14 results on '"Wennberg, Patrik"'
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2. Screening for type 2 diabetes: do screen-detected cases fare better?
- Author
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Feldman, Adina L., Griffin, Simon J., Fhärm, Eva, Norberg, Margareta, Wennberg, Patrik, Weinehall, Lars, and Rolandsson, Olov
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- 2017
- Full Text
- View/download PDF
3. EPIC-Heart: The cardiovascular component of a prospective study of nutritional, lifestyle and biological factors in 520,000 middle-aged participants from 10 European countries
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Danesh, John, Saracci, Rodolfo, Berglund, Göran, Feskens, Edith, Overvad, Kim, Panico, Salvatore, Thompson, Simon, Fournier, Agnès, Clavel-Chapelon, Françoise, Canonico, Marianne, Kaaks, Rudolf, Linseisen, Jakob, Boeing, Heiner, Pischon, Tobias, Weikert, Cornelia, Olsen, Anja, Tjønneland, Anne, Johnsen, Søren Paaske, Jensen, Majken Karoline, Quirós, Jose R., Svatetz, Carlos Alberto Gonzalez, Pérez, Maria-José Sánchez, Larrañaga, Nerea, Sanchez, Carmen Navarro, Iribas, Concepción Moreno, Bingham, Sheila, Khaw, Kay-Tee, Wareham, Nick, Key, Timothy, Roddam, Andrew, Trichopoulou, Antonia, Benetou, Vassiliki, Trichopoulos, Dimitrios, Masala, Giovanna, Sieri, Sabina, Tumino, Rosario, Sacerdote, Carlotta, Mattiello, Amalia, Verschuren, W. M. Monique, Bueno-de-Mesquita, H. Bas, Grobbee, Diederick E., van der Schouw, Yvonne T., Melander, Olle, Hallmans, Göran, Wennberg, Patrik, Lund, Eiliv, Kumle, Merethe, Skeie, Guri, Ferrari, Pietro, Slimani, Nadia, Norat, Teresa, and Riboli, Elio
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- 2007
4. Change in lifestyle behaviors and diabetes risk: evidence from a population-based cohort study with 10 year follow-up
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Feldman, Adina L, Long, Gráinne H, Johansson, Ingegerd, Weinehall, Lars, Fhärm, Eva, Wennberg, Patrik, Norberg, Margareta, Griffin, Simon J, Rolandsson, Olov, and Apollo - University of Cambridge Repository
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Adult ,Dietary Fiber ,Male ,Epidemiology ,Health Behavior ,Medicine (miscellaneous) ,Endocrinology and Diabetes ,Health Behaviour ,Risk Factors ,Diabetes Mellitus ,Humans ,Prospective Studies ,Exercise ,Life Style ,lcsh:RC620-627 ,Sweden ,Nutrition and Dietetics ,Research ,Incidence ,lcsh:Public aspects of medicine ,Public Health, Global Health, Social Medicine and Epidemiology ,lcsh:RA1-1270 ,Middle Aged ,Dietary Fats ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,lcsh:Nutritional diseases. Deficiency diseases ,Logistic Models ,Diabetes Mellitus, Type 2 ,Socioeconomic Factors ,Endokrinologi och diabetes ,Female ,Self Report ,Public Health ,Energy Intake ,Follow-Up Studies - Abstract
Background Promoting positive changes in lifestyle behavior in the whole population may be a feasible and effective approach to reducing type 2 diabetes burden, but the impact of population shifts of modifiable risk factors remains unclear. Currently most of the evidence on modifiable lifestyle behavior and type 2 diabetes risk on a population level comes from studies of between-individual differences. The objective of the study was to investigate the association and potential impact on disease burden for within-individual change in lifestyle behavior and diabetes risk. Methods Population-based prospective cohort study of 35,680 participants aged 30–50 at baseline in 1990–2003 in Västerbotten County, Sweden (follow-up until 2013). Five self-reported modifiable lifestyle behaviors (tobacco use, physical activity, alcohol intake, dietary fiber intake and dietary fat intake) were measured at baseline and 10 year follow-up. Lifestyle behaviors were studied separately, and combined in a score. Incident diabetes was detected by oral glucose tolerance tests. Multivariate logistic regression models and population attributable fractions (PAF) were used to analyze the association between change in lifestyle behavior between baseline and 10 year follow-up, and risk of incident diabetes. Results Incident diabetes was detected in 1,184 (3.3%) participants at 10 year follow-up. There was a reduced diabetes risk associated with increase in dietary fiber intake, odds ratio (OR) 0.79 (95% confidence interval (CI) 0.66, 0.96) for increase of at least one unit standard deviation (3.0 g/1,000 kcal) of the baseline distribution, PAF 16.0% (95% CI 4.2, 26.4%). Increase in the lifestyle behavior score was associated with reduced diabetes risk, OR 0.92 (95% CI 0.85, 0.99) per unit increase of the score. Conclusions These results support a causal link between lifestyle behavior and type 2 diabetes incidence. A small shift in lifestyle behaviors, in particular intake of dietary fiber, has the potential to reduce diabetes burden in the population and might be a suitable target for public health intervention. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0489-8) contains supplementary material, which is available to authorized users.
