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151. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies

Author: Wood, Angela M, Kaptoge, Stephen, Butterworth, Adam S, Willeit, Peter, Warnakula, Samantha, Bolton, Thomas, Paige, Ellie, Paul, Dirk S, Sweeting, Michael, Burgess, Stephen, Bell, Steven, Tjønneland, Anne, Brenner, Hermann, Palmieri, Luigi, Dallongeville, Jean, Brunner, Eric J, Assmann, Gerd, Trevisan, Maurizio, Gillum, Richard F, Ford, Ian, Sattar, Naveed, Astle, William, Lazo, Mariana, Thompson, Simon G, Ferrari, Pietro, Leon, David A, Smith, George Davey, Peto, Richard, Jackson, Rod, Banks, Emily, Di Angelantonio, Emanuele, Danesh, John, Stevens, David, Butterworth, Adam, Koulman, Albert, Selmer, Randi M, Verschuren, Monique, Sato, Shinichi, Njølstad, Inger, Woodward, Mark, Veikko, Salomaa, Nordestgaard, Børge G, Yeap, Bu B, Flecther, Astrid, Melander, Olle, Kuller, Lewis H, Balkau, Beverley, Marmot, Michael, Koenig, Wolfgang, Casiglia, Edoardo, Cooper, Cyrus, Verschuren, W M Monique, Arndt, Volker, Franco, Oscar H, Wennberg, Patrik, Gallacher, John, Gómez de la Cámara, Agustín, Völzke, Henry, Dahm, Christina C, Dale, Caroline E, Bergmann, Manuela, Crespo, Carlos, van der Schouw, Yvonne T, Kaaks, Rudolf, Simons, Leon A, Lagiou, Pagona, Schoufour, Josje D, Boer, Jolanda M.A, Key, Timothy J, Rodriguez, Beatriz, Moreno-Iribas, Conchi, Davidson, Karina W, Taylor, James O, Sacerdote, Carlotta, Wallace, Robert B, Quiros, J. Ramon, Rimm, Eric B, Tumino, Rosario, Blazer III, Dan G, Linneberg, Allan, Daimon, Makoto, Panico, Salvatore, Howard, Barbara, Skeie, Guri, Salomaa, Veikko, Strandberg, Timo, Weiderpass, Elisabete, Nietert, Paul J, Psaty, Bruce M, Kromhout, Daan, Salamanca-Fernandez, Elena, Kiechl, Stefan, Krumholz, Harlan M, Grioni, Sara, Palli, Domenico, Huerta, José M, Price, Jackie, Sundström, Johan, Arriola, Larraitz, Arima, Hisatomi, Travis, Ruth C, Panagiotakos, Demosthenes B, Karakatsani, Anna, Trichopoulou, Antonia, Kühn, Tilman, Grobbee, Diederick E, Barrett-Connor, Elizabeth, van Schoor, Natasja, Boeing, Heiner, Overvad, Kim, Kauhanen, Jussi, Wareham, Nick, Langenberg, Claudia, Forouhi, Nita, Wennberg, Maria, Després, Jean-Pierre, Cushman, Mary, Cooper, Jackie A, Rodriguez, Carlos J, Sakurai, Masaru, Shaw, Jonathan E, Knuiman, Matthew, Fletcher, Astrid, Voortman, Trudy, Meisinger, Christa, Dallongeville, Jean-Pierre, Gillumn, Richard F, Ford, Ian Ford, Thompson, Simon, Davey Smith, George, de la Cámara, Agustín Gómez, Bergmann, Manuela M, Crespo, Carlos J, Boer, Jolanda M A, Quiros, J Ramon, Blazer, Dan G, Wood, Angela M, Kaptoge, Stephen, Butterworth, Adam S, Willeit, Peter, Warnakula, Samantha, Bolton, Thomas, Paige, Ellie, Paul, Dirk S, Sweeting, Michael, Burgess, Stephen, Bell, Steven, Tjønneland, Anne, Brenner, Hermann, Palmieri, Luigi, Dallongeville, Jean, Brunner, Eric J, Assmann, Gerd, Trevisan, Maurizio, Gillum, Richard F, Ford, Ian, Sattar, Naveed, Astle, William, Lazo, Mariana, Thompson, Simon G, Ferrari, Pietro, Leon, David A, Smith, George Davey, Peto, Richard, Jackson, Rod, Banks, Emily, Di Angelantonio, Emanuele, Danesh, John, Stevens, David, Butterworth, Adam, Koulman, Albert, Selmer, Randi M, Verschuren, Monique, Sato, Shinichi, Njølstad, Inger, Woodward, Mark, Veikko, Salomaa, Nordestgaard, Børge G, Yeap, Bu B, Flecther, Astrid, Melander, Olle, Kuller, Lewis H, Balkau, Beverley, Marmot, Michael, Koenig, Wolfgang, Casiglia, Edoardo, Cooper, Cyrus, Verschuren, W M Monique, Arndt, Volker, Franco, Oscar H, Wennberg, Patrik, Gallacher, John, Gómez