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oai:open-archive.highwire.org:amjepid:138/4/2052015-05-11HighWireOUPamjepid:138:4
Associations between Changes in Physical Activity and Risk Factors for Coronary Heart Disease in a Community-based Sample of Men and Women: The Stanford Five-City Project
Young, Deborah Rohm
Haskell, William L.
Jatulis, Darius E.
Fortmann, Stephen P.
ORIGINAL CONTRIBUTIONS
Aerobic exercise training studies involving volunteers generally result in an improved cardiovascular risk factor profile. Little is known, however, about associations between physical activity change and risk factor change in a more representative sample, such as a community. This investigation evaluated correlations between a composite physical activity change score and change in cardiovascular risk factors from 1979 to 1985 in the cohort sample of the Stanford Five-City Project. Men (<it>n</it> = 380) and women (<it>n</it> = 427) between the ages of 18 and 74 years were evaluated for change in self-reported physical activity and change in total cholesterol, high density lipoprotein cholesterol (HDL cholesterol), systolic blood pressure, resting pulse rate, and body mass index (weight (kg)/height (m)2). For men, improvement in the composite physical activity score significantly correlated with an increase in HDL cholesterol (<it>r</it> = 0.14, <it>p</it> = 0.005) and decreases in body mass index (<it>r</it> = −0.16,<it>p</it> = 0.001) and estimated 10-year coronary heart disease risk score (<it>r</it> = −0.10,<it>p</it> = 0.056). For women, improvement in the physical activity score was associated with changes in HDL cholesterol (<it>r</it> = 0.11 ,<it>p</it> = 0.028) and resting pulse rate (<it>r</it> = −0.15, <it>p</it> = 0.001). These data demonstrate that an increase in physical activity over 5 years is favorably associated with changes in major cardiovascular disease risk factors in men and women and support the public hearth efficacy of community-wide promotion of physical activity. <it>Am J Epidemiol</it> 1993; 138:205–16.
Oxford University Press
1993-08-15 00:00:00.0
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Copyright (C) 1993, Oxford University Press
oai:open-archive.highwire.org:amjepid:138/4/2172015-05-11HighWireOUPamjepid:138:4
Dietary Fat and Sports Activity as Determinants for Age at Menarche
Merzenich, Hiltrud
Boeing, Heiner
Wahrendorf, Jürgen
ORIGINAL CONTRIBUTIONS
A prospective study (1985–1991) was conducted to evaluate the role of nutrition, physical activity, and other life-style factors for the age at menarche, a known breast cancer risk factor. In 1988–1989, a total of 261 girls, aged 8–15 years, from a nationwide representative nutrition and activity survey (1985–1988) responded additionally to a mailed questionnaire on personal maturation and anthropometric data, physical activity, and information about nutritional habits, measured by a short food-frequency questionnaire. All girls without menarche at the time of questionnaire mailing were observed for 2 years or until the event of menarche. At the end of the follow-up period, 79% of the girls had experienced menarche. The survey and questionnaire data were analyzed for their relation to age at menarche using Cox's proportional hazards method. After excluding participants with largely deviating measurements between survey and questionnaire, the increased energy-adjusted fat intake was associated with accelerated menarche (relative risk = 2.1; 95% confidence interval 1.1–4.0; lowest vs. highest quartile), while increased sports activity was associated with a delay in menarche (relative risk = 0.3; 95% confidence interval 0.1–0.5; lowest vs. highest quartile). Parameters of physical development such as body weight or body fatness were found to be predictors of menarche. The study provides evidence that dietary effects on breast cancer risk might be indirect by influencing hormonal events like the age at menarche. <it>Am J Epidemiol</it> 1993; 138:217–24.