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- 2017
5. Assessing Risk Prediction Models Using Individual Participant Data From Multiple Studies
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Pennells, Lisa, Kaptoge, Stephen, White, Ian R., Thompson, Simon G., Wood, Angela M., Tipping, Robert W., Folsom, Aaron R., Couper, David J., Ballantyne, Christie M., Coresh, Josef, Goya Wannamethee, S., Morris, Richard W., Kiechl, Stefan, Willeit, Johann, Willeit, Peter, Schett, Georg, Ebrahim, Shah, Lawlor, Debbie A., Yarnell, John W., Gallacher, John, Cushman, Mary, Psaty, Bruce M., Tracy, Russ, Tybjærg-Hansen, Anne, Price, Jackie F., Lee, Amanda J., McLachlan, Stela, Khaw, Kay-Tee, Wareham, Nicholas J., Brenner, Hermann, Schöttker, Ben, Müller, Heiko, Jansson, Jan-Håkan, Wennberg, Patrik, Salomaa, Veikko, Harald, Kennet, Jousilahti, Pekka, Vartiainen, Erkki, Woodward, Mark, D'Agostino, Ralph B., Bladbjerg, Else-Marie, Jørgensen, Torben, Kiyohara, Yutaka, Arima, Hisatomi, Doi, Yasufumi, Ninomiya, Toshiharu, Dekker, Jacqueline M., Nijpels, Giel, Stehouwer, Coen D. A., Kauhanen, Jussi, Salonen, Jukka T., Meade, Tom W., Cooper, Jackie A., Shea, Steven, Döring, Angela, Kuller, Lewis H., Grandits, Greg, Gillum, Richard F., Mussolino, Michael, Rimm, Eric B., Hankinson, Sue E., Manson, JoAnn E., Pai, Jennifer K., Kirkland, Susan, Shaffer, Jonathan A., Shimbo, Daichi, Bakker, Stephan J. L., Gansevoort, Ron T., Hillege, Hans L., Amouyel, Philippe, Arveiler, Dominique, Evans, Alun, Ferrières, Jean, Sattar, Naveed, Westendorp, Rudi G., Buckley, Brendan M., Cantin, Bernard, Lamarche, Benoît, Barrett-Connor, Elizabeth, Wingard, Deborah L., Bettencourt, Richele, Gudnason, Vilmundur, Aspelund, Thor, Sigurdsson, Gunnar, Thorsson, Bolli, Kavousi, Maryam, Witteman, Jacqueline C., Hofman, Albert, Franco, Oscar H., Howard, Barbara V., Zhang, Ying, Best, Lyle, Umans, Jason G., Onat, Altan, Sundström, Johan, Michael Gaziano, J., Stampfer, Meir, Ridker, Paul M., Marmot, Michael, Clarke, Robert, Collins, Rory, Fletcher, Astrid, Brunner, Eric, Shipley, Martin, Kivimäki, Mika, Buring, Julie, Cook, Nancy, Ford, Ian, Shepherd, James, Cobbe, Stuart M., Robertson, Michele, Walker, Matthew, Watson, Sarah, Alexander, Myriam, Butterworth, Adam S., Angelantonio, Emanuele Di, Gao, Pei, Haycock, Philip, Wormser, David, Danesh, John, MUMC+: HVC Pieken Maastricht Studie (9), Interne Geneeskunde, MUMC+: MA Interne Geneeskunde (3), and RS: CARIM - R3 - Vascular biology
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Male ,Epidemiology ,Practice of Epidemiology ,Poison control ,Coronary Disease ,Weighting ,Inverse variance ,Risk Assessment ,risk prediction ,Meta-Analysis as Topic ,Risk Factors ,Statistics ,Medicine ,Humans ,Prospective Studies ,coronary heart disease ,10. No inequality ,Prospective cohort study ,Survival analysis ,Proportional Hazards Models ,Models, Statistical ,business.industry ,Proportional hazards model ,C index ,Individual participant data ,inverse variance ,individual participant data ,Middle Aged ,D measure ,Risk prediction ,Coronary heart disease ,meta-analysis ,Meta-analysis ,C-Reactive Protein ,Data Interpretation, Statistical ,weighting ,Female ,business ,Risk assessment - Abstract
Individual participant time-to-event data from multiple prospective epidemiologic studies enable detailed investigation into the predictive ability of risk models. Here we address the challenges in appropriately combining such information across studies. Methods are exemplified by analyses of log C-reactive protein and conventional risk factors for coronary heart disease in the Emerging Risk Factors Collaboration, a collation of individual data from multiple prospective studies with an average follow-up duration of 9.8 years (dates varied). We derive risk prediction models using Cox proportional hazards regression analysis stratified by study and obtain estimates of risk discrimination, Harrell's concordance index, and Royston's discrimination measure within each study; we then combine the estimates across studies using a weighted meta-analysis. Various weighting approaches are compared and lead us to recommend using the number of events in each study. We also discuss the calculation of measures of reclassification for multiple studies. We further show that comparison of differences in predictive ability across subgroups should be based only on within-study information and that combining measures of risk discrimination from case-control studies and prospective studies is problematic. The concordance index and discrimination measure gave qualitatively similar results throughout. While the concordance index was very heterogeneous between studies, principally because of differing age ranges, the increments in the concordance index from adding log C-reactive protein to conventional risk factors were more homogeneous.
