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Importance: Prospective studies linking shift work to coronary heart disease (CHD) have been inconsistent and limited by short follow-up.Objective: To determine whether rotating night shift work is associated with CHD risk.Design, Setting, and Participants: Prospective cohort study of 189,158 initially healthy women followed up over 24 years in the Nurses' Health Studies (NHS [1988-2012]: N = 73,623 and NHS2 [1989-2013]: N = 115,535).Exposures: Lifetime history of rotating night shift work (≥3 night shifts per month in addition to day and evening shifts) at baseline (updated every 2 to 4 years in the NHS2).Main Outcomes and Measures: Incident CHD; ie, nonfatal myocardial infarction, CHD death, angiogram-confirmed angina pectoris, coronary artery bypass graft surgery, stents, and angioplasty.Results: During follow-up, 7303 incident CHD cases occurred in the NHS (mean age at baseline, 54.5 years) and 3519 in the NHS2 (mean age, 34.8 years). In multivariable-adjusted Cox proportional hazards models, increasing years of baseline rotating night shift work was associated with significantly higher CHD risk in both cohorts. In the NHS, the association between duration of shift work and CHD was stronger in the first half of follow-up than in the second half (P=.02 for interaction), suggesting waning risk after cessation of shift work. Longer time since quitting shift work was associated with decreased CHD risk among ever shift workers in the NHS2 (P<.001 for trend). [table: see text]Conclusions and Relevance: Among women who worked as registered nurses, longer duration of rotating night shift work was associated with a statistically significant but small absolute increase in CHD risk. Further research is needed to explore whether the association is related to specific work hours and individual characteristics. [ABSTRACT FROM AUTHOR]

The article discusses a prospective cohort study of the relationship between breast cancer risk (BCR) and moderate alcohol consumption during adult life (AL). The authors analyzed BCR data for 105,986 women enrolled in the Nurses' Health Study from 1980 to 2008. They observed that there was a ten percent increase in BCR with every ten grams daily intake of alcohol. They found that binge drinking was linked with BCR after controlling for cumulative alcohol intake (AI). They concluded that AI, both earlier and later in AL, was separately associated with risk.

The article presents a study assessing the relationship between cigarette smoking and cessation on mortality in women. The outcomes measured by a prospective observational study included hazard ratios for total mortality categorized into vascular and respiratory diseases, lung cancer, and other causes. Researchers concluded the risk of vascular mortality due to smoking in women may be rapidly eliminated upon cessation and significantly reduced within 20 years for lung diseases. Delaying the age at which a women starts smoking also reduced the risk for respiratory disease, lung cancer and other smoking-related cancer deaths.

The article presents a medical research study that examined whether single nucleotide polymorphisms in the genes CFH and LOC387715 could be used in the prognosis for the progression of age-related macular degeneration and its associated visual loss. The status of the age-related macular degeneration was determined by the grading of fundus photographs. The primary outcome measured in the study was the incidence rate of dry and neovascular advanced age-related macular degeneration. The authors found that polymorphisms in the genes CFH and LOC387715 are independently related to the progression of age-related macular degeneration.

The article presents a study done by physicians on the influence of sleep deprivation on interns in their first year of postgraduate medical training. The article reports that lack of sleep induced by repeated extended-duration work shifts increase the risk of medicinal failures, such as the transmission of blood-borne pathogens including hepatitis and human immunodeficiency viruses. The study also assesses nighttime risks of percutaneous injuries in comparison with daytime risks. The article includes statistics and analysis from the study.

The article reports on a study which looked at whether adult weight change affected the risk of postmenopausal breast cancer. Researchers found that women who gained weight later in life, especially after menopause, had an increased risk of breast cancer. Weight loss after menopause was found to be associated with a decreased risk.

