Who tended to continue smoking after cancer diagnosis: the national health and nutrition examination survey 1999--2008

ABSTRACT: BACKGROUND: It has been estimated that there are approximately 12 million cancer survivors in the United States. Continued smoking after a cancer diagnosis is linked to adverse effects among cancer survivors on overall survival, treatment effectiveness, and quality of life. Little is known about who is more likely to quit smoking after his/her cancer diagnosis. The objective of this study is to evaluate factors associated with smoking cessation in cancer survivors, which to date has not been well studied. METHOD: The National Health and Nutrition Examination Survey (NHANES) 1999--2008 surveys were used in this study. A total of 2,374 cancer survivors aged 20 and over with valid smoking status in the NHANES 99--08 survey were included in this study. Among them, 566 cancer survivors who regularly smoked at the time of their cancer diagnosis were included in the analyses. RESULTS: Around 50.6% of cancer survivors smoked regularly prior to their cancer diagnosis and only 36.1% of them quit smoking after their cancer diagnosis. Racial disparity was observed in smoking cessation among cancer survivors. Hispanics (OR = 0.23, 95% CI = 0.10-0.57) were less likely to quit smoking than Whites after their cancer diagnosis. CONCLUSION: Two-thirds of cancer survivors continued smoking after cancer diagnosis. Our study observed that the high risk group of continued smokers among cancer survivors is made up of those who are female, younger, Hispanic, with longer smoking history, underweight or with normal weight and without smoking-related cancer. These findings suggest that smoking cessation for cancer survivors should target on the high risk subgroups.     

Top 10 dietary supplements of korean adults from the 4th Korea national health and nutrition examination survey

The aim of this study is to assess the prevalence, types, and trends of dietary supplement (DS) use. We analyzed the Dietary Supplement Questionnaire data of Korean aged 19 years old or older from the Nutrition Survey of the 4th Korea National Health and Nutrition Survey. Each reported DS was coded based on ingredients according to the 2010 Korean Food and Drug Administration Notification. The prevalence (standard error) of current DS use was 20.6% (0.7) for men, 32.2% (0.7) for women. Those with DS use for longer than two weeks during previous one year were 27.2% (0.7), and 40.2% (0.8), for men and women respectively. Vitamin mineral supplement (221.6/10(3) persons) was the most frequently consumed DS in Korean adults. The trend for DS use in Korean adults is changing as well as increasing.     

Investigation of job-related pesticide exposure in the third national health and nutrition examination survey

The Third National Health and Nutrition Examination Survey gathered health and job data from a sample of the US population. Researchers collected urine samples from a subset of subjects and analyzed it for 12 pesticide residues or metabolites (ie, analytes). They investigated the relationship between the industries and jobs reported and the analytes detected in the urine samples. The authors found an association between several jobs and the concentration for one or more pesticide analytes above the 90th percentile. They applied a job exposure matrix to categorize subjects on their potential for job exposures to pesticides. For the detected analytes, the subjects with the highest potential for occupational exposures to insecticides were more likely to have an analyte concentration above the 90th percentile and to have an average analyte concentration score 30% higher than that of subjects reporting jobs with the lowest exposure potential. These findings indicate that occupational exposure may not be a major source of pesticide exposure among the general population.     

Dietary fiber and C-reactive protein: findings from national health and nutrition examination survey data

A higher intake of dietary fiber may decrease the risk of developing cardiovascular disease. We examined the association between dietary fiber and serum concentration of C-reactive protein (CRP), a possible predictor of cardiovascular events, using data from the National Health and Nutrition Examination Survey 1999-2000. Among 3920 participants > or = 20 y old, dietary fiber intake was inversely associated with serum CRP concentration. The odds ratio (OR) for increased CRP concentration (>3.0 mg/L) was 0.49 (95% CI 0.37-0.65; P for trend < 0.001) for the highest quintile of fiber intake compared with the lowest. Adjustment for age, gender, race, education, smoking, physical activity, BMI, total energy, and fat intake resulted in a slight attenuation (OR 0.59; CI 0.41-0.85; P for trend = 0.006). Excluding participants with cardiovascular conditions, diabetes, or cancer did not alter the results. Our findings indicate that fiber intake is independently associated with serum CRP concentration and support the recommendation of a diet with a high fiber content.     

Discrepancies between self-reported smoking and carboxyhemoglobin: an analysis of the second national health and nutrition survey.