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- 2014
6. Beyond the established risk factors of myocardial infarction : lifestyle factors and novel biomarkers
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Wennberg, Patrik
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Allmänmedicin ,myocardial infarction ,occupational physical activity ,General Practice ,physical activity ,haemostatic markers ,lifestyle factors ,commuting activity ,epidemiology ,primary prevention ,inflammatory markers ,leisure time physical activity ,snuff use - Abstract
Age, male sex, hypertension, smoking, diabetes, dyslipidaemia, and obesity are considered as established risk factors for cardiovascular diseases. Several of these established cardiovascular risk factors are strongly influenced by lifestyle. Novel biomarkers from different mechanistic pathways have been associated with cardiovascular risk, but their clinical utility is still uncertain. The overall objective of the thesis was to evaluate the associations between certain lifestyle factors (physical activity and snuff use), biomarkers reflecting the haemostatic and the inflammatory systems and risk of a future first-ever myocardial infarction. A prospective incident nested case-control study design was used with a total of 651 cases of myocardial infarction and 2238 matched controls from the population-based Northern Sweden Health and Disease Study. The effects of commuting activity, occupational and leisure time physical activity on risk of myocardial infarction were studied. A clearly increased risk of myocardial infarction was found for car commuting compared to active commuting (walking, cycling or going by bus). High versus low leisure time physical activity was associated with decreased risk of myocardial infarction. Low occupational physical activity was associated with risk of myocardial infarction in men. The risk of myocardial infarction or sudden cardiac death was studied in male snuff users compared to non-tobacco users. No increased risk was found for myocardial infarction or sudden cardiac death among snuff users without a previous history of smoking. However, for sudden cardiac death the study did not have statistical power to detect small differences in risk. Plasma levels of haemostatic markers have previously shown to be associated with risk of myocardial infarction, but as haemostatic markers are also acute-phase reactants, it is not clear if their association with myocardial infarction is independent of inflammatory markers. In the present study, the haemostatic markers D-dimer, von Willebrand factor (VWF), tissue plasminogen activator (t-PA), and tissue plasminogen activator/plasminogen activator inhibitor-1 complex (t-PA/PAI-1 complex) were associated with risk of myocardial infarction after adjustment for established risk factors and the inflammatory markers C-reactive protein (CRP) and interleukin 6 (IL-6). Furthermore, the addition of eight haemostatic and inflammatory markers could improve the predictive ability for future myocardial infarction beyond that of a model utilizing only established risk factors. Established risk factors and novel biomarkers were explored as potential mediators of the reduced risk of myocardial infarction related to active commuting. A combination of established risk factors, haemostatic and inflammatory markers appeared to explain a substantial proportion (40%) of the difference in risk for myocardial infarction between active commuters and car commuters. IL-6, t-PA, t-PA/PAI-1 complex, apo B/apo A-1 ratio, and BMI seemed to be the largest potential mediators when tested individually. In conclusion, regular physical activity such as active commuting is associated with reduced risk of a first-ever myocardial infarction. This effect could in part be mediated through a beneficial influence on haemostasis and inflammation, as well as a positive impact on established risk factors. Several haemostatic markers are associated with risk of myocardial infarction independent of established risk factors and inflammatory markers. The combination of haemostatic and inflammatory markers may enhance predictive ability beyond established risk factors. Our findings do not support the hypothesis that snuff use increases the risk of myocardial infarction.
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- 2009
7. Fatigue in the general population- associations to age, sex, socioeconomic status, physical activity, sitting time and self-rated health: the northern Sweden MONICA study 2014.
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Engberg, Isak, Segerstedt, Johan, Waller, Göran, Wennberg, Patrik, and Eliasson, Mats
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HEALTH & social status ,FATIGUE (Physiology) ,PHYSICAL activity ,MENTAL fatigue ,SEDENTARY behavior ,EPIDEMIOLOGY ,AGE distribution ,COMPARATIVE studies ,EXERCISE ,HEALTH status indicators ,LONGITUDINAL method ,RESEARCH methodology ,MEDICAL cooperation ,PUBLIC health surveillance ,RESEARCH ,SELF-evaluation ,SEX distribution ,SOCIAL classes ,EVALUATION research ,DISEASE prevalence ,CROSS-sectional method ,SEDENTARY lifestyles - Abstract
Background: Fatigue is widespread in the population and a common complaint in primary care. Little is known about prevalence of fatigue in the population and its predictors. We aimed to describe the pattern of fatigue in the general population and to explore the associations with age, sex, socioeconomic status, self-reported physical activity, sitting time and self-rated health.Methods: One thousand, five hundred and fifty-seven out of 2500 invited subjects in the Northern Sweden MONICA Study 2014, aged 25-74 years, filled out the Multidimensional Fatigue Inventory (MFI-20), consisting of four subscales: General fatigue (GF), Physical fatigue (PF), Reduced activity (RA) and Mental fatigue (MF). Questions regarding age, sex, socioeconomic status, physical activity, sitting time and self-rated health were also included.Results: Higher age correlated significantly with lower fatigue scores for the GF and MF subscales. Women had higher fatigue scores than men on all subscales (p < 0.05). Among men, higher socioeconomic status was related to lower fatigue for the GF, PF and RA subscales (age adjusted p < 0.05). Among women, higher socioeconomic status was related to lower fatigue for the PF and MF subscales (age adjusted p < 0.05). Higher physical activity was connected to lower levels of fatigue for all subscales (age and sex adjusted p < 0.001) except for MF. Longer time spent sitting was also related to more fatigue on all subscales (age and sex adjusted p < 0.005) except for MF. Better self-rated health was strongly associated with lower fatigue for all subscales (age and sex adjusted p < 0.001).Conclusion: Older, highly educated, physically active men, with little sedentary behavior are generally the least fatigued. Self-rated health is strongly related to fatigue. Interventions increasing physical exercise and reducing sedentary behavior may be important to help patients with fatigue and should be investigated in prospective studies. [ABSTRACT FROM AUTHOR]- Published
- 2017
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8. Moist smokeless tobacco (Snus) use and risk of Parkinson's disease.