de la Cámara, Agustín, Völzke, Henry, Dahm, Christina C, Dale, Caroline E, Bergmann, Manuela, Crespo, Carlos, van der Schouw, Yvonne T, Kaaks, Rudolf, Simons, Leon A, Lagiou, Pagona, Schoufour, Josje D, Boer, Jolanda M.A, Key, Timothy J, Rodriguez, Beatriz, Moreno-Iribas, Conchi, Davidson, Karina W, Taylor, James O, Sacerdote, Carlotta, Wallace, Robert B, Quiros, J. Ramon, Rimm, Eric B, Tumino, Rosario, Blazer III, Dan G, Linneberg, Allan, Daimon, Makoto, Panico, Salvatore, Howard, Barbara, Skeie, Guri, Salomaa, Veikko, Strandberg, Timo, Weiderpass, Elisabete, Nietert, Paul J, Psaty, Bruce M, Kromhout, Daan, Salamanca-Fernandez, Elena, Kiechl, Stefan, Krumholz, Harlan M, Grioni, Sara, Palli, Domenico, Huerta, José M, Price, Jackie, Sundström, Johan, Arriola, Larraitz, Arima, Hisatomi, Travis, Ruth C, Panagiotakos, Demosthenes B, Karakatsani, Anna, Trichopoulou, Antonia, Kühn, Tilman, Grobbee, Diederick E, Barrett-Connor, Elizabeth, van Schoor, Natasja, Boeing, Heiner, Overvad, Kim, Kauhanen, Jussi, Wareham, Nick, Langenberg, Claudia, Forouhi, Nita, Wennberg, Maria, Després, Jean-Pierre, Cushman, Mary, Cooper, Jackie A, Rodriguez, Carlos J, Sakurai, Masaru, Shaw, Jonathan E, Knuiman, Matthew, Fletcher, Astrid, Voortman, Trudy, Meisinger, Christa, Dallongeville, Jean-Pierre, Gillumn, Richard F, Ford, Ian Ford, Thompson, Simon, Davey Smith, George, de la Cámara, Agustín Gómez, Bergmann, Manuela M, Crespo, Carlos J, Boer, Jolanda M A, Quiros, J Ramon, and Blazer, Dan G
Abstract: BACKGROUND: Low-risk limits recommended for alcohol consumption vary substantially across different national guidelines. To define thresholds associated with lowest risk for all-cause mortality and cardiovascular disease, we studied individual-participant data from 599 912 current drinkers without previous cardiovascular disease. METHODS:We did a combined analysis of individual-participant data from three large-scale data sources in 19 high-income countries (the Emerging Risk Factors Collaboration, EPIC-CVD, and the UK Biobank). We characterised dose–response associations and calculated hazard ratios (HRs) per 100 g per week of alcohol (12·5 units per week) across 83 prospective studies, adjusting at least for study or centre, age, sex, smoking, and diabetes. To be eligible for the analysis, participants had to have information recorded about their alcohol consumption amount and status (ie, non-drinker vs current drinker), plus age, sex, history of diabetes and smoking status, at least 1 year of follow-up after baseline, and no baseline history of cardiovascular disease. The main analyses focused on current drinkers, whose baseline alcohol consumption was categorised into eight predefined groups according to the amount in grams consumed per week. We assessed alcohol consumption in relation to all-cause mortality, total cardiovascular disease, and several cardiovascular disease subtypes. We corrected HRs for estimated long-term variability in alcohol consumption using 152 640 serial alcohol assessments obtained some years apart (median interval 5·6 years [5th–95th percentile 1·04–13·5]) from 71 011 participants from 37 studies. FINDINGS: In the 599 912 current drinkers included in the analysis, we recorded 40 310 deaths and 39 018 incident cardiovascular disease events during 5·4 million person-years of follow-up. For all-cause mortality, we recorded a positive and curvilinear association with the level of alcohol consumption, with the minimum mortality risk around o
Published: 2018

