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Castro-Quezada I.,University of Granada | Artacho R.,University of Granada | Molina-Montes E.,Campus Universitario Of La Cartuja | Molina-Montes E.,CIBER ISCIII | And 2 more authors.
European Journal of Nutrition | Year: 2015

Purpose: To examine the association between dietary glycaemic index (GI) and dietary glycaemic load (GL) with cardiovascular disease (CVD) risk factors in a rural elderly population. Methods: A cross-sectional study was conducted in 343 subjects (60–74 years) residing in a Spanish rural area (Priego de Córdoba). Subjects were selected using stratified random sampling. Food intake was assessed using a validated food frequency questionnaire (FFQ). We assigned GI values to each item of the FFQ to estimate dietary GI and GL. Multivariate linear regression models were fitted to assess the association between GI/GL with CVD risk factors (blood glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, apolipoprotein A1, body mass index, waist circumference and blood pressure). The potential modifying effect of sex, smoking status, diabetes and medication has been explored. Results: A statistically significant inverse association between dietary GI and blood glucose was found in the multivariate model (p = 0.029): for every 10 unit increment of GI, serum glucose levels decreased by 0.2 units. However, statistical significance was lost after controlling for diabetes or hypoglycaemic medication. In the crude model, dietary GL was associated with triglycerides (ß for every 10 GL units increase = 0.70, p = 0.005), but statistical significance was lost in the multivariate model (p = 0.508). No associations were found between dietary GI/GL and the rest of the variables studied. Conclusions: Neither dietary GI nor GL were associated with CVD risk factors in the study population of Priego de Córdoba. Results obtained suggest the necessity to consider the diagnosis of diabetes in these studies. © 2014, Springer-Verlag Berlin Heidelberg.

Curiel-Balsera E.,University of Malaga | Curiel-Balsera E.,Coronary Unit | Munoz-Bono J.,University of Malaga | Olea-Jimenez V.,University of Malaga | And 6 more authors.
Minerva Anestesiologica | Year: 2015

Background. Statin use prior to cardiac surgery has been reported to improve outcomes in the postoperative period because of other effects apart from decreasing lipid levels. Objective of the study was to analyse mortality and acute renal failure (ARF) during the cardiac surgery postoperative period in patients treated with or without statins. Methods. This prospective cohort study comprised adult patients who underwent cardiac surgery at 11 institutions in the Andalusian community from March 2008 to July 2012 included in the ARIAM adult cardiac surgery project. We performed a first analysis in the whole cohort and in a second analysis statin users prior to surgery were pair matched with non-users according to their propensity score based on demographics, comorbidities, medication and surgical data. We analysed differences in outcomes, ARF, need for renal replacement therapy (RRT) and a composite end point with mortality or major morbidity in both groups. Results. The study included 7276 patients, of whom 3749 were treated with statins. Overall, hospital mortality was 10.1%, 10.5% developed ARF and 2.5% required RRT. In the whole non-matched cohort, statins were associated with lower hospital mortality (OR 0.79; 95% CI, 0.67-0.93) and less ARF (OR 0.79; 95% CI, 0.68-0.93). However, after propensity score analysis in the matched cohort of 3056 patients (1528 in each group), statin use was not consistently associated with less ARF (OR 0.94; 95% CI, 0.74-1.19), hospital mortality (OR 0.83; 95% CI, 0.68-1.1) or composite outcome (OR 0.857; 95% CI, 0.723-1.015). Conclusion. Despite better outcomes for the statin users in the whole cohort, the matched analysis showed that statin use before cardiac surgery was not associated with a lower risk of ARF. Nor was presurgery statin use associated with lower hospital mortality. © 2015 edizioni minerva medica.

Li K.,German Cancer Research Center | Husing A.,German Cancer Research Center | Fortner R.T.,German Cancer Research Center | Tjonneland A.,Danish Cancer Society | And 38 more authors.
British Journal of Cancer | Year: 2015