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Fei Yang, Pedersen, Nancy L., Weimin Ye, Zhiwei Liu, Norberg, Margareta, Forsgren, Lars, Lagerros, Ylva Trolle, Bellocco, Rino, Alfredsson, Lars, Knutsson, Anders, Jansson, Jan-Håkan, Wennberg, Patrik, Galanti, Maria Rosaria, Lager, Anton C. J., Araghi, Marzieh, Lundberg, Michael, Magnusson, Cecilia, Wirdefeldt, Karin, Yang, Fei, and Ye, Weimin
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PARKINSON'S disease ,BRAIN diseases ,TOBACCO analysis ,SNUS (Tobacco) ,PHYSIOLOGICAL effects of nicotine ,LONGITUDINAL method ,META-analysis ,MULTIVARIATE analysis ,SELF-evaluation ,SMOKELESS tobacco ,TOBACCO ,PROPORTIONAL hazards models - Abstract
Background: Cigarette smoking is associated with a lower risk of Parkinson's disease. It is unclear what constituent of tobacco smoke may lower the risk. Use of Swedish moist smokeless tobacco (snus) can serve as a model to disentangle what constituent of tobacco smoke may lower the risk. The aim of this study was to determine whether snus use was associated with a lower risk of Parkinson's disease.Methods: Individual participant data were collected from seven prospective cohort studies, including 348 601 men. We used survival analysis with multivariable Cox regression to estimate study-specific relative risk of Parkinson's disease due to snus use, and random-effects models to pool estimates in a meta-analysis. The primary analyses were restricted to never-smokers to eliminate the potential confounding effect of tobacco smoking.Results: During a mean follow-up time of 16.1 years, 1199 incident Parkinson's disease cases were identified. Among men who never smoked, ever-snus users had about 60% lower Parkinson's disease risk compared with never-snus users [pooled hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.28-0.61]. The inverse association between snus use and Parkinson's disease risk was more pronounced in current (pooled HR 0.38, 95% CI 0.23-0.63), moderate-heavy amount (pooled HR 0.41, 95% CI 0.19-0.90) and long-term snus users (pooled HR 0.44, 95% CI 0.24-0.83).Conclusions: Non-smoking men who used snus had a substantially lower risk of Parkinson's disease. Results also indicated an inverse dose-response relationship between snus use and Parkinson's disease risk. Our findings suggest that nicotine or other components of tobacco leaves may influence the development of Parkinson's disease. [ABSTRACT FROM AUTHOR]- Published
- 2017
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9. Change in lifestyle behaviors and diabetes risk: evidence from a population-based cohort study with 10 year follow-up.
- Author
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Feldman, Adina L., Long, Gráinne H., Johansson, Ingegerd, Weinehall, Lars, Fhärm, Eva, Wennberg, Patrik, Norberg, Margareta, Griffin, Simon J., and Rolandsson, Olov
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TYPE 2 diabetes prevention ,TYPE 2 diabetes risk factors ,ANTHROPOMETRY ,BEHAVIOR modification ,CHI-squared test ,CONFIDENCE intervals ,ALCOHOL drinking ,DIETARY fiber ,FAT content of food ,GLUCOSE tolerance tests ,HEALTH behavior ,INGESTION ,LONGITUDINAL method ,MULTIVARIATE analysis ,PROBABILITY theory ,QUESTIONNAIRES ,RESEARCH evaluation ,RESEARCH funding ,SELF-evaluation ,T-test (Statistics) ,LOGISTIC regression analysis ,TOBACCO products ,LIFESTYLES ,PHYSICAL activity ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
Background: Promoting positive changes in lifestyle behavior in the whole population may be a feasible and effective approach to reducing type 2 diabetes burden, but the impact of population shifts of modifiable risk factors remains unclear. Currently most of the evidence on modifiable lifestyle behavior and type 2 diabetes risk on a population level comes from studies of between-individual differences. The objective of the study was to investigate the association and potential impact on disease burden for within-individual change in lifestyle behavior and diabetes risk. Methods: Population-based prospective cohort study of 35,680 participants aged 30-50 at baseline in 1990-2003 in Västerbotten County, Sweden (follow-up until 2013). Five self-reported modifiable lifestyle behaviors (tobacco use, physical activity, alcohol intake, dietary fiber intake and dietary fat intake) were measured at baseline and 10 year follow-up. Lifestyle behaviors were studied separately, and combined in a score. Incident diabetes was detected by oral glucose tolerance tests. Multivariate logistic regression models and population attributable fractions (PAF) were used to analyze the association between change in lifestyle behavior between baseline and 10 year follow-up, and risk of incident diabetes. Results: Incident diabetes was detected in 1,184 (3.3%) participants at 10 year follow-up. There was a reduced diabetes risk associated with increase in dietary fiber intake, odds ratio (OR) 0.79 (95% confidence interval (CI) 0.66, 0.96) for increase of at least one unit standard deviation (3.0 g/1,000 kcal) of the baseline distribution, PAF 16.0% (95% CI 4.2, 26.4%). Increase in the lifestyle behavior score was associated with reduced diabetes risk, OR 0.92 (95% CI 0.85, 0.99) per unit increase of the score. Conclusions: These results support a causal link between lifestyle behavior and type 2 diabetes incidence. A small shift in lifestyle behaviors, in particular intake of dietary fiber, has the potential to reduce diabetes burden in the population and might be a suitable target for public health intervention. [ABSTRACT FROM AUTHOR]
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- 2017
- Full Text
- View/download PDF
10. Impact of weight maintenance and loss on diabetes risk and burden: a population-based study in 33,184 participants.
- Author
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Feldman, Adina L., Griffin, Simon J., Ahern, Amy L., Long, Grainne H., Weinehall, Lars, Fhärm, Eva, Norberg, Margareta, and Wennberg, Patrik
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WEIGHT loss ,DIABETES prevention ,BODY mass index ,CONFIDENCE intervals ,PUBLIC health ,TYPE 2 diabetes prevention ,BODY weight ,LONGITUDINAL method ,TYPE 2 diabetes ,RESEARCH funding ,RELATIVE medical risk ,DISEASE incidence - Abstract
Background: Weight loss in individuals at high risk of diabetes is an effective prevention method and a major component of the currently prevailing diabetes prevention strategies. The aim of the present study was to investigate the public health potential for diabetes prevention of weight maintenance or moderate weight loss on a population level in an observational cohort with repeated measurements of weight and diabetes status.Methods: Height, weight and diabetes status were objectively measured at baseline and 10 year follow-up in a population-based cohort of 33,184 participants aged 30-60 years between 1990 and 2013 in Västerbotten County, Sweden. The association between risk of incident diabetes and change in BMI or relative weight was modelled using multivariate logistic regression. Population attributable fractions (PAF) were used to assess population impact of shift in weight.Results: Mean (SD) BMI at baseline was 25.0 (3.6) kg/m2. Increase in relative weight between baseline and follow-up was linearly associated with incident diabetes risk, odds ratio (OR) 1.05 (95% confidence interval (CI) 1.04-1.06) per 1% change in weight. Compared to weight maintenance (±1.0 kg/m2), weight gain of > +1.0 kg/m2 was associated with an increased risk of incident diabetes, OR 1.52 (95% CI 1.32, 1.74), representing a PAF of 21.9% (95% CI 15.8, 27.6%). For moderate weight loss (-1.0 to -2.0 kg/m2) the OR was 0.72 (95% CI 0.52, 0.99).Conclusions: Weight maintenance in adulthood is strongly associated with reduced incident diabetes risk and there is considerable potential for diabetes prevention in promoting this as a whole population strategy. [ABSTRACT FROM AUTHOR]- Published
- 2017
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11. Bicycling to Work and Primordial Prevention of Cardiovascular Risk: A Cohort Study Among Swedish Men and Women
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Grøntved, Anders, Koivula, Robert W., Johansson, Ingegerd, Wennberg, Patrik, Østergaard, Lars, Hallmans, Göran, Renström, Frida, and Franks, Paul W.
