HR: 0.93; 95% CI: 0.86–1.00). The associations between individual-level social capital and mortality are gender- and age-related. Understanding the gender and age perspectives appears to be essential for better insight into the interrelations between social capital and health.     

Association between domains of physical activity and all-cause,cardiovascular and cancer mortality

Few studies have investigated the independent effects of domain-specific physical activity on mortality. We sought to investigate the association of physical activity performed in different domains of daily living on all-cause, cardiovascular (CVD) and cancer mortality. Using a prospective cohort design, 4,672 men and women, aged 25–74 years, who participated in the baseline examination of the MONICA/KORA Augsburg Survey 1989/1990 were classified according to their activity level (no, light, moderate, vigorous). Domains of self-reported physical activity (work, transportation, household, leisure time) and total activity were assessed by the validated MOSPA (MONICA Optional Study on Physical Activity) questionnaire. After a median follow-up of 17.8 years, a total of 995 deaths occurred, with 452 from CVD and 326 from cancer. For all-cause mortality, hazard ratios and 95% confidence interval (HR, 95% CI) of the highly active versus the inactive reference group were 0.69 (0.48–1.00) for work, 0.48 (0.36–0.65) for leisure time, and 0.73 (0.59–0.90) for total activity after multivariable adjustments. Reduced risks of CVD mortality were observed for high levels of work (0.54, 0.31–0.93), household (0.80, 0.54–1.19), leisure time (0.50, 0.31–0.79) and total activity (0.75, 0.55–1.03). Leisure time (0.36, 0.23–0.59) and total activity (0.62, 0.43–0.88) were associated with reduced risks of cancer mortality. Light household activity was related to lower all-cause (0.82, 0.71–0.95) and CVD (0.72, 0.58–0.89) mortality. No clear effects were found for transportation activities. Our findings suggest that work, household, leisure time and total physical activity, but not transportation activity, may protect from premature mortality.     

Body Mass Index and Mortality in a Prospectively Studied Cohort of Scandinavian Women: The Women’s Lifestyle and Health Cohort Study

Overweight and obesity increase the risk of numerous chronic diseases, including several forms of cancer. However, the association between excess body weight and all-cause mortality among young and middle-aged women is incompletely known, and the impact of menopausal status on the association has hardly been investigated. We studied prospectively a cohort comprising a population sample of 102,446 women from Norway and Sweden aged 30–50 years when they answered an extensive questionnaire in 1991/1992. During follow-up through year 2000, 1187 women in the cohort died. We used Cox proportional hazard models to estimate multivariate Hazard rate ratios (HRR) with 95% confidence intervals (CI) of death in relation to body mass index (BMI, weight (kg)/height (m²)) at start of follow-up. Both in age-adjusted models and in models adjusting for several variables (including smoking and physical activity) mortality increased with increasing BMI among premenopausal women, whereas a U-shaped relationship was seen among the postmenopausal women. Among premenopausal women obesity (BMI 30.0) doubled the mortality (HRR = 2.2, 95% CI: 1.7–3.0) when compared to women of normal weight (BMI 18.5–24.9), whilst the association was modest after menopause. Although we had limited power to analyze women who were underweight (BMI<18.5), an excess mortality of about 50% was seen among postmenopausal women. No excess risk was found for underweight premenopausal women. The data indicate that the rapidly growing prevalence of obesity in many Western countries will substantially increase premature deaths among young women.     

Body mass index and mortality: results of a cohort of 184,697 adults in Austria

There is still a debate about the role of body mass index (BMI) as a risk factor for all-cause mortality. Most investigations with large sample sizes focused on populations from the United States, studies from Central-European cohorts are not available. We investigated the association between BMI and all-cause mortality and cause-specific mortality within a cohort in Austria. Design of this article is “Cohort study”. The Subjects used were 184,697 men and women (mean age 41.7 ± 15.4 years). Weight and height were measured. Cox proportional hazards models were used to estimate hazard ratios (HR). During a median follow-up of 15.1 years 15,557 deaths (6,077 from cardiovascular disease, 4,443 from cancer and 606 from respiratory disease) were seen. A U-shaped association between BMI and all-cause mortality was observed in men and women. Compared with the reference category (BMI 22.5–24.9 kg/m2) high risks were found both in the highest category of BMI (≥35 kg/m²) with HR of 2.13 (95% CI, 1.82–2.48) in men and 1.60 (95% CI, 1.42–1.81) in women and in the lowest category (<18.5 kg/m2) with HR of 2.57 (95% CI, 2.17–3.05) in men and 1.40 (95% CI, 1.21–1.62) in women. Similar patterns were seen among ever-smokers and non-smokers. Increased mortality with increasing BMI was driven by cardiovascular diseases and to a lesser extent by cancers. Respiratory diseases contributed to mortality in the lowest BMI category independently from smoking status. Underweight and obesity were both associated with higher all-cause mortality in men and women. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Effects of physical activity,body mass index,waist-to-hip ratio and waist circumference on total mortality risk in the Swedish National March Cohort

