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Matthews C.E.,U.S. National Cancer Institute | Cohen S.S.,EpidStat Institute | Fowke J.H.,Vanderbilt University | Han X.,International Epidemiology Institute | And 6 more authors.
American Journal of Epidemiology | Year: 2014

There is limited evidence demonstrating the benefits of physical activity with regard to mortality risk or the harms associated with sedentary behavior in black adults, so we examined the relationships between these health behaviors and cause-specific mortality in a prospective study that had a large proportion of black adults. Participants (40-79 years of age) enrolled in the Southern Community Cohort Study between 2002 and 2009 (n = 63,308) were prospectively followed over 6.4 years, and 3,613 and 1,394 deaths occurred in blacks and whites, respectively. Black adults who reported the highest overall physical activity level (≥32.3 metabolic equivalent-hours/day vs. <9.7 metabolic equivalent-hours/day) had lower risks of death from all causes (hazard ratio (HR) = 0.76. 95% confidence interval (CI): 0.69, 0.85), cardiovascular disease (HR = 0.81, 95% CI: 0.67, 0.98), and cancer (HR = 0.76, 95% CI: 0.62, 0.94). In whites, a higher physical activity level was associated with a lower risk of death from all causes (HR = 0.76, 95% CI: 0.64, 0.90) and cardiovascular disease (HR = 0.69, 95% CI: 0.49, 0.99) but not cancer (HR = 0.95, 95% CI: 0.67, 1.34). Spending more time being sedentary (>12 hours/day vs. <5.76 hours/day) was associated with a 20%-25% increased risk of all-cause mortality in blacks and whites. Blacks who reported the most time spent being sedentary (≥10.5 hours/day) and lowest level of physical activity (<12.6 metabolic equivalent-hours/day) had a greater risk of death (HR = 1.47, 95% CI: 1.25, 1.71). Our study provides evidence that suggests that health promotion efforts to increase physical activity level and decrease sedentary time could help reduce mortality risk in black adults. © The Author 2014.


Moulard O.,Oncology Global Evidence and Value Development | Mehta J.,Sanofi S.A. | Fryzek J.,EpidStat Institute | Olivares R.,Oncology Global Evidence and Value Development | And 2 more authors.
European Journal of Haematology | Year: 2014

Background: Primary myelofibrosis (PMF), essential thrombocythemia (ET), and polycythemia vera (PV) are BCR ABL-negative myeloproliferative neoplasms (MPN). Published epidemiology data are scarce, and multiple sources are needed to assess the disease burden. Methods: We assembled the most recent information available on the incidence and prevalence of myelofibrosis (MF), ET, and PV by conducting a structured and exhaustive literature review of the published peer-reviewed literature in EMBASE and by reviewing online documentation from disease registries and relevant health registries in European countries. The search was restricted to human studies written in English or French and published between January 1, 2000, and December 6, 2012. Results: Eleven articles identified from EMBASE, three online hematology or oncology registries, and two Web-based databases or reports were used to summarize epidemiological estimates for MF, PV, and ET. The incidence rate of MF ranged from 0.1 per 100 000 per year to 1 per 100 000 per year. Among the various registries, the incidence of PV ranged from 0.4 per 100 000 per year to 2.8 per 100 000 per year, while the literature estimated the range of PV incidence to be 0.68 per 100 000 to 2.6 per 100 000 per year. The estimated incidence of ET was between 0.38 per 100 000 per year and 1.7 per 100 000 per year. While a few studies reported on the MPNs' prevalences, it is difficult to compare them as various types of prevalence were calculated (point prevalence vs. period prevalence) and standardization was made according to different populations (e.g., the world population and the European population). Conclusion: There is a wide variation in both prevalence and incidence estimates observed across European data sources. Carefully designed studies, with standardized definitions of MPNs and complete ascertainment of patients including both primary and secondary MFs, should be conducted so that estimates of the population aimed to receive novel treatments for these neoplasms are better understood assist public health planning and provide valuable information about the burden of illness to policy makers, funding agencies, resource planners, healthcare insurers, and pharmaceutical manufacturers. © 2013 John Wiley & Sons A/S.