Context Reduced intake of saturated fat is widely recommended for prevention of cardiovascular disease. The type of macronutrient that should replace saturated fat remains uncertain. Objective To compare the effects of 3 healthful diets, each with reduced saturated fat intake, on blood pressure and serum lipids. Design, Setting, and Participants Randomized, 3-period, crossover feeding study (April 2003 to June 2005) conducted in Baltimore, Md, and Boston, Mass. Participants were 164 adults with prehypertension or stage 1 hypertension. Each feeding period lasted 6 weeks and body weight was kept constant. Interventions A diet rich in carbohydrates; a diet rich in protein, about half from plant sources; and a diet rich in unsaturated fat, predominantly monounsaturated fat. Main Outcome Measures Systolic blood pressure and low-density lipoprotein cholesterol. Results Blood pressure, low-density lipoprotein cholesterol, and estimated coronary heart disease risk were lower on each diet compared with baseline. Compared with the carbohydrate diet, the protein diet further decreased mean systolic blood pressure by 1.4 mm Hg (P = .002) and by 3.5 mm Hg (P = .006) among those with hypertension and decreased low-density lipoprotein cholesterol by 3.3 mg/dL (0.09 mmol/L; P = .01), high-density lipoprotein cholesterol by 1.3 mg/dL (0.03 mmol/L; P = .02), and triglycerides by 15.7 mg/dL (0.18 mmol/L; P<.001). Compared with the carbohydrate diet, the unsaturated fat diet decreased systolic blood pressure by 1.3 mm Hg (P = .005) and by 2.9 mm Hg among those with hypertension (P = .02), had no significant effect on low-density lipoprotein cholesterol, increased high-density lipoprotein cholesterol by 1.1 mg/dL (0.03 mmol/L; P = .03), and lowered triglycerides by 9.6 mg/dL (0.11 mmol/L; P = .02). Compared with the carbohydrate diet, estimated 10-year coronary heart disease risk was lower and similar on the protein and unsaturated fat diets. Conclusion In the setting of a healthful diet, partial substitution of carbohydrate with either protein or monounsaturated fat can further lower blood pressure, improve lipid levels, and reduce estimated cardiovascular risk. Clinical Trials Registration ClinicalTrials.gov Identifier: NCT00051350. [ABSTRACT FROM AUTHOR]

Context: The effect of fish consumption or long-chain omega-3 polyunsaturated fatty acid (PUFA) intake on risk of stroke remains uncertain. Objective: To examine the relation of fish consumption and long-chain omega-3 PUFA intake and risk of stroke in men. Design and Setting: The Health Professional Follow-up Study, a US prospective cohort study with 12 years of follow-up. Participants: A total of 43 671 men aged 40 to 75 years who completed a detailed and validated semiquantitative food frequency questionnaire and who were free of cardiovascular disease at baseline in 1986. Main Outcome Measure: Relative risk (RR) of stroke by subtype based on cumulative average fish consumption or long-chain omega-3 PUFA intake, ascertained in 1986, 1990, and 1994. Results: We documented 608 strokes during the 12-year follow-up period, including 377 ischemic, 106 hemorrhagic, and 125 unclassified strokes. Compared with men who consumed fish less than once per month, the multivariate RR of ischemic stroke was significantly lower among those who ate fish 1 to 3 times per month (RR, 0.57; 95% confidence interval [CI], 0.35-0.95). However, a higher frequency of fish intake was not associated with further risk reduction; the RR was 0.54 (95% CI, 0.31-0.94) for men who consumed fish 5 or more times per week. This lack of linearity was confirmed by spline analyses. By dichotomized fish intake, the multivariate RR for men who consumed fish at least once per month compared with those who ate fish less than once per month was 0.56 (95% CI, 0.38-0.83) for ischemic stroke and 1.36 (95% CI, 0.48-3.82) for hemorrhagic stroke. The inverse association between fish intake and risk of ischemic stroke was not materially modified by use of aspirin. No significant associations were found between fish or long-chain omega-3 PUFA intake and risk of hemorrhagic stroke. Conclusion: Our findings suggest that eating fish once per month or more can reduce the risk of ischemic stroke in men. [ABSTRACT FROM AUTHOR]

Presents a study to assess the association between folate intake and risk of breast cancer and whether higher folate intake may reduce excess risk among women who consume alcohol. Design; Setting and participants; Main outcome measures; Results; Conclusions.

Presents a study to examine the association between egg consumption and risk of coronary heart disease and stroke in men and women. Design and setting; Participants; Main outcome measures; Results; Conclusions.

Presents a study to determine whether intakes of fat and fatty acids are associated with breast cancer. Design and setting; Participants; Main outcome measure; Results; Conclusion.

Presents a study that examined a prospective association between regular aspirin use and the risk of myocardial infarction and other cardiovascular events in women. Investigation of the incidence of myocardial infarction in a controlled group of women who took and did not took aspirin; Assessments of the relative risk factors for coronary disease; Recommendation of a randomized trial in women to provide data on the role of aspirin in the primary prevention of cardiovascular disease.

Examines relative weight and height in relation to subsequent breast cancer risk among women 30 to 55 years of age and free from cancer in 1976. Decrease in breast cancer risk with increasing relative weight; Suggestion that obesity among premenopausal and early postmenopausal women does not increase breast cancer risk substantially; Possibility that higher alcohol intake might explain the increased risk of breast cancer in lean premenopausal women.

Presents a letter to the editor in response to a comment on a series of studies about estrogen replacement therapy and risk of breast cancer published in the 'Journal of the American Medical Association.'

A reply is presented by Drs. Johanna M. Seddon, Peter J. Francis and Bernard Rosner to a letter to the editor about their article "Association of CFH Y402H and LOC387715 A695 with progression of age-related macular degeneration."