The health benefits of physical activity (PA) have been well documented. However, there is less research investigating whether or not these health benefits might differ among males and females or among subjects characterized by different levels of body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC). Baseline total PA, BMI, WHR and waist circumference were measured in 14,585 men and 26,144 women who participated in the Swedish National March. Their effects on all-cause mortality were analyzed with a follow-up time of almost 10 years. Sedentary men with a BMI ≥ 30 had a 98% (95% CI: 30–201%) increased risk of mortality compared to normal weight men with a high level of total PA. The same trend was observed for sedentary men with high WHR or waist circumference, compared to lean and highly active men. Sedentary women with a waist circumference of 88 cm or more had almost doubled, i.e. 97% (95% CI: 35–189%) increased mortality risk compared to physically active women with a waist circumference below 80 cm. BMI in men, but waist circumference in women better forecast all-cause mortality. We found no substantial effect modification between different measures of adiposity and physical activity—physical inactivity and obesity seem to increase total mortality risk independently and additively.     

All-cause Mortality and Mortality of Myocardial Infarction for 989 Legally Castrated Men

Background: Male gender is an independent coronary risk factor. Method: Long-term follow-up of 989 Danish men who underwent legal castration between 1929 and 1968. Results: The legally castrated men were unmarried and belonged to social class IV and V more often than were Danish men in general. During the follow-up until 2000, 835 of the 989 (85%) castrated men died, including 148 who died of myocardial infarction. In multiple Poisson regression analyses, the men had a standardized mortality rate (SMR) for all-cause mortality of 1.30 (95% CI: 1.26–1.36) and a SMR for mortality of myocardial infarction of 1.08 (95% CI: 1.04–1.16). Thus, the castrated men had a lower proportion of deaths of myocardial infarction (148/792, 18.7% (95% CI: 16.0–21.6%)) than was expected based on the mortality rates for the Danish male population (136/608, 22.4%). The castrated men had discordant changes for the SMR for all-cause mortality and mortality of myocardial infarction whereas subgroups of the Danish population previously has been found to have concordant changes for the two SMRs. Conclusion: The castrated men had fewer deaths of myocardial infarction than expected, so men may not have increased risk of coronary heart disease from unphysiologically low levels of endogenous androgens. An erratum to this article is available at .     

Five year changes in waist circumference, body mass index and obesity in Augsburg, Germany

Summary Aims To assess temporal changes in body fat distribution, body mass index and obesity in Augsburg, Germany. Methods Waist circumference, weight and height were measured in two independent samples of 4804 and 4792, men and women, aged 25–74 years, in the MONICA Augsburg surveys 1989/90 and 1994/95. Abdominal obesity was defined as waist circumference greater than the 80^th gender-specific percentile (men:103, women: 92 cm) in the 1989/90 population. Obesity was defined as a body mass index (BMI) ≥ 30 kg/m². Results Age-standardized mean waist circumference increased by more than 1 cm (p-value < 0.00003) in both men and women while BMI increased by 0.3–0.4 kg/m² (p-value < 0.01). We observed both a shift to higher values in the waist circumference distribution plus – particularly in women older than 45 years – a substantial right shift in the top of the distribution. Moreover, survey participants in 1994/95 who were at the higher end of the BMI distributions were disproportionately more obese than their respective peers in 1989/90. The prevalence of abdominal obesity rose by 3.3 % in men and 3.6 % in women, while the prevalence of obesity rose by 2 % from 17 % in men and by 2.5 % from 19 % in women. Conclusions While changes in the Augsburg population may not be as alarming as in other countries, the secular increase in waist circumferences in both men and women occurring over a short time period indicates a need for prevention given the already high absolute weight, BMI and waist circumference levels in the population. Received: 8 August 2001, Accepted: 14 November 2001     