Oxford University Press
1993-08-15 00:00:00.0
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Copyright (C) 1993, Oxford University Press
oai:open-archive.highwire.org:amjepid:138/4/2252015-05-11HighWireOUPamjepid:138:4
Alcohol and Nutrients in Relation to Colon Cancer in Middle-aged Adults
Meyer, François
White, Emily
ORIGINAL CONTRIBUTIONS
A population-based case-control study was conducted from 1985 to 1989 in western Washington State to assess the relation between nutrients and the incidence of colon cancer in men and women aged 30–62. A food frequency questionnaire was used to document the usual diet 7 years before diagnosis for 424 cases and at a similar time for 414 controls. Alcohol consumption was strongly related to the risk of colon cancer in both men and women, with age-adjusted odds ratios (ORs) of colon cancer = 1.0, 1.9, 1.7, and 2.6 for 0, <10, 10–29, and >30 g/day intake for men and adjusted odds ratios = 1.0, 1.3, 1.8, and 2.5 for the same categories for women. The trend odds ratio associated with a one-category increment in the four-level alcohol consumption variable was 1.3 (95% confidence interval (CI) 1.0–1.5) in men and 1.4 (95% CI 1.0–1.7) in women. For both sexes, higher dietary fiber intakes were associated with lower relative risks for colon cancer, with age-, energy-, and alcohol-adjusted odds ratios = 1.0, 0.9, 0.8, and 0.6 across quartiles of consumption for men (trend OR for a one-quartile increment = 0.8, 95% CI 0.7–1.1) and adjusted odds ratios = 1.0, 0.9, 0.5, and 0.5 for women (trend OR = 0.8, 95% CI 0.6–1.0). In men, this was mostly attributable to intake of cereal fiber (trend OR = 0.8,95% CI 0.6–1.0) while, in women, this association mostly reflected the effect of fruit fiber (trend OR = 0.8, 95% CI 0.6–0.9) and vegetable fiber (trend OR = 0.8, 95% CI 0.7–1.0). Calcium was associated with a decreased risk of colon cancer among women only (adjusted OR across quartiles = 1.0, 0.5, 0.6, 0.3; trend OR = 0.7, 95% CI 0.6–1.0). There was no indication of an association between colon cancer and fat or protein consumption or dietary vitamins. <it>Am J Epidemiol</it> 1993;138:225–36.
Oxford University Press
1993-08-15 00:00:00.0
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oai:open-archive.highwire.org:amjepid:138/4/2372015-05-11HighWireOUPamjepid:138:4
Can Men Be Trusted? A Comparison of Pregnancy Histories Reported by Husbands and Wives
Fikree, Fariyal F.
Gray, Ronald H.
Shah, Farida
ORIGINAL CONTRIBUTIONS
Agreement between pregnancies and pregnancy outcomes reported by husbands and wives was assessed in a sample of 857 couples interviewed between June 1989 and July 1990. The respondents were men employed in a semiconductor manufacturing plant in Burlington, Vermont, and their wives. The wives' reports were used as the standard against which the husbands' reproductive histories were evaluated. Measures included sensitivity, specificity, and percentage of agreement. Reports were considered to be congruent if an outcome reported by the husband agreed with the outcome reported by the wife within a period of �6 months. Although men and women reported similar numbers of livebirths (1,478 and 1,500, respectively), men tended to misreport the timing of events; therefore, complete agreement on the numbers and dates of births was only 88.5%. Men also misreported the prevalence of low birth weight (sensitivity, 74%). Specificity was poorer for the younger (<35 years) and less educated (≤12 years) respondents. Husbands' reports of spontaneous abortions had lower sensitivity (71.2%) than their reports of livebirths, particularly among the better educated (66.9%). Induced abortions were frequently omitted by the husbands (sensitivity, 35.1%), and events such as stillbirths or tubal pregnancies were too few in number to permit meaningful analysis. It is concluded that husbands' misreporting of their wives' reproductive histories may be substantial and sufficient to compromise the validity of epidemiologic studies. It would, therefore, be prudent to avoid the use of husbands as proxy informants of their wives' reproductive histories. <it>Am J Epidemiol</it> 1993; 138:237–42.