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cardiovascular disease prevention ,cycling ,hypertension ,impaired glucose tolerance ,obesity ,physical exercise ,type 2 diabetes mellitus ,Cardiovascular Disease ,Epidemiology ,Exercise ,Lifestyle ,Obesity - Abstract
Background: Bicycling to work may be a viable approach for achieving physical activity that provides cardiovascular health benefits. In this study we investigated the relationship of bicycling to work with incidence of obesity, hypertension, hypertriglyceridemia, and impaired glucose tolerance across a decade of follow‐up in middle‐aged men and women. Methods and Results: We followed 23 732 Swedish men and women with a mean age of 43.5 years at baseline who attended a health examination twice during a 10‐year period (1990–2011). In multivariable adjusted models we calculated the odds of incident obesity, hypertension, hypertriglyceridemia, and impaired glucose tolerance, comparing individuals who commuted to work by bicycle with those who used passive modes of transportation. We also examined the relationship of change in commuting mode with incidence of these clinical risk factors. Cycling to work at baseline was associated with lower odds of incident obesity (odds ratio [OR]=0.85, 95% CI 0.73–0.99), hypertension (OR=0.87, 95% CI 0.79–0.95), hypertriglyceridemia (OR=0.85, 95% CI 0.76–0.94), and impaired glucose tolerance (OR=0.88, 95% CI 0.80–0.96) compared with passive travel after adjusting for putative confounding factors. Participants who maintained or began bicycling to work during follow‐up had lower odds of obesity (OR=0.61, 95% CI 0.50–0.73), hypertension (OR=0.89, 95% CI 0.80–0.98), hypertriglyceridemia (OR=0.80, 95% CI 0.70–0.90), and impaired glucose tolerance (OR=0.82, 95% CI 0.74–0.91) compared with participants not cycling to work at both times points or who switched from cycling to other modes of transport during follow‐up. Conclusions: These data suggest that commuting by bicycle to work is an important strategy for primordial prevention of clinical cardiovascular risk factors among middle‐aged men and women.
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- 2016
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12. Separate and combined associations of obesity and metabolic health with coronary heart disease: a pan-European case-cohort analysis
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Sara Grioni, Giuseppe Matullo, Heiner Boeing, Ioanna Tzoulaki, J. Ramón Quirós, Yvonne T. van der Schouw, Concepción Moreno-Iribas, Jolanda M. A. Boer, Elio Riboli, Michail Katsoulis, Larraitz Arriola, Guri Skeie, Pietro Ferrari, Emanuele Di Angelantonio, Timothy J. Key, Adam S. Butterworth, Matthias Johansson, Gunnar Engström, Antonia Trichopoulou, Patrik Wennberg, Verena Katzke, Fabrice Bonnet, Calogero Saieva, Elisabete Weiderpass, Heinz Freisling, W M Monique Verschuren, Anne Kirstine Eriksen, Laura Johnson, Annika Steffen, Kim Overvad, John Danesh, Karel G.M. Moons, Magdalena Stepien, Margareta Norberg, Michael J. Sweeting, Vassiliki Benetou, Nicholas J. Wareham, Olle Melander, Elena Molina-Portillo, Claudia Agnoli, Rudolf Kaaks, Camille Lassale, Salvatore Panico, Claudia Langenberg, Rosario Tumino, Anne Tjønneland, José María Huerta, Sandra Colorado-Yohar, Daphne L. van der A, Lassale, Camille, Tzoulaki, Ioanna, Moons, Karel G. M, Sweeting, Michael, Boer, Jolanda, Johnson, Laura, Huerta, José María, Agnoli, Claudia, Freisling, Heinz, Weiderpass, Elisabete, Wennberg, Patrik, Van Der A, Daphne L, Arriola, Larraitz, Benetou, Vassiliki, Boeing, Heiner, Bonnet, Fabrice, Colorado yohar, Sandra M, Engström, Gunnar, Eriksen, Anne K, Ferrari, Pietro, Grioni, Sara, Johansson, Matthia, Kaaks, Rudolf, Katsoulis, Michail, Katzke, Verena, Key, Timothy J, Matullo, Giuseppe, Melander, Olle, Molina portillo, Elena, Moreno iribas, Concepción, Norberg, Margareta, Overvad, Kim, Panico, Salvatore, Quirós, J. Ramón, Saieva, Calogero, Skeie, Guri, Steffen, Annika, Stepien, Magdalena, Tjønneland, Anne, Trichopoulou, Antonia, Tumino, Rosario, Van Der Schouw, Yvonne T, Verschuren, W. M. Monique, Langenberg, Claudia, Di Angelantonio, Emanuele, Riboli, Elio, Wareham, Nicholas J, Danesh, John, Butterworth, Adam S., Imperial College Trust, and Commission of the European Communities
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Gerontology ,Male ,obesity ,Cardiac & Cardiovascular Systems ,Epidemiology ,CARDIOMETABOLIC TRAITS ,physical activity ,Coronary Disease ,030204 cardiovascular system & hematology ,Body Mass Index ,German ,0302 clinical medicine ,030212 general & internal medicine ,ALL-CAUSE MORTALITY ,media_common ,Adiposity ,2. Zero hunger ,Coronary heart disease ,Metabolic syndrome ,Obesity ,METABOLICALLY HEALTHY ,Middle Aged ,waist circumference ,3. Good health ,Europe ,MENDELIAN RANDOMIZATION ,language ,Female ,body mass index procedure ,Cardiology and Cardiovascular Medicine ,Life Sciences & Biomedicine ,Cohort study ,medicine.medical_specialty ,1102 Cardiovascular Medicine And Haematology ,smoking ,POOLED ANALYSIS ,03 medical and health sciences ,medicine ,Journal Article ,media_common.cataloged_instance ,Humans ,overweight ,European union ,coronary heart disease ,Metabolic health ,INCIDENT CARDIOVASCULAR-DISEASE ,Government ,Science & Technology ,business.industry ,FAT DISTRIBUTION ,coronary heart disease risk ,medicine.disease ,language.human_language ,BODY-MASS INDEX ,PHYSICAL-ACTIVITY ,Cardiovascular System & Hematology ,Family medicine ,Case-Control Studies ,Cardiovascular System & Cardiology ,RISK-FACTORS ,business - Abstract