Trying to Lose or Maintain Weight During Pregnancy—United States, 2003

Objectives Current pregnancy weight gain recommendations are for women to gain between 15 and 40 pounds; weight loss or weight maintenance is not recommended. However, for many women, overweight and obesity are chronic conditions, and commitment to weight loss or maintenance could override advice to gain weight during pregnancy. Our objective was to determine the prevalence of trying to lose or maintain weight among U.S. women during pregnancy. Methods The Behavioral Risk Factor Surveillance System is a state-based, random-digit-dialed telephone survey of noninstitutionalized, U.S. civilians aged ≥18 years. We identified women aged 18–44 years who reported being pregnant during 2003 (n = 2,464), assessed the prevalence of trying to lose or maintain weight and assessed independent associations with selected demographic, clinical, and behavioral factors using multinomial logistic regression. Results Among women who reported being pregnant, 7.5% (confidence interval [CI] = 5.7–9.8%) and 34.3% (CI = 31.0–37.7%) were trying to lose or maintain weight, respectively. Among women who reported trying to lose or maintain weight, exercise was a more prevalent weight control strategy than dietary change. After adjustment, women who drank alcohol during the past 30 days (Odds ratio [OR] = 8.86, CI: 4.51–17.42) or women who received advice in the past year to lose weight (OR = 9.10, CI: 3.20–25.87) were more likely to report trying to lose weight; women advised to maintain (OR = 0.20, CI: 0.07–0.60) or gain (OR = 0.04, CI: 0.01–0.23) weight were less likely to report trying to lose weight. Conclusions Despite guidelines to gain weight during pregnancy, about 8% and 34% of U.S. pregnant women reported trying to lose or maintain weight, respectively. Providers may encounter an increasing number of pregnant women whose weight control intentions conflict with current guidelines for pregnancy weight gain. Further research in this area is warranted. The conclusions in this report are those of the authors and do not necessarily reflect those of the Centers for Disease Control and Prevention.     

Effects of black and green tea consumption on blood glucose levels in non-obese elderly men and women from Mediterranean Islands (MEDIS epidemiological study)

Background Obesity and diabetes are metabolic disorders that affect a large amount of the elderly population and are related to increased cardiovascular risk. Tea intake has been associated with lower risk of mortality and morbidity in some, but not all studies. We evaluated the association between tea intake, blood glucose levels, in a sample of elderly adults. Methods During 2005–2006, 300 men and women from Cyprus, 142 from Mitilini and 100 from Samothraki islands (aged 65–100 years) were enrolled. Dietary habits (including tea consumption) were assessed through a food frequency questionnaire. Among various factors, fasting blood glucose and body mass index (BMI) were measured. Results Fifty-four percent of the participants reported that they consume tea at least once a week (mean intake 1.6 ± 1.1 cup/day). A significant interaction was observed between tea intake, obesity status on glucose levels (P < 0.001). After adjusting for various confounders, tea intake was associated with lower blood glucose levels in non-obese (P for trend <0.001), but not in obese people (P = 0.24). Multiple logistic regression analysis revealed that moderate tea consumption (1–2 cups/day) was associated with 88% (95% CI 76–98%) lower odds of having diabetes among non-obese participants, irrespective of age, sex, smoking, physical activity status, dietary habits and other clinical characteristics. Conclusion Tea consumption is associated with reduced levels of fasting blood glucose only among non-obese elderly people.     

Differential Mortality Patterns Between Nicaraguan Immigrants and Native-born Residents of Costa Rica

Background This study describes the all-cause and cause-specific mortality of Nicaraguan-born and native-born inhabitants of Costa Rica and examines the influence of socioeconomic and demographic factors on differential mortality risks. Methods We analyzed Costa Rican vital records for the years 1996–2005 with negative binomial regression models to determine the relative mortality risks of Nicaraguan immigrants versus Costa Rican natives with adjustments for age, urbanization, unemployment, poverty, education, and residential segregation. Results Nicaraguan-born men and women had reduced mortality risks of 32% and 34% relative to their Costa Rican-born counterparts. Excess homicide mortality was found among Nicaraguan-born men [rate ratio (RR) = 1.35, 95% CI: 1.19–1.53] and women (RR = 1.41, 95% CI: 1.02–1.95). Discussion The Nicaraguan-born population had a reduced all-cause mortality risk versus Costa Rican-born people over the years 1996–2005, due to markedly lower disease mortality. Homicide is a major source of excess mortality among Nicaraguan-born immigrants versus Costa Rican natives.     