News Article | November 1, 2016
Site: www.eurekalert.org

Park Ridge, Ill. (November 1, 2016) - On the heels of the 2015 Dietary Guidelines for Americans that placed no daily limit on dietary cholesterol and noted eggs are an affordable, accessible, nutrient-rich source of high quality protein, new research shows eggs are associated with a 12 percent reduction in the risk of stroke, the 5th leading cause of death in the United States. The study is published in the Journal of the American College of Nutrition (1). Researchers report that consumption of up to one egg per day had no association with coronary heart disease (CHD) and a 12 percent reduction of stroke risk. These findings come from a systematic review and meta-analysis of studies dating back between 1982 and 2015, which evaluated relationships between egg intake and coronary heart disease (total of 276,000 subjects) and stroke (total of 308,000 subjects). Principal Investigator on this study, Dr. Dominik Alexander of the EpidStat Institute, Ann Arbor, MI, notes that mechanistic work is needed to understand the connection between egg consumption and stroke risk. However, he theorizes that, "Eggs do have many positive nutritional attributes, including antioxidants, which have been shown to reduce oxidative stress and inflammation. They are also an excellent source of protein, which has been related to lower blood pressure." One large egg boasts 6 grams of high-quality protein and antioxidants lutein and zeaxanthin, found within the egg yolk, as well as vitamins E, D, and A. Alexander's research lends further support to changes in the recently-released 2015 Dietary Guidelines for Americans, which have eliminated dietary cholesterol limits, and now include regular consumption of eggs among lean protein choices (2). It also builds on a 2015 meta-analysis in which dietary cholesterol was shown to have no association with cardiovascular diseases, including coronary artery disease and stroke (3). "This systematic review and meta-analysis underscores prior research, showing the lack of a relationship between eggs and heart disease and now suggests a possible beneficial effect of eating eggs on risk of stroke," Tia M. Rains, PhD, Interim Executive Director of the Egg Nutrition Center, the scientific research arm of the American Egg Board. More information on the nutritional benefits of eggs can be found at The Egg Nutrition Center http://www. . ENC is dedicated to providing accurate information on eggs, nutrition, and health, and sponsors scientific research on these topics. Research grants are openly solicited and reviewed by experts in nutrition research to ensure scientific rigor. Independent scientists guide many of the research projects and provide analysis and interpretation of scientific literature. The ENC is the scientific research arm of the American Egg Board, which uses funds from egg farmers for promotion and research. The U.S. Department of Agriculture provides oversight of its activities. ENC is located in Park Ridge, Ill. Visit http://www. for more information. Through AEB, U.S. egg producers come together, in accordance with statutory authority, to establish, finance and execute coordinated programs, on research, education and promotion--all geared to drive demand for eggs and egg products. AEB and all program activities are funded by U.S. egg producers, subject to USDA approval. Visit http://www. for more information. (1) Alexander DD, Miller PE, Vargas AJ, Weed DL, Cohen SS. Meta-analysis of egg consumption and risk of coronary heart disease and stroke. J Am Coll Nutr. 2016 Oct 6:1-13. (2) U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015-2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Pages 23-25. Available at http://health. . (3) Berger S, Raman G, Vishwanathan R, Jacques PF, Johnson EJ. Dietary cholesterol and cardiovascular disease: a systematic review and meta-analysis. Am J Clin Nutr. 2015;102(2):276-94.


News Article | November 2, 2016
Site: www.biosciencetechnology.com

A systematic review and meta-analysis of studies going back more than three decades linked eating eggs with a 12 percent decrease in the risk of stroke. The findings were published in the Journal of the American College of Nutrition. For the study researchers, led by Dr. Dominik Alexander of the EpidStat Institute analyzed the link between eating eggs and stroke in 308,000 people, as well as coronary heart disease in 276,000 people. They found a daily intake of eggs had no link to coronary heart disease and had benefits related to risk of stroke. More research is needed to understand the mechanism at work behind the consumption of eggs and reduced risk of stroke, but Alexander proposed a possible theory. “Eggs do have many positive nutritional attributes, including antioxidants, which have been shown to reduce oxidative stress and inflammation,” Alexander said in a prepared statement. “They are also an excellent source of protein which has been related to lower blood pressure.” In addition to antioxidants, one egg contains 6 grams of good protein, along with vitamins A, D, and E. The U.S. Department of Health and Human Services and the U.S. Department of Agriculture’s 2015 Dietary Guidelines for Americans recently added eggs to its recommended sources of protein and also removed dietary cholesterol limits.