Environmental, self-report, and demographic factors mediated the relationship between self-reported cigarette smoking and carboxyhemoglobin among 2114 smokers and 3918 nonsmokers. Self-reported nonsmokers with carboxyhemoglobin levels between 2% and 3% were more likely to be self-reported ex-smokers, to live in a larger community, and to be younger, less educated, and male than were self-reported nonsmokers with carboxyhemoglobin levels of less than 2%. Self-reported nonsmokers with strong evidence of cigarette consumption (carboxyhemoglobin level greater than 3%) were more likely to be self-reported ex-smokers, younger, less educated, and non-White than were nonsmokers with carboxyhemoglobin levels of less than 2%.     

Anthropometric measurements and survival in older Americans: Results from the third national health and nutrition examination survey

Objectives

The impact of adiposity on mortality in older adults remains controversial. Some reports suggest that measures of general adiposity such as body mass index (BMI) predict better survival. We assessed the relationship between measures of adiposity and mortality in older adults.

Design

Cross-sectional analysis of a population-based sample.

Setting

Non-institutionalized persons in the United States participating in the National Health and Nutrition Examination Surveys III and its linked mortality dataset.

Participants

A subsample of 4,489 non-institutionalized survey participants aged >60 years with measures of body composition using bioimpedance. To account for possible residual confounding, smokers, subjects with heart failure, respiratory disease, kidney disease and cancer were excluded (n=2,920). Data from 1569 subjects were analysed.

Measurements

BMI, waist circumference (WC), waist-hip ratio (WHR), lean mass (LM) and % Body Fat (BF) were classified by tertiles (lowest=referent). Proportional-hazard models evaluated the association of anthropometric indices with overall and cardiovascular mortality.

Results

Mean age was 69.4years, and 265(16.9%) were >80 years. There were 717(47.6%) women and 792 deaths of which 284 [35.9%] were cardiovascular related. Elevated BMI was associated with reduced cardiovascular mortality (HR 0.53 [0.30–0.84]), and remained significant after adjusting for LM (HR 0.54 [0.31–0.93]). Elevated %BF was associated with reduced mortality from cardiovascular causes (HR 0.52 [0.29–0.91]). Low BMI was associated with higher risk of cardiovascular (HR 3.66 [1.25–10.69]) and overall death (HR 2.44 [1.22–4.90]).

Conclusion

Measures of adiposity in older participants are associated with lower mortality from cardiovascular causes that cannot be explained by major known confounders between obesity and mortality. Further studies need to elucidate a possible protective role and interplay between adiposity and skeletal muscle in older adults.     

Social relationships and cardiovascular disease risk factors: findings from the third national health and nutrition examination survey

Objective. Our aim was to study the associations between social relationships and several health behaviors in a national sample of the U.S. population. Methods. Using data from National Health and Nutrition Examination Survey III, which was conducted from 1988 to 1994, we examined the associations between the frequencies of organizational and individual relationships (derived from factor analysis) and cigarette smoking, not having had a blood pressure check during the preceding 12 months, not having had a cholesterol check, not engaging in physical activity, and eating fruits and vegetables fewer than five times per day among men and women aged 18 years and older. Results. After adjusting for age, sex, race, educational attainment, marital status, and employment status, increases in organizational relationships were associated with decreases in all five behaviors: significant inverse linear trends were noted only for smoking and physical activity. For individual relationships, significant inverse linear trends were noted for not having a blood pressure check within the previous 12 months, not having had a cholesterol check, and inadequate fruit and vegetable consumption. For physical inactivity, the shape of the relationship approximated a threshold response. For smoking, a significant positive linear trend was present. Conclusions. These results support findings from previous studies and indicate that social relationships have a beneficial effect on several behaviors that directly or indirectly affect the risk of cardiovascular disease.     

Promotion of dietary carbohydrate as an approach to weight maintenance after initial weight loss: a pilot study

Aim To test a novel approach to weight management based on positive advice to eat more carbohydrate-rich foods.
Methods Twenty-nine overweight/mildly obese male and female volunteers were recruited. For a 2-week period they were required to replace one main meal each day with a serving of breakfast cereal. This was followed by 4 weeks eating adlib on a high-carbohydrate regime. Each subject, who acted as his/her own control, kept a 3-day unweighed food diary at baseline, 2 weeks and 6 weeks. Anthropometric measurements were made at each stage.
Results Twenty-two subjects completed the study. Mean weight loss at 2 weeks was 2.0 kg, a statistically significant reduction, which was maintained at 6 weeks. Significant changes in mean energy intake ( 2.29 MJ day¹), in percentage energy from carbohydrate (+ 8%) and from fat ( 11%) were observed after 2 weeks, and remained significant at the end of the study.
Conclusions The results of this pilot study show that replacing a main meal with breakfast cereal led to moderate weight loss, and a follow-up high-carbohydrate phase enabled weight loss to be sustained. We suggest that this regime has potential for further investigation and that promotion of carbohydrate-rich foods should be part of public health messages for weight control.     