Aims: The hypothesis of ‘metabolically healthy obesity’ implies that, in the absence of metabolic dysfunction, individuals with excess adiposity are not at greater cardiovascular risk. We tested this hypothesis in a large pan-European prospective study. Methods and results: We conducted a case-cohort analysis in the 520 000-person European Prospective Investigation into Cancer and Nutrition study (‘EPIC-CVD’). During a median follow-up of 12.2 years, we recorded 7637 incident coronary heart disease (CHD) cases. Using cut-offs recommended by guidelines, we defined obesity and overweight using body mass index (BMI), and metabolic dysfunction (‘unhealthy’) as >_ 3 of elevated blood pressure, hypertriglyceridaemia, low HDL-cholesterol, hyperglycaemia, and elevated waist circumference. We calculated hazard ratios (HRs) and 95% confidence intervals (95% CI) within each country using Prentice-weighted Cox proportional hazard regressions, accounting for age, sex, centre, education, smoking, diet, and physical activity. Compared with metabolically healthy normal weight people (reference), HRs were 2.15 (95% CI: 1.79; 2.57) for unhealthy normal weight, 2.33 (1.97; 2.76) for unhealthy overweight, and 2.54 (2.21; 2.92) for unhealthy obese people. Compared with the reference group, HRs were 1.26 (1.14; 1.40) and 1.28 (1.03; 1.58) for metabolically healthy overweight and obese people, respectively. These results were robust to various sensitivity analyses. Conclusion: Irrespective of BMI, metabolically unhealthy individuals had higher CHD risk than their healthy counterparts. Conversely, irrespective of metabolic health, overweight and obese people had higher CHD risk than lean people. These findings challenge the concept of ‘metabolically healthy obesity’, encouraging population-wide strategies to tackle obesity., European Union (EU) HEALTH-F2-2012-279233, European Research Council (ERC) 268834, Medical Research Council UK (MRC) G0800270 MR/L003120/1 MR/M012190/1, British Heart Foundation SP/09/002 RG/08/014 RG13/13/30194, National Institute for Health Research (NIHR), Regional Government of Asturias, Hellenic Health Foundation, German Cancer Aid, German Cancer Research Centre, German Federal Ministry of Education and Research, Cancer Research UK 570/A16491, Regione Sicilia, Associazione Iblea per la Ricerca Epidemiologica (A.I.R.E.) - ONLUS Ragusa, Associazione Volontari Italiani Sangue AVIS Ragusa, Compagnia di San Paolo, Human Genetics Foundation-Torino (HuGeF), British Heart Foundation RG/13/13/30194 RG/08/014/24067, Cancer Research UK 16491, Medical Research Council UK (MRC) MR/L003120/1 G0800270 MC_UU_12015/1, National Institute for Health Research (NIHR) NF-SI-0512-10135 NF-SI-0512-10165, Novo Nordisk Foundation NNF17OC0026936
- Published
- 2019
13. Physical activity, mediating factors and risk of colon cancer:insights into adiposity and circulating biomarkers from the EPIC cohort
- Author
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Catalina Bonet, Antonia Trichopoulou, Dagmar Drogan, Tilman Kühn, Elisabete Weiderpass, Dagfinn Aune, Pagona Lagiou, Elio Riboli, Kim Overvad, Rosario Tumino, Kay-Tee Khaw, Miren Dorronsoro, María José Sánchez, A. M. May, Marion Carayol, Elissavet Valanou, Christina C. Dahm, Kristin Benjaminsen Borch, Christina Bamia, Marie Christine Bouton-Ruault, Krasimira Aleksandrova, Tobias Pischon, Patrik Wennberg, Aurelio Barricarte, Rudolf Kaaks, Heather Ward, Sunday Oluwafemi Oyeyemi, Nada Assi, Eleni Peppa, Domenico Palli, Bethany Van Guelpen, Mazda Jenab, Anne Tjønneland, Jonna K. van Vulpen, Timothy J. Key, Sabina Rinaldi, Heiner Boeing, Paula Jakszyn, Heinz Freisling, Carmen Navarro, Salvatore Panico, Carlo La Vecchia, J. Ramón Quirós, Claudia Agnoli, Nicholas J. Wareham, Bas Bueno-de-Mesquita, Carlotta Sacerdote, Michael F. Leitzmann, Imperial College Trust, Aleksandrova, Krasimira, Jenab, Mazda, Leitzmann, Michael, Bueno de mesquita, Ba, Kaaks, Rudolf, Trichopoulou, Antonia, Bamia, Christina, Lagiou, Pagona, Rinaldi, Sabina, Freisling, Heinz, Carayol, Marion, Pischon, Tobia, Drogan, Dagmar, Weiderpass, Elisabete, Jakszyn, Paula, Overvad, Kim, Dahm, Christina C, Tjønneland, Anne, Bouton ruault, Marie christine, Kühn, Tilman, Peppa, Eleni, Valanou, Elissavet, La Vecchia, Carlo, Palli, Domenico, Panico, Salvatore, Sacerdote, Carlotta, Agnoli, Claudia, Tumino, Rosario, May, Anne, Van Vulpen, Jonna, Benjaminsen Borch, Kristin, Oluwafemi Oyeyemi, Sunday, Quirós, J. Ramón, Bonet, Catalina, Sánchez, María josé, Dorronsoro, Miren, Navarro, Carmen, Barricarte, Aurelio, Van Guelpen, Bethany, Wennberg, Patrik, Key, Timothy J, Khaw, Kay tee, Wareham, Nichola, Assi, Nada, Ward, Heather A, Aune, Dagfinn, Riboli, Elio, and Boeing, Heiner