Nguyen-Nielsen M.,Aarhus University Hospital | Skovbo S.,Aarhus University Hospital | Svaneby D.,Aarhus University Hospital | Pedersen L.,Aarhus University Hospital | And 2 more authors.
European Journal of Medical Genetics | Year: 2013

X-linked hypohidrotic ectodermal dysplasia (XLHED) is characterised by hypohidrosis, sparse hair, and teeth abnormalities. Infants with XLHED have an increased risk of death by hyperpyrexia. XLHED is the most common form of hypohidrotic ectodermal dysplasia (HED); however, no population-based prevalence estimates are available. We aimed to: 1) estimate the prevalence of XLHED in the Danish population per January 1, 2011; 2) identify the most frequent age at time of diagnosis; and 3) quantify the most frequent clinical feature associated with XLHED. Materials and methods: We conducted a nationwide cross-sectional study (1995-2010). We leveraged national medical registries and data from clinical departments to categorise XLHED cases into three groups: 1) Molecularly-confirmed XLHED; 2) Clinically- diagnosed HED (registered with ICD-10 Q 82.4); and 3) Possible HED (registered with sufficient clinical features based on a clinical algorithm that we designed). Results: We identified 90 molecularly-confirmed XLHED, 146 clinically-diagnosed HED, and 988 possible HED cases between 1995 and 2010 (total n = 1224). The prevalence was 21.9 per 100,000 overall and 1.6 per 100,000 when restricting to molecularly-confirmed XLHED cases. The most frequent age at time of XLHED diagnosis occurred between the ages of 11 and 18 years. Teeth abnormalities occurred in 79% of all cases and 52% of molecularly-confirmed cases as a primary clinical marker. Conclusion: We present the first ever population-based prevalence estimates of XLHED and suggest that the prevalence of XLHED may be higher than previously estimated. Diagnosis occurs most frequently during adolescence and teeth abnormalities were the most frequent clinical marker of XLHED. © 2013 Elsevier Masson SAS.


Hirko K.A.,Harvard University | Kantor E.D.,Harvard University | Cohen S.S.,EpidStat Institute | Blot W.J.,International Epidemiology Institute | And 3 more authors.
American Journal of Epidemiology | Year: 2015

Although much research has been conducted on the role adult body mass index (BMI) plays in mortality, there have been fewer studies that evaluated the associations of BMI in young adulthood and adult weight trajectory with mortality, and it remains uncertain whether associations differ by race or sex. We prospectively examined the relationships of BMI in young adulthood (21 years of age) and adult obesity trajectory with later-life mortality rates among 75,881 men and women in the Southern Community Cohort Study. Study participants were enrolled between 2002 and 2009 at ages 40-79 years and were followed through December, 2011. Multivariable Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals. There were 7,301 deaths in the 474,970 person-years of follow-up. Participants who reported being overweight or obese as young adults had mortality rates that were 19% (95% confidence interval: 12, 27) and 64% (95% confidence interval: 52, 78) higher, respectively, than those of their normal weight counterparts. The results did not significantly differ by race or sex. Participants who reported being obese in young adulthood only or in both young and middle adulthood experienced mortality rates that were 40%-90% higher than those of participants who were nonobese at either time. These results suggest that obesity in young adulthood is associated with higher mortality risk regardless of race, sex, and obesity status in later life. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.


Fryzek J.,EpidStat Institute | Pastula S.,PLLC PLLC | Jiang X.,PLLC PLLC | Garabrant D.H.,EpidStat Institute | Garabrant D.H.,PLLC PLLC
Journal of Occupational and Environmental Medicine | Year: 2013

Objective: Evaluate whether childhood cancer incidence is associated with counties with hydraulic fracturing (HF). Methods: We compared cancer incidence in children in Pennsylvania counties before and after HF drilling began, using standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). Results: The total number of cancers observed was close to expected both before drilling began (SIR = 0.94; 95% CI, 0.90 to 0.99) and after drilling (SIR = 1.02; 95% CI, 0.98 to 1.07) for counties with oil and natural gas wells. Analyses for childhood leukemia were also unremarkable (SIR for leukemia before drilling = 0.97 [95% CI, 0.88 to 1.06]; SIR for leukemia after drilling = 1.01 [95% CI, 0.92 to 1.11]). A slightly elevated SIR was found for central nervous system tumors after drilling (SIR = 1.13; 95% CI, 1.02 to 1.25). This was because of a slight excess in those counties with the fewest number of wells. Conclusions: This study offers comfort concerning health effects of HF on childhood cancers. Copyright © 2013 by American College of Occupational and Environmental Medicine.


Alexander D.D.,EpidStat Institute | Weed D.L.,DLW Consulting Services | Miller P.E.,EpidStat Institute | Mohamed M.A.,Doctors Without Borders
Journal of the American College of Nutrition | Year: 2015