网络成瘾治疗单元的概述

随着互联网的飞速发展，网络成瘾的青少年逐渐增多，网络成瘾严重影响青少年身心健康的成长，成为社会的一大难题，引起了医学家、心理学家、社会学家等的重视，并成为一项极其具有挑战性的工作。多数学者把网络成瘾称为“网络成瘾综合征（intemet addiction disorder，IAD）”，网络成瘾又称病理性互联网使用（pathological internet use，PIU），临床表现为：对网络有一种心理上的依赖感，不断增加上网时间；从上网行为中获得愉快与满足，下网后烦躁不安感；在现实生活中花很少的时间参与社会活动及他人交往；以网上虚拟空间来逃避现实生活环境；     

中国居民2002年营养与健康状况调查

目的 了解中国国民的营养与健康现状。方法 调查目标总体为31个省、自治区、直辖市，采用多阶段分层整群随机抽样方法。调查于2002年开展，包括询问调查、医学体检、实验室检测和膳食调查4个部分。结果 城市居民能量食物来源构成中，谷类食物仅占48．5％，脂肪供能比高达35．0％；农村居民膳食结构趋于合理(61．4％ vs．27．5％)。5岁以下儿童生长迟缓率为14．3％，低体重率为7．8％。3～12岁儿童维生素A缺乏率为9．3％。人群贫血患病率为15．2％。人群超重率为17．6％，肥胖率为5．6％。≥18岁人群高血压患病率为18．8％；糖尿病患病率2．6％；高胆固醇血症、高甘油三酯血症、低高密度脂蛋白胆固醇血症患病率依次为2．9％、11．9％、7．4％。高血压知晓率、治疗率、治疗者控制率分别为30．2％、247％、25．0％。中国人群的营养与健康状况存在较明显的城乡差异以及年龄别差异。结论 中国人群的健康面临双重疾病负担。城乡个体营养与健康水平的差异加大了疾病预防控制工作的难度。     

Impact of smoking and thiocyanate on perchlorate and thyroid hormone associations in the 2001-2002 national health and nutrition examination survey

BACKGROUND: Findings from a recent large study suggest that perchlorate at commonly occurring exposure concentrations may decrease thyroid hormone levels in some women. Decreases in thyroid hormone seen with perchlorate exposure could be even greater in people with concomitant exposure to agents such as thiocyanate that may affect the thyroid by mechanisms similar to those of perchlorate. OBJECTIVES AND METHODS: We used data from the National Health and Nutrition Examination Survey to assess the impact of smoking and thiocyanate on the relationship between urinary per-chlorate and serum thyroxine (T(4)) and thyroid-stimulating hormone (TSH). RESULTS: In women with urinary iodine levels < 100 microg/L, the association between the logarithm of perchlorate and decreased T(4) was greater in smokers [regression coefficient (beta) = -1.66, p = 0.0005] than in nonsmokers (beta = -0.54, p = 0.04). In subjects with high, medium, and low cotinine levels, these regression coefficients were -1.47 (p = 0.0002), -0.57 (p = 0.03), and -0.16 (p = 0.59). For high, medium, and low thiocyanate tertiles they were -1.67 (p = 0.0009), -0.68 (p = 0.09), and -0.49 (p = 0.11). Clear interactions between perchlorate and smoking were not seen with TSH or with T(4) in women with urinary iodine levels > or = 100 microg/L or in men. CONCLUSIONS: These results suggest that thiocyanate in tobacco smoke and perchlorate interact in affecting thyroid function, and this effect can take place at commonly occurring perchlorate exposures. Agents other than tobacco smoke might cause similar interactions, and further research on these agents could help identify people who are particularly susceptible to perchlorate.     