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Oncology ,Male ,SOLUBLE LEPTIN RECEPTOR ,Colorectal cancer ,Epidemiology ,physical activity ,law.invention ,Body Mass Index ,COLORECTAL-CANCER ,0302 clinical medicine ,Randomized controlled trial ,Weight loss ,law ,Risk Factors ,030212 general & internal medicine ,Prospective Studies ,Vitamin D ,VITAMIN-D ,Public, Environmental & Occupational Health ,METABOLIC SYNDROME ,adiposity ,Leptin ,0104 Statistics ,General Medicine ,Middle Aged ,SERUM-LEVELS ,Europe ,NUTRITION COHORT ,1117 Public Health And Health Services ,colon cancer ,030220 oncology & carcinogenesis ,Cohort ,Colonic Neoplasms ,biomarker ,Female ,medicine.symptom ,Waist Circumference ,Life Sciences & Biomedicine ,Adult ,medicine.medical_specialty ,WEIGHT-LOSS ,CONTROLLED-TRIAL ,Article ,03 medical and health sciences ,Internal medicine ,medicine ,Vitamin D and neurology ,Journal Article ,Humans ,mediating factors ,Exercise ,METAANALYSIS ,Aged ,Science & Technology ,RECTAL CANCERS ,business.industry ,Physical activity ,biomarkers ,medicine.disease ,Logistic Models ,Case-Control Studies ,Metabolic syndrome ,business - Abstract
Background: There is convincing evidence that high physical activity lowers the risk of colon cancer; however, the underlying biological mechanisms remain largely unknown. We aimed to determine the extent to which body fatness and biomarkers of various biologically plausible pathways account for the association between physical activity and colon cancer.Methods: We conducted a nested case-control study in a cohort of 519 978 men and women aged 25 to 70 years followed from 1992 to 2003. A total of 713 incident colon cancer cases were matched, using risk-set sampling, to 713 controls on age, sex, study centre, fasting status and hormonal therapy use. The amount of total physical activity during the past year was expressed in metabolic equivalent of task [MET]-h/week. Anthropometric measurements and blood samples were collected at study baseline.Results: High physical activity was associated with a lower risk of colon cancer: relative risk ≥91 MET-h/week vs Conclusions: Promoting physical activity, particularly outdoors, and maintaining metabolic health and adequate vitamin D levels could represent a promising strategy for colon cancer prevention.
- Published
- 2017
14. Parity, breastfeeding and risk of coronary heart disease:A pan-European case-cohort study
- Author
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Kim Overvad, Eleni Klinaki, Elisabete Weiderpass, Emanuele Di Angelantonio, Giuseppe Matullo, Giovanna Masala, Anna Winkvist, Simon G. Thompson, M. Luisa Redondo, Françoise Clavel-Chapelon, Isabel Drake, Elena Molina-Portillo, N. Charlotte Onland-Moret, Therese Haugdahl Nøst, Adam S. Butterworth, Salma Butt, Diana Gavrila, Conchi Moreno-Iribas, Vassiliki Benetou, Antonia Trichopoulou, Tilman Kühn, Anja Olsen, Melissa A. Merritt, Ioanna Tzoulaki, Anne Tjønneland, Angela M. Wood, Larraitz Arriola, Renée Turzanski-Fortner, Fabrice Bonnet, Elio Riboli, Rosario Tumino, Karel G.M. Moons, Sanne A.E. Peters, Patrik Wennberg, Heiner Boeing, Timothy J. Key, Yvonne T. van der Schouw, Camille Lassale, Nicholas J. Wareham, Michael J. Sweeting, Salvatore Panico, Vittorio Krogh, John Danesh, Department of Epidemiology, German Institute of Human Nutrition (DIfE) Potsdam-Rehbrücke, University Medical Center [Utrecht], Department of Public Health & Primary Care, University of Cambridge [UK] (CAM), Department of Community Medicine, The Arctic University of Norway [Tromsø, Norway] (UiT), Department of Research, Cancer Registry of Norway, Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet [Stockholm], Genetic Epidemiology Group [Helsinki], Folkhälsan Research Center, Faculty of Medecine [Helsinki], Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Faculty of Medecine [Helsinki], Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Instituto de Investigación Sanitaria Biodonostia - San Sebastián, WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Hellenic Health Foundation, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Foie, métabolismes et cancer, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Department of Clinical Sciences, Lund University [Lund], Mode de vie, génétique et santé : études intégratives et transgénérationnelles (U1018 (Équipe 9)), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Gustave Roussy (IGR), Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIBER de Epidemiología y Salud Pública (CIBERESP), Cancer Epidemiology Unit, University of Oxford-Cancer Epidemiology Unit, Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori - National Cancer Institute [Milan], German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Biomarkers Research, Imperial College School of Public Health, Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Department of Genetics, Biology and Biochemistry, Università degli studi di Torino = University of Turin (UNITO), Institute for Scientific Interchange Foundation, Universidad de Granada = University of Granada (UGR), Public Health Institute of Navarra, Pamplona, Spain, and CIBER Epidemiología y Salud Pública (CIBERESP), Danish Cancer Society Research Center, Department of Clinical Epidemiology, Aarhus University Hospital, Dipartimento di Medicina Clinica e Chirurgia, University of Naples Federico II = Università degli studi di