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Purpose: The health benefits of the Mediterranean diet (MedDiet) have been widely studied. However, controversy remains for one of its components: alcohol intake. We aimed to assess the joint effect of adherence to the MedDiet and alcohol-drinking pattern on all-cause mortality. Methods: We used data from 20,506 subjects from a prospective cohort of Spanish university graduates, the Seguimiento Universidad de Navarra (SUN) cohort. Adherence to the MedDiet was operationalized using four different dietary indexes and then categorized in low or high adherence, according to the median score. Alcohol-drinking pattern was evaluated with the previously defined the Mediterranean alcohol-drinking pattern (MADP), grouped into three categories of adherence (low, moderate and high adherence) and a fourth category for abstainers. The outcome was all-cause mortality. Results: During a median follow-up of 12.1 years, we observed 460 deaths. No statistically significant supra-multiplicative interaction between the two exposures was found. Low adherence to both the MedDiet and MADP was associated with higher all-cause mortality compared to high adherence to both exposures [multivariable-adjusted hazard ratio (HR) = 2.02, 95% confidence interval (CI): 1.33–3.07]. Similar results were found for cancer mortality and cardiovascular mortality. Conclusions: Although the combined effect of the MedDiet and MADP was not significantly higher than the product of their individual effects, a low adherence to both the MedDiet and MADP was associated with higher rates of all-cause mortality. This report also shows the usefulness of the dietary pattern approach applied to alcohol intake and of including the drinking pattern as another component of the MedDiet. [ABSTRACT FROM AUTHOR]

Background: Predicting the future burden of cancer is a key issue for health services planning, where a method for selecting the predictive model and the prediction base is a challenge. A method, named here Goodness-of-Fit optimal (GoF-optimal), is presented to determine the minimum prediction base of historical data to perform 5-year predictions of the number of new cancer cases or deaths. Methods: An empirical ex-post evaluation exercise for cancer mortality data in Spain and cancer incidence in Finland using simple linear and log-linear Poisson models was performed. Prediction bases were considered within the time periods 1951-2006 in Spain and 1975-2007 in Finland, and then predictions were made for 37 and 33 single years in these periods, respectively. The performance of three fixed different prediction bases (last 5, 10, and 20 years of historical data) was compared to that of the prediction base determined by the GoF-optimal method. The coverage (COV) of the 95% prediction interval and the discrepancy ratio (DR) were calculated to assess the success of the prediction. Results: The results showed that (i) models using the prediction base selected through GoF-optimal method reached the highest COV and the lowest DR and (ii) the best alternative strategy to GoF-optimal was the one using the base of prediction of 5-years. Conclusions: The GoF-optimal approach can be used as a selection criterion in order to find an adequate base of prediction. [ABSTRACT FROM AUTHOR]

Our objective was to investigate whether there might be excess cancer mortality in the vicinity of Spanish installations for the production of cement, lime, plaster, and magnesium oxide, according to different categories of industrial activity. An ecologic study was designed to examine municipal mortality due to 33 types of cancer (period 1997–2006) in Spain. Population exposure to pollution was estimated on the basis of distance from town to industrial facility. Using spatial Besag–York–Mollié regression models with integrated nested Laplace approximations for Bayesian inference, we assessed the relative risk of dying from cancer in a 5-km zone around installations, analyzed the effect of category of industrial activity according to the manufactured product, and conducted individual analyses within a 50-km radius of each installation. Excess all cancer mortality (relative risk, 95% credible interval) was detected in the vicinity of these installations as a whole (1.04, 1.01–1.07 in men; 1.03, 1.00–1.06 in women), and, principally, in the vicinity of cement installations (1.05, 1.01–1.09 in men). Special mention should be made of the results for tumors of colon–rectum in both sexes (1.07, 1.01–1.14 in men; 1.10, 1.03–1.16 in women), and pleura (1.71, 1.24–2.28), peritoneum (1.62, 1.15–2.20), gallbladder (1.21, 1.02–1.42), bladder (1.11, 1.03–1.20) and stomach (1.09, 1.00–1.18) in men in the vicinity of all such installations. Our results suggest an excess risk of dying from cancer, especially in colon–rectum, in towns near these industries. [ABSTRACT FROM AUTHOR]

Abstract: Background: Waste treatment plants release toxic emissions into the environment which affect neighboring towns. Objectives: To investigate whether there might be excess cancer mortality in towns situated in the vicinity of Spanish-based incinerators and installations for the recovery or disposal of hazardous waste, according to the different categories of industrial activity. Methods: An ecologic study was designed to examine municipal mortality due to 33 types of cancer, across the period 1997–2006. Population exposure to pollution was estimated on the basis of distance from town of residence to pollution source. Using Besag–York–Mollié (BYM) regression models with Integrated Nested Laplace approximations for Bayesian inference, and Mixed Poisson regression models, we assessed the risk of dying from cancer in a 5-kilometer zone around installations, analyzed the effect of category of industrial activity, and conducted individual analyses within a 50-kilometer radius of each installation. Results: Excess cancer mortality (BYM model: relative risk, 95% credible interval) was detected in the total population residing in the vicinity of these installations as a whole (1.06, 1.04–1.09), and, principally, in the vicinity of incinerators (1.09, 1.01–1.18) and scrap metal/end-of-life vehicle handling facilities, in particular (1.04, 1.00–1.09). Special mention should be made of the results for tumors of the pleura (1.71, 1.34–2.14), stomach (1.18, 1.10–1.27), liver (1.18, 1.06–1.30), kidney (1.14, 1.04–1.23), ovary (1.14, 1.05–1.23), lung (1.10, 1.05–1.15), leukemia (1.10, 1.03–1.17), colon–rectum (1.08, 1.03–1.13) and bladder (1.08, 1.01–1.16) in the vicinity of all such installations. Conclusions: Our results support the hypothesis of a statistically significant increase in the risk of dying from cancer in towns near incinerators and installations for the recovery or disposal of hazardous waste. [Copyright &y& Elsevier]