Predictors of non-alcoholic fatty liver in a group of non-obese and non-diabetic Iranian adults

Non-alcoholic fatty liver disease (NAFLD) is not uncommon in non-obese people. We examined the independent predictors of NAFLD in a group of non-obese and non-diabetic men and women in Rasht, Iran. Sixty-one adults aged 38.4 ± 8.4 years (32 men and 29 women) with body mass index (BMI) <30 kg/m² and non-diabetic with clinical features of NAFLD who visited our center between 2007 and 2009 were compared to 147 non-obese, non-diabetic and normal liver subjects (40 men and 107 women) aged 40.8 ± 9.1. Data on blood lipids, anthropometry, fasting blood glucose, exercise, and educational levels were gathered using a questionnaire. Logistic regression analysis revealed that weight gain during adulthood [OR = 1.90 (95% CI = 1.03–1.84), P < 0.04] and high serum triglyceride levels [OR = 1.19 (95% CI = 1.09–1.28), P < 0.0001] were independent predictors of NAFLD in this group of non-obese subjects. BMI, educational levels, gender, and habitual physical activity were not independently related to NAFLD in this study. These data suggest that weight gain after 20 years of age rather than BMI and high levels of triglyceride may serve as screening tool for NAFLD in clinical practice in this population. In nutritional management of these apparently normal weight subjects with NAFLD modest weight loss is necessary.     

Categories of glucose tolerance and continuous glycemic measures and mortality

We investigated the association of undiagnosed diabetes, previously known diabetes and prediabetes (WHO 1999 classification) with all-cause and cause-specific mortality in an older German population. Previous study results for mortality in patients with very low levels of HbA1c, fasting plasma glucose (FPG), and 2-h plasma glucose (2hPG) are still inconclusive. Thus we have extended the analyses to continuous measures of glycemia. A total of 1,466 subjects aged 55–74 years from the population-based KORA survey S4 (conducted from 1999 to 2001) were included in our observational mortality study (152 subjects with previously known diabetes, and 1,314 further subjects who underwent oral glucose tolerance tests). Mortality was followed up for a maximum of 10.0 years (median follow-up 8.8 years). A total of 180 (12.3%) of the 1,466 subjects have died during the follow-up period. The age- and sex-adjusted hazard ratios for all-cause mortality were 2.6 (95%CI, 1.7–3.8) for known diabetes, 2.8 (95%CI, 1.7–4.4) for undiagnosed diabetes, and 1.1 (95%CI, 0.8–1.7) for prediabetes [reference: normal glucose tolerance (NGT)]. After multivariable adjustment, undiagnosed diabetes was associated with 3.0-fold increased cancer mortality, 1.1-fold increased cardiovascular mortality, and 4.7-fold increased non-cancer, non-cardiovascular mortality compared with NGT. For HbA1c, FPG, and 2hPG, J-shaped associations with all-cause mortality were observed. Undiagnosed diabetes is associated with increased all-cause, cancer, and non-cancer non-cardiovascular mortality, but not with cardiovascular mortality in this older population. All-cause mortality in undiagnosed diabetes is similar to that in previously known diabetes but much higher than mortality in prediabetes and NGT.     

Apolipoprotein E gene is related to mortality only in normal weight individuals: The Rotterdam study

Objective To investigate the relationship between the apolipoprotein E (APOE) gene and the risk of mortality in normal weight, overweight and obese individuals. Methods and Results In a population-based study of 7,983 individuals aged 55 years and older, we compared the risks of all-cause and coronary heart disease (CHD) mortality by APOE genotype, both overall and in subgroups defined by body mass index (BMI). We found significant evidence for interaction between APOE and BMI in relation to total cholesterol (p = 0.04) and HDL cholesterol (p < 0.001). Overall, APOE*2 carriers showed a decreased risk of all-cause mortality. Analyses within BMI strata showed a beneficial effect of APOE*2 only in normal weight persons (adjusted hazard ratio (HR) 0.7[95% CI 0.5–0.9]). APOE*2 was not associated with a lower risk of all-cause mortality in overweight or obese persons. The effect of APOE*2 in normal weight individuals tended to be due to the risk of CHD mortality (adjusted HR 0.5 [95% CI 0.2–1.2]). Conclusion The APOE*2 allele confers a lower risk of all-cause mortality only to normal weight individuals.     