Napoli Federico II, Public Health Directorate Asturias, Bureau of Epidemiologic Research, Academy of Athens, Cancer Registry and Histopathology Unit, Department of Oncology-Civile - M.P.Arezzo Hospital, Imperial College London, Umeå University, Medical Research Council Epidemiology Unit, European Union [HEALTH-F2-2012-279233], European Research Council [268834], Swedish Scientific Council, Regional Government of Skane and Vasterbotten (Sweden), Compagnia di San Paolo, Human Genetics Foundation-Torino (HuGeF), UK Medical Research Council [G0800270, MR/L003120/1, MR/M012190/1], British Heart Foundation [SP/09/002, RG/08/014, RG13/13/30194], UK National Institute of Health Research, Regional Government of Asturias, Cancer Research UK [570/A16491], Sicilian Government, AIRE ONLUS Ragusa, AVIS Ragusa, Swedish Cancer Society, The Arctic University of Norway, University of Helsinki-University of Helsinki-Faculty of Medecine [Helsinki], University of Helsinki-University of Helsinki, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut Gustave Roussy (IGR), University of Oxford [Oxford]-Cancer Epidemiology Unit, University of Turin, Universidad de Granada (UGR), University of Naples Federico II, Wood, Angela [0000-0002-7937-304X], Sweeting, Michael [0000-0003-0980-8965], Thompson, Simon [0000-0002-5274-7814], Di Angelantonio, Emanuele [0000-0001-8776-6719], Wareham, Nicholas [0000-0003-1422-2993], Danesh, John [0000-0003-1158-6791], Butterworth, Adam [0000-0002-6915-9015], Apollo - University of Cambridge Repository, Peters, Sanne Ae, van der Schouw, Yvonne T, Wood, Angela M, Sweeting, Michael J, Moons, Karel Gm, Weiderpass, Elisabete, Arriola, Larraitz, Benetou, Vassiliki, Boeing, Heiner, Bonnet, Fabrice, Butt, Salma T, Clavel Chapelon, Françoise, Drake, Isabel, Gavrila, Diana, Key, Timothy J, Klinaki, Eleni, Krogh, Vittorio, Kühn, Tilman, Lassale, Camille, Masala, Giovanna, Matullo, Giuseppe, Merritt, Melissa, Molina Portillo, Elena, Moreno Iribas, Conchi, Nøst, Therese H, Olsen, Anja, Onland Moret, N. Charlotte, Overvad, Kim, Panico, Salvatore, Redondo, M. Luisa, Tjønneland, Anne, Trichopoulou, Antonia, Tumino, Rosario, Turzanski Fortner, Renée, Tzoulaki, Ioanna, Wennberg, Patrik, Winkvist, Anna, Thompson, Simon G, Di Angelantonio, Emanuele, Riboli, Elio, Wareham, Nicholas J, Danesh, John, Butterworth, Adam S., Commission of the European Communities, and Jonchère, Laurent
- Subjects
Pediatrics ,breastfeeding ,coronary heart disease ,Parity ,Women ,Epidemiology ,Cardiology and Cardiovascular Medicine ,Breastfeeding ,Coronary Disease ,030204 cardiovascular system & hematology ,0302 clinical medicine ,Pregnancy ,Risk Factors ,Medicine ,030212 general & internal medicine ,Prospective Studies ,Age of Onset ,Prospective cohort study ,number ,Incidence ,Hazard ratio ,health ,Middle Aged ,3. Good health ,European Prospective Investigation into Cancer and Nutrition ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Europe ,Breast Feeding ,Population Surveillance ,Female ,pregnancy ,women ,Cohort study ,Adult ,medicine.medical_specialty ,life-style ,lactation ,Risk Assessment ,Article ,03 medical and health sciences ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Journal Article ,Humans ,cancer ,maternal cardiovascular-disease ,Proportional hazards model ,business.industry ,duration ,mortality ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Breast feeding ,Demography ,Follow-Up Studies ,Forecasting - Abstract
Objective: There is uncertainty about the direction and magnitude of the associations between parity, breastfeeding and the risk of coronary heart disease (CHD). We examined the separate and combined associations of parity and breastfeeding practices with the incidence of CHD later in life among women in a large, pan-European cohort study. Methods: Data were used from European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD, a case–cohort study nested within the EPIC prospective study of 520,000 participants from 10 countries. Information on reproductive history was available for 14,917 women, including 5138 incident cases of CHD. Using Prentice-weighted Cox regression separately for each country followed by a random-effects meta-analysis, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for CHD, after adjustment for age, study centre and several socioeconomic and biological risk factors. Results: Compared with nulliparous women, the adjusted HR was 1.19 (95% CI: 1.01–1.41) among parous women; HRs were higher among women with more children (e.g., adjusted HR: 1.95 (95% CI: 1.19–3.20) for women with five or more children). Compared with women who did not breastfeed, the adjusted HR was 0.71 (95% CI: 0.52–0.98) among women who breastfed. For childbearing women who never breastfed, the adjusted HR was 1.58 (95% CI: 1.09–2.30) compared with nulliparous women, whereas for childbearing women who breastfed, the adjusted HR was 1.19 (95% CI: 0.99–1.43). Conclusion: Having more children was associated with a higher risk of CHD later in life, whereas breastfeeding was associated with a lower CHD risk. Women who both had children and breastfed did have a non-significantly higher risk of CHD.
- Published
- 2016
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