The potential relationship between red meat consumption and colorectal cancer (CRC) has been the subject of scientific debate. Given the high degree of resulting uncertainty, our objective was to update the state of the science by conducting a systematic quantitative assessment of the epidemiologic literature. Specifically, we updated and expanded our previous meta-analysis by integrating data from new prospective cohort studies and conducting a broader evaluation of the relative risk estimates by specific intake categories. Data from 27 independent prospective cohort studies were meta-analyzed using random-effects models, and sources of potential heterogeneity were examined through subgroup and sensitivity analyses. In addition, a comprehensive evaluation of potential dose-response patterns was conducted. In the meta-analysis of all cohorts, a weakly elevated summary relative risk was observed (1.11, 95% CI: 1.03–1.19); however, statistically significant heterogeneity was present. In general, summary associations were attenuated (closer to the null and less heterogeneous) in models that isolated fresh red meat (from processed meat), adjusted for more relevant factors, analyzed women only, and were conducted in countries outside of the United States. Furthermore, no clear patterns of dose-response were apparent. In conclusion, the state of the epidemiologic science on red meat consumption and CRC is best described in terms of weak associations, heterogeneity, an inability to disentangle effects from other dietary and lifestyle factors, lack of a clear dose-response effect, and weakening evidence over time. Key Teaching Points: •The role of red meat consumption in colorectal cancer risk has been widely contested among the scientific community.•In the current meta-analysis of red meat intake and colorectal cancer, we comprehensively examined associations by creating numerous sub-group stratifications, conducting extensive sensitivity analyses, and evaluating dose-response using several different methods.•Overall, all summary associations were weak in magnitude with no clear dose-response patterns.•Interpretation of findings from epidemiologic studies investigating diet and health outcomes involves numerous methodological considerations, such as accurately measuring food intake, dietary pattern differences across populations, food definitions, outcome classifications, bias and confounding, multicollinearity, biological mechanisms, genetic variation in metabolizing enzymes, and differences in analytical metrics and statistical testing parameters. © 2015 The Author(s). Published with license by Taylor & Francis Group, LLC.


Mehta J.,Sanofi S.A. | Wang H.,Sanofi S.A. | Fryzek J.P.,EpidStat Institute | Iqbal S.U.,Sanofi S.A. | Mesa R.,Mayo Clinic Cancer Center
Leukemia and Lymphoma | Year: 2014

Myelofibrosis (MF), polycythemia vera (PV) and essential thrombocythemia (ET) may lead to bone marrow fibrosis. Because the disease course of ET and PV are long and the disease course of MF may be fatal, healthcare resource utilization (HRU) associated costs of these neoplasms are especially important to understand. We used a large US health insurance claim database to describe the costs of these diseases. Compared to age-gender matched comparisons without myeloproliferative neoplasms (MPN), all aspects of HRU that we examined, including inpatient, outpatient and emergency room visits and pharmacy, as well as overall healthcare expenditures, were significantly higher in patients with MF, PV and ET (e.g. MF total costs = $54 168 vs. $10 203; PV = $14 903 vs. $7913; ET = $29 553 vs. $8026) than in matched comparisons. In order to reduce the burden of illness associated with these diseases, continued efforts in the development of more efficacious treatments for these disorders are needed. © 2014 Informa UK, Ltd.


Yurko-Mauro K.,Clinical Research | Alexander D.D.,EpidStat Institute
PLoS ONE | Year: 2015

Introduction: Subjective memory complaints are common with aging. Docosahexaenoic acid (DHA; 22:6 n-3) is a long-chain polyunsaturated fatty acid (LCPUFA) and an integral part of neural membrane phospholipids that impacts brain structure and function. Past research demonstrates a positive association between DHA plasma status/dietary intake and cognitive function. Objectives: The current meta-analysis was designed to determine the effect of DHA intake, alone or combined with eicosapentaenoic acid (EPA; 20:5 n-3), on specific memory domains: episodic, working, and semantic in healthy adults aged 18 years and older. A secondary objective was to systematically review/summarize the related observational epidemiologic literature. Methods: A systematic literature search of clinical trials and observational studies that examined the relationship between n-3 LCPUFA on memory outcomes in healthy adults was conducted in Ovid MEDLINE and EMBASE databases. Studies of subjects free of neurologic disease at baseline, with or without mild memory complaints (MMC), were included. Random effects meta-analyses were conducted to generate weighted group mean differences, standardized weighted group mean differences (Hedge's g), z-scores, and p-values for heterogeneity comparing DHA/EPA to a placebo. A priorisub-group analyses were conducted to evaluate the effect of age at enrollment, dose level, and memory type tested. Results: Episodic memory outcomes of adults with MMC were significantly (P<.004) improved with DHA/EPA supplementation. Regardless of cognitive status at baseline, > 1 g/day DHA/EPA improved episodic memory (P<.04). Semantic and working memory changes from baseline were significant with DHA but no between group differences were detected. Observational studies support a beneficial association between intake/blood levels of DHA/EPA and memory function in older adults. Conclusion: DHA, alone or combined with EPA, contributes to improved memory function in older adults with mild memory complaints. © 2015 Yurko-Mauro et al.

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