Oxford University Press
1993-08-15 00:00:00.0
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oai:open-archive.highwire.org:amjepid:138/4/2432015-05-11HighWireOUPamjepid:138:4
Effect of Fecal Contamination on Diarrheal Illness Rates in Day-Care Centers
Laborde, Danielle J.
Weigle, Kristen A.
Weber, David J.
Kotch, Jonathan B.
ORIGINAL CONTRIBUTIONS
Contact spread of enteropathogens in day-care centers is supported by the recovery (presence vs. absence) of fecal conforms from hands and day-care center fomites. This prospective study was conducted to determine what, if any, quantitative measures of fecal conforms predict the risk of diarrhea among day-care center attendees. Diarrheal illness without concomitant respiratory symptoms was monitored among 221 children aged <3 years in 37 classrooms (24 day-care centers) through biweekly parental telephone interviews from October 1988 to May 1989 in Cumberland County, North Carolina. The risk of diarrhea was expressed as new episodes/classroom-fortnight. Contamination was expressed as the log<inf>10</inf> fecal coliform count per unit of surface area, per toy, and per child and staff hands. Significant predictors of diarrheal risk were any hand contamination (<it>p</it> = 0.003) and the number of contaminated moist sites (hands, faucets, and sinks) (<it>p</it> = 0.006). After adjusting for the child/staff ratio using weighted multiple regression, the authors found that classrooms with either any hand contamination (<it>p</it> = 0.0015) or contamination on all moist sites (<it>p</it> = 0.015) had a significant twofold increased rate of diarrhea compared with classrooms without contamination. This was the first study to demonstrate an increased risk of diarrhea associated with fecal contamination and the frequent sink contamination in day-care centers. <it>Am J Epidemiol</it> 1993;138:243/55.
Oxford University Press
1993-08-15 00:00:00.0
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oai:open-archive.highwire.org:amjepid:138/4/2562015-05-11HighWireOUPamjepid:138:4
Composite Risk Score for Kaposi's Sarcoma Based on a Case-Control and Longitudinal Study in the Multicenter AIDS Cohort Study (MACS) Population
Armenian, Haroutune K.
Hoover, Donald R.
Rubb, Susan
Metz, Sharon
Kaslow, Richard
Visscher, Barbara
Chmiel, Joan
Kingsley, Lawrence
Saah, Alfred
ORIGINAL CONTRIBUTIONS
The possibility that an agent in addition to human immunodeficiency virus type 1 may be involved in the etiology of Kaposi's sarcoma in acquired immunodeficiency syndrome (AIDS) patients was investigated between 1984 and 1992 in this nested case-control analysis from the Multicenter AIDS Cohort Study (MACS) of homosexual and bisexual men. A total of 316 cases of Kaposi's sarcoma were identified and compared with 510 participants with AIDS and no evidence of cancer. More of the Kaposi's sarcoma cases were from Los Angeles and used a higher number of recreational drugs. The Kaposi's sarcoma cases were also more active sexually. There was a dose-response relation between Kaposi's sarcoma and the number of sexual partners, with an odds ratio of 2 between the most and least sexually active subgroups. The odds ratio for Kaposi's sarcoma increased to 4.18 (95% confidence interval 1.29–14.1) in the presence of a history of five infections. Hepatitis and gonorrhea contributed the most to this relation. The various observed odds ratios did not change after multivariate adjustment for the other risk factors. A model was developed combining all predictive associations into a composite risk score ranging from one to 12 and based on history of infections, sexual activity, use of poppers/nitrites, and having had sexual partners from the West Coast of the United States. The subgroup with the highest scores, compared to the subgroup with the lowest score, had an odds ratio of 8.93 (95% confidence interval 3.21–30.44) for Kaposi's sarcoma. A longitudinal proportional hazards analysis among all 2,190 human immunodeficiency virus type 1 -seroprevalent men at study entry, based on this risk score and CD4 cells at baseline, confirmed these findings. Identifying these specific subgroups that are at high and low risk for Kaposi's sarcoma will help future investigations to be more focused in their search for an additional etiologic factor for Kaposi's sarcoma in AIDS. <it>Am J Epidemiol</it> 1993; 138:256–65.