Mortality Excess in Individuals with Elevated IgA Anti-Transglutaminase Antibodies: The KORA/MONICA Augsburg Cohort Study 1989–1998

Objectives : Immunoglobulin A (IgA) autoantibodies to tissue transglutaminase (tTG) are commonly used for screening and diagnosing of celiac disease. We examined the hypothesis that elevated IgA anti-tTG antibodies were associated with higher all-cause mortality risk. Methods The cohort, 2333 men and 2300 women, was based on the follow-up of participants of a representative population-based survey in Southern Germany (KORA/MONICA Augsburg project) conducted in 1989–1990. The endpoint for the vital status with cause of death was the year 1998. The sera drawn at baseline and stored at −80 °C, were recently screened with an IgA enzyme-linked immunosorbent assay (ELISA) using human recombinant tTG. Age-standardized mortality rates and age-adjusted hazard ratios were calculated. Results From the 4633 sera analyzed, 63 had an IgA anti-tTG concentration ≥7 AU/ml. Of these 63 individuals, 15 died between 1989 and 1998. The age-adjusted hazard ratio (HR_a) of all-cause mortality was 1.86 (95% CI: 1.01–3.41) and 3.92 (95% CI: 1.44–10.71) for men and women, respectively. The excess of cancer mortality was even higher with an HR_a of 2.47 (95% CI: 0.89–6.83) in men and of 6.65 (95% CI: 2.04–21.63) in women. Conclusions: Individuals with elevated IgA anti-tTG antibodies had a highly increased mortality risk, particularly due to cancer. New studies are necessary to clarify if this increased risk is due to undiagnosed celiac disease or/and if this elevated IgA anti-tTG antibodies level is a marker of serious diseases like cancer, chronic liver disease or end-stage heart failure.     

Effect of coffee consumption on all-cause and total cancer mortality: findings from the JACC study

Coffee consumption is known to be related to various health conditions. Recently, its antioxidant effects have been suggested to be associated with all-cause or cancer mortality by various cohort studies. However, there has been only one small Asian cohort study that has assessed this association. Thus, we tried to assess the association of coffee with all-cause and total cancer mortality by conducting a large-scale cohort study in Japan. A total of 97,753 Japanese men and women aged 40–79 years were followed for 16 years. Hazard ratios and 95% confidence intervals of all-cause and total cancer mortality in relation to coffee consumption were calculated from proportional-hazards regression models. A total of 19,532 deaths occurred during the follow-up period; 34.8% of these deaths were caused by cancer. The all-cause mortality risk decreased with increasing coffee consumption in both men and women, with a risk elevation at the highest coffee consumption level (≥4 cups/day) compared with the 2nd highest consumption level in women, although the number of subjects evaluated at this level was small. No association was found between coffee consumption and total cancer mortality among men, whereas a weak inverse association was found among women. The present cohort study among the Japanese population suggested that there are beneficial effects of coffee on all-cause mortality among both men and women. Furthermore, the results showed that coffee consumption might not be associated with an increased risk of total cancer mortality.     

Psychosocial risk factors, weight changes and risk of obesity: the Copenhagen City Heart Study

The aim of the study was to establish the effects of a range of psychosocial factors on weight changes and risk of obesity. The study population consisted of the 4,753 participants in the third (1991–1994) and fourth wave (2001–2003) of the Copenhagen City Heart Study, Denmark. At baseline the participants were asked comprehensive questions on major life events, work stress, vital exhaustion, social network, economic hardship, and intake of sleep medication. Weight and height were measured by health professionals. Weight changes and incident obesity was used as outcome measures. The participants on average gained 2 kg of weight and 8% became obese during follow-up. The experience of major life events in childhood, work life and adult life was associated with weight gain and obesity in women, but not in men. Vital exhaustion was associated with weight gain in a dose–response manner in men (P = 0.002) and younger women (P = 0.02). Persons with high vital exhaustion gained approximately 2 kg more during follow-up compared to those with no vital exhaustion. Women with high vital exhaustion were also more likely to become obese during follow-up (OR = 2.39; 95% CI: 1.14–5.03). There were no clear patterns in the associations between social network, economic hardship and weight gain or obesity. The number of psychosocial risk factors, as an indicator for clustering, was not associated with weight gain or obesity. In conclusion, major life events and vital exhaustion seem to play a role for weight gain and risk of obesity, especially in women.