152. Association of LPA variants with risk of coronary disease and the implications for lipoprotein(a)-lowering therapies: A mendelian randomization analysis

Author: Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Burgess, Stephen, Ference, Brian A., Staley, James R., Freitag, Daniel F., Mason, Amy M., Nielsen, Sune F., Willeit, Peter, Young, Robin, Surendran, Praveen, Karthikeyan, Savita, Bolton, Thomas R., Peters, James E., Kamstrup, Pia, Tybjærg-Hansen, Anne, Benn, Marianne, Langsted, Anne, Schnohr, Peter, Vedel-Krogh, Signe, Kobylecki, Camilla J., Ford, Ian, Packard, Chris, Trompet, Stella, Jukema, J. Wouter, Sattar, Naveed, Di Angelantonio, Emanuele, Saleheen, Danish, Howson, Joanna M.M., Nordestgaard, Børge G., Butterworth, Adam S., Danesh, John, Bargess, Stephen, Overvad, Kim, Tjønneland, Anne, Clavel-Chapelon, Francoise, Kaaks, Rudolf, Boeing, Heiner, Trichopoulou, Antonia, Ferrari, Pietro, Palli, Domenico, Krogh, Vittorio, Panico, Salvatore, Tumino, Rosario, Matullo, Giuseppe, Boer, Jolanda, Van Der Schouw, Yvonne, Weiderpass, Elisabete, Quiros, J. Ramon, Sánchez, María José, Navarro, Carmen, Moreno-Iribas, Conchi, Arriola, Larraitz, Melander, Olle, Wennberg, Patrik, Wareham, Nicholas J., Key, Timothy J., Riboli, Elio, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Burgess, Stephen, Ference, Brian A., Staley, James R., Freitag, Daniel F., Mason, Amy M., Nielsen, Sune F., Willeit, Peter, Young, Robin, Surendran, Praveen, Karthikeyan, Savita, Bolton, Thomas R., Peters, James E., Kamstrup, Pia, Tybjærg-Hansen, Anne, Benn, Marianne, Langsted, Anne, Schnohr, Peter, Vedel-Krogh, Signe, Kobylecki, Camilla J., Ford, Ian, Packard, Chris, Trompet, Stella, Jukema, J. Wouter, Sattar, Naveed, Di Angelantonio, Emanuele, Saleheen, Danish, Howson, Joanna M.M., Nordestgaard, Børge G., Butterworth, Adam S., Danesh, John, Bargess, Stephen, Overvad, Kim, Tjønneland, Anne, Clavel-Chapelon, Francoise, Kaaks, Rudolf, Boeing, Heiner, Trichopoulou, Antonia, Ferrari, Pietro, Palli, Domenico, Krogh, Vittorio, Panico, Salvatore, Tumino, Rosario, Matullo, Giuseppe, Boer, Jolanda, Van Der Schouw, Yvonne, Weiderpass, Elisabete, Quiros, J. Ramon, Sánchez, María José, Navarro, Carmen, Moreno-Iribas, Conchi, Arriola, Larraitz, Melander, Olle, Wennberg, Patrik, Wareham, Nicholas J., Key, Timothy J., and Riboli, Elio
Published: 2018

153. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies

Author: Public Health Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Cardiovasculaire Epidemiologie, Cardiovasculaire Epi Team 9, Wood, Angela M., Kaptoge, Stephen, Butterworth, Adam, Willeit, Peter, Warnakula, Samantha, Bolton, Thomas, Paige, Ellie, Paul, Dirk S., Sweeting, Michael, Burgess, Stephen, Bell, Steven, Astle, William, Stevens, David, Koulman, Albert, Selmer, Randi M., Verschuren, Monique, Sato, Shinichi, Njølstad, Inger, Woodward, Mark, Salomaa, Veikko, Nordestgaard, Børge G., Yeap, Bu B., Fletcher, Astrid, Melander, Olle, Kuller, Lewis H., Balkau, Beverley, Marmot, Michael, Koenig, Wolfgang, Casiglia, Edoardo, Cooper, Cyrus, Arndt, Volker, Franco, Oscar H., Wennberg, Patrik, Gallacher, John, de la Cámara, Agustín Gómez, Völzke, Henry, Dahm, Christina C., Dale, Caroline E., Bergmann, Manuela, Crespo, Carlos, van der Schouw, Yvonne T., Kaaks, Rudolf, Simons, Leon A., Lagiou, Pagona, Schoufour, Josje D., Boer, Jolanda M.A., Key, Timothy J., Rodriguez, Beatriz, Moreno-Iribas, Conchi, Grobbee, Diederick E., Emerging Risk Factors Collaboration/EPIC-CVD/UK Biobank Alcohol Study Group, Public Health Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Cardiovasculaire Epidemiologie, Cardiovasculaire Epi Team 9, Wood, Angela M., Kaptoge, Stephen, Butterworth, Adam, Willeit, Peter, Warnakula, Samantha, Bolton, Thomas, Paige, Ellie, Paul, Dirk S., Sweeting, Michael, Burgess, Stephen, Bell, Steven, Astle, William, Stevens, David, Koulman, Albert, Selmer, Randi M., Verschuren, Monique, Sato, Shinichi, Njølstad, Inger, Woodward, Mark, Salomaa, Veikko, Nordestgaard, Børge G., Yeap, Bu B., Fletcher, Astrid, Melander, Olle, Kuller, Lewis H., Balkau, Beverley, Marmot, Michael, Koenig, Wolfgang, Casiglia, Edoardo, Cooper, Cyrus, Arndt, Volker, Franco, Oscar H., Wennberg, Patrik, Gallacher, John, de la Cámara, Agustín Gómez, Völzke, Henry, Dahm, Christina C., Dale, Caroline E., Bergmann, Manuela, Crespo, Carlos, van der Schouw, Yvonne T., Kaaks, Rudolf, Simons, Leon A., Lagiou, Pagona, Schoufour, Josje D., Boer, Jolanda M.A., Key, Timothy J., Rodriguez, Beatriz, Moreno-Iribas, Conchi, Grobbee, Diederick E., and Emerging Risk Factors Collaboration/EPIC-CVD/UK Biobank Alcohol Study Group
Published: 2018