Background: Ovarian cancer has a high case-fatality ratio, largely due to late diagnosis. Epidemiologic risk prediction models could help identify women at increased risk who may benefit from targeted prevention measures, such as screening or chemopreventive agents. Methods: We built an ovarian cancer risk prediction model with epidemiologic risk factors from 202 206 women in the European Prospective Investigation into Cancer and Nutrition study. Results: Older age at menopause, longer duration of hormone replacement therapy, and higher body mass index were included as increasing ovarian cancer risk, whereas unilateral ovariectomy, longer duration of oral contraceptive use, and higher number of full-term pregnancies were decreasing risk. The discriminatory power (overall concordance index) of this model, as examined with five-fold cross-validation, was 0.64 (95% confidence interval (CI): 0.57, 0.70). The ratio of the expected to observed number of ovarian cancer cases occurring in the first 5 years of follow-up was 0.90 (293 out of 324, 95% CI: 0.81-1.01), in general there was no evidence for miscalibration. Conclusion: Our ovarian cancer risk model containing only epidemiological data showed modest discriminatory power for a Western European population. Future studies should consider adding informative biomarkers to possibly improve the predictive ability of the model. © 2015 Cancer Research UK. All rights reserved.

Kuijsten A.,Wageningen University | Aune D.,Norwegian University of Science and Technology | Aune D.,Imperial College London | Schulze M.B.,German Institute of Human Nutrition | And 47 more authors.
Diabetologia | Year: 2015

Aims/hypothesis: Intake of dietary fibre has been associated with a reduced risk of type 2 diabetes, but few European studies have been published on this. We evaluated the association between intake of dietary fibre and type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study and in a meta-analysis of prospective studies. Methods: During 10.8 years of follow-up, 11,559 participants with type 2 diabetes were identified and a subcohort of 15,258 participants was selected for the case-cohort study. Country-specific HRs were estimated using Prentice-weighted Cox proportional hazards models and were pooled using a random effects meta-analysis. Eighteen other cohort studies were identified for the meta-analysis. Results: In the EPIC-InterAct Study, dietary fibre intake was associated with a lower risk of diabetes (HRQ4 vs Q1 0.82; 95% CI 0.69, 0.97) after adjustment for lifestyle and dietary factors. Similar inverse associations were observed for the intake of cereal fibre and vegetable fibre, but not fruit fibre. The associations were attenuated and no longer statistically significant after adjustment for BMI. In the meta-analysis (19 cohorts), the summary RRs per 10 g/day increase in intake were 0.91 (95% CI 0.87, 0.96) for total fibre, 0.75 (95% CI 0.65, 0.86) for cereal fibre, 0.95 (95% CI 0.87, 1.03) for fruit fibre and 0.93 (95% CI 0.82, 1.05) for vegetable fibre. Conclusions/interpretation: The overall evidence indicates that the intake of total and cereal fibre is inversely related to the risk of type 2 diabetes. The results of the EPIC-InterAct Study suggest that the association may be partially explained by body weight. © 2015, The Author(s).

Muezzinler A.,German Cancer Research Center | Muezzinler A.,A+ Network | Mons U.,German Cancer Research Center | Gellert C.,German Cancer Research Center | And 44 more authors.
American Journal of Preventive Medicine | Year: 2015

Introduction Smoking is known to be a major cause of death among middle-aged adults, but evidence on its impact and the benefits of smoking cessation among older adults has remained limited. Therefore, we aimed to estimate the influence of smoking and smoking cessation on all-cause mortality in people aged ≥60 years. Methods Relative mortality and mortality rate advancement periods (RAPs) were estimated by Cox proportional hazards models for the population-based prospective cohort studies from Europe and the U.S. (CHANCES [Consortium on Health and Ageing: Network of Cohorts in Europe and the U.S.]), and subsequently pooled by individual participant meta-analysis. Statistical analyses were performed from June 2013 to March 2014. Results A total of 489,056 participants aged ≥60 years at baseline from 22 population-based cohort studies were included. Overall, 99,298 deaths were recorded. Current smokers had 2-fold and former smokers had 1.3-fold increased mortality compared with never smokers. These increases in mortality translated to RAPs of 6.4 (95% CI=4.8, 7.9) and 2.4 (95% CI=1.5, 3.4) years, respectively. A clear positive dose-response relationship was observed between number of currently smoked cigarettes and mortality. For former smokers, excess mortality and RAPs decreased with time since cessation, with RAPs of 3.9 (95% CI=3.0, 4.7), 2.7 (95% CI=1.8, 3.6), and 0.7 (95% CI=0.2, 1.1) for those who had quit <10, 10 to 19, and ≥20 years ago, respectively. Conclusions Smoking remains as a strong risk factor for premature mortality in older individuals and cessation remains beneficial even at advanced ages. Efforts to support smoking abstinence at all ages should be a public health priority. © 2015 American Journal of Preventive Medicine.

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