Oxford University Press
1993-08-15 00:00:00.0
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oai:open-archive.highwire.org:amjepid:138/4/2662015-05-11HighWireOUPamjepid:138:4
Epidemiologic Analysis of Kaposi's Sarcoma as an Early and Later AIDS Outcome in Homosexual Men
Hoover, Donald R.
Black, Cynthia
Jacobson, Lisa P.
Martinez-Maza, Otoniel
Seminara, Daniela
Saah, Alfred
Von Roenn, Jamie
Anderson, Roger
Armenian, Haroutune K.
ORIGINAL CONTRIBUTIONS
The authors separately studied the epidemiology (risk and risk factors) of Kaposi's sarcoma occurring as an initial acquired immunodeficiency syndrome (AIDS) outcome (earty Kaposi's sarcoma) and later after a different initial AIDS outcome (later Kaposi's sarcoma) in a cohort of 2,591 human immunodeficiency virus type 1-infected gay men of the Multicenter AIDS Cohort Study between 1984 and 1992. Among 844 AIDS cases, 202 presented with early Kaposi's sarcoma, 101 subsequently developed later Kaposi's sarcoma, and 541 were not diagnosed with Kaposi's sarcoma. Overall, 37.4% of AIDS cases were diagnosed with Kaposi's sarcoma prior to death. Kaposi's sarcoma diagnosed on the skin was significantly more common with early Kaposi's sarcoma (77.3%) than with later Kaposi's sarcoma (65.1%). Men presenting with an AIDS outcome other than Kaposi's sarcoma were at high risk for later Kaposi's sarcoma. Later Kaposi's sarcoma onset in men with a previous AIDS outcome was associated with the following characteristics: 1) lower immune status prior to AIDS and 2) longer post-AIDS survival. A Kaposi's sarcoma diagnosis in a man with a previous AIDS illness approximately doubled the risk (hazard) for death. Histories of urethral gonorrhea and scabies prior to study entry were more common in early Kaposi's sarcoma cases than in later Kaposi's sarcoma cases. However, self-reported sexual activity at study entry and prior to AIDS onset was highest in the later Kaposi's sarcoma group. In this cohort, cigarette smoking had a <it>protective</it> association against all Kaposi's sarcoma in univariate and multivariate models. Only 21.0% of the later Kaposi's sarcoma and 25.0% of the early Kaposi's sarcoma men smoked at least one-half pack of cigarettes daily at study entry compared with 33.8% of non-Kaposi's sarcoma and 35.5% of seroprevalent men still AIDS free. The reasons for this surprising association are unclear. However, other evidence which documents that habitual smoking alters the immune system (and possibly cytokine levels) in ways that could perhaps influence Kaposi's sarcoma pathogenesis should be considered. <it>Am J Epidemiol</it> 1993; 138:266–78.
Oxford University Press
1993-08-15 00:00:00.0
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oai:open-archive.highwire.org:amjepid:138/4/2792015-05-11HighWireOUPamjepid:138:4
ERRATUM
ERRATUM
Allison Hodge notes an error in her recent paper coauthored with Dr. Gary K. Dowse, Veronica R. Collins, and Dr. Paul Z. Zimmet (Hodge AM, Dowse GK, Collins VR, et al. Abnormal glucose tolerance and alcohol consumption in three populations at high risk of non-insulin-dependent diabetes mellitus. Am J Epidemiol 1993; 137:178–89). Hodge states that, on page 186, the results for males have been duplicated for females in table 4. The complete and corrected table 4 appears below. The authors apologize for not noticing this error in proof.
Oxford University Press
1993-08-15 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/138/4/279
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Copyright (C) 1993, Oxford University Press