Dietary factors related to hypertension risk in Korean adults-data from the Korean national health and nutrition examination survey III

Regional differences between large cities and rural areas are observed in the Korean National Health and Nutrition Examination Survey (KNHANES). This present study was conducted to evaluate the effect of dietary factors on hypertension risk in Korean populations, especially residents of the Chungcheong province which was not in metropolitan area, using KNHANES III. A total of 544 adults aged ≥ 19 years were placed into either the normotensive or the hypertensive group. Subject characteristics, BMI, blood pressure, and nutrient intakes were compared between the two groups using a chi-square test and t-test. We estimated odds ratios (ORs) using multiple logistic regression, adjusted for energy intake and selected covariates. There were significant differences in age, education level, alcohol consumption, and BMI between the normotensive and hypertensive groups. We found decreased ORs for the medium versus lowest tertile of calcium intake (multivariate OR = 0.43, 95% CI: 0.21-0.88), for the highest versus lowest tertile of calcium intake (multivariate OR = 0.43, 95% CI: 0.20-0.90) with significant trends in risk (P = 0.040), and for the medium versus lowest tertile of potassium intake (multivariate OR = 0.43, 95% CI: 0.20-0.89). Subjects with the highest sodium/calcium ratio had a 2.10-fold greater risk of hypertension compared to the subject with the lowest, with significant trends in risk (P = 0.002). Adequate calcium and potassium intake should be encouraged and regional differences should be considered in making a healthy plan for hypertension management.     

Prevalence of self-reported hypercholesterolaemia and its relation to dietary habits, in Greek adults; a national nutrition & health survey

Background  

The strong causal role of hypercholesterolaemia on the progression of atherosclerosis and subsequently on the development of cardiovascular disease is well described. Main aim of this study was to evaluate the prevalence of self-reported hypercholesterolaemia and its relation to nutritional habits, in a representative nationwide sample of adult Greek population.     

Mineral intakes of elderly adult supplement and non-supplement users in the third national health and nutrition examination survey

Calcium, iron and zinc are important in many of the body's functions. We report dietary and combined (diet + supplements) intakes for these minerals for elderly supplement and non-supplement users in the United States and the prevalence of inadequate intakes. We calculated usual dietary intakes for adults 60 y and older from third National Health and Nutrition Examination Survey, 1988-94; mineral intakes from supplements and calcium-containing antacids were added to usual dietary intakes. We evaluated iron and zinc intakes using the dietary reference intakes, recommended dietary allowances and estimated average requirements for elderly adults, as well as calcium intakes using the Adequate Intake and the Healthy People 2010 objective. The highest prevalences of inadequate dietary intakes was for calcium (males, 70-75%; females, 87%) and zinc (males, 35-41%; females, 36-45%). Dietary supplements improved intakes, but nearly two-thirds of elderly adults had combined intakes below the calcium objective. Non-Hispanic blacks usually had lower intakes than non-Hispanic whites and higher prevalences of intakes below the standards. Supplement users had significantly higher mean dietary intakes than non-supplement users for all three minerals for total females and non-Hispanic white females (P < 0.05 for each mineral). Many elderly adults had inadequate dietary zinc intakes, and calcium intakes fell below the Healthy People 2010 objective; dietary supplements improved intakes. Even with supplements most older adults still had intakes below the calcium objective, partly because the supplements they took usually contained low doses of calcium. Total female and non-Hispanic white female supplement users were the only groups that had higher dietary intakes than non-supplement users for all three minerals.     

Risk factors of type 2 diabetes among Korean adults: The 2001 Korean national health and nutrition examination survey

This study aimed to identify risk factors for type 2 diabetes (T2D) in Korea, a rapidly changing country. Data of 5,132 adults aged 20-85 were used from the 2001 Korean Health and Nutrition Examination Survey. Multiple logistic regression was carried out to identify risk factors for T2D. Three models were specified: (i) socioeconomic and demographic factors (model 1: age, gender, education, poverty income ratio, employment), (ii) behavioral risk factors and covariates (model 2: obesity, physical activity, smoking, alcohol drinking, dietary quality, family history of T2D, co-morbidity) and (iii) socioeconomic, demographic, and behavioral factors (model 3). The prevalence of T2D was 7.4%. Less education (OR 1.41, 95% CI 1.08-1.84), age (OR 2.19, 95% CI 1.56-3.08 in 40-59 yrs, OR 4.05, 95% CI 2.76-5.95 in 60 yrs + comparing to 20-39 yrs) and abdominal obesity (OR 2.24, 95% CI 1.79-2.82) were risk factors for T2D even after controlling for other factors simultaneously. There was a significant association of T2D with ever smoking (OR 1.34, 95% CI 1.06-1.67). The relationship of age with T2D was modified by gender in model 1 and the relationship of smoking with T2D was modified by obesity in model 2. Less educated, older, obese or ever smokers were more likely to have T2D. Gender mediated the relationship of age, and obesity mediated the relationship of smoking, with T2D. Intervention programs for T2D in Korea should take the interactions among risk factors into account.