154. Separate and combined associations of obesity and metabolic health with coronary heart disease: A pan-European case-cohort analysis

Author: Circulatory Health, Epi Methoden, Child Health, Cancer, JC onderzoeksprogramma Methodologie, Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Public Health Epidemiologie, 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, Matthias, Kaaks, Rudolf, Katsoulis, Michail, Katzke, Verena, Key, Timothy J., Matullo, Giuseppe, Melander, Olle, Molina-Portillo, Elena, Moreno-Iribas, Concepcion, Norberg, Margareta, Overvad, Kim, Panico, Salvatore, Quiros, 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., Circulatory Health, Epi Methoden, Child Health, Cancer, JC onderzoeksprogramma Methodologie, Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Public Health Epidemiologie, 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, Matthias, Kaaks, Rudolf, Katsoulis, Michail, Katzke, Verena, Key, Timothy J., Matullo, Giuseppe, Melander, Olle, Molina-Portillo, Elena, Moreno-Iribas, Concepcion, Norberg, Margareta, Overvad, Kim, Panico, Salvatore, Quiros, 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, and Butterworth, Adam S.
Published: 2018

155. Treadmill workstations in office workers who are overweight or obese:a randomised controlled trial

Author: Bergman, Frida, Wahlström, Viktoria, Stomby, Andreas, Otten, Julia, Lanthén, Ellen, Renklint, Rebecka, Waling, Maria, Sörlin, Ann, Boraxbekk, Carl-Johan, Wennberg, Patrik, Öhberg, Fredrik, Levine, James A., Olsson, Tommy, Bergman, Frida, Wahlström, Viktoria, Stomby, Andreas, Otten, Julia, Lanthén, Ellen, Renklint, Rebecka, Waling, Maria, Sörlin, Ann, Boraxbekk, Carl-Johan, Wennberg, Patrik, Öhberg, Fredrik, Levine, James A., and Olsson, Tommy
Abstract: Background: Treadmill workstations that enable office workers to walk on a treadmill while working at their computers might increase physical activity in offices, but long-term effects are unknown. We therefore investigated whether treadmill workstations in offices increased daily walking time. Methods: We did a randomised controlled trial of healthy office workers who were either overweight or obese. We recruited participants from 13 different companies, which comprised 17 offices, in Umeå Sweden. We included people who were aged 40–67 years, had sedentary work tasks, and had a body-mass index (BMI) between 25 kg/m2 and 40 kg/m2. After the baseline measurement, we stratified participants by their BMI (25–30 kg/m2 and >30 to 40 kg/m2); subsequently, an external statistician randomly assigned these participants (1:1) to either the intervention group (who received treadmill workstations for optional use) or the control group (who continued to work at their sit–stand desks as usual). Participants in the intervention group received reminders in boosting emails sent out to them at four occasions during the study period. Researchers were masked to group assignment until after analysis of the primary outcome. After the baseline measurement, participants were not masked to group belongings. The primary outcome was total daily walking time at weekdays and weekends, measured at baseline, 2 months, 6 months, 10 months, and 13 months with the accelerometer activPAL (PAL Technologies, Glasgow, UK), which was worn on the thigh of participants for 24 h a day for 7 consecutive days. We used an intention-to-treat approach for our analyses. This trial is registered with ClinicalTrials.gov, number NCT01997970, and is closed to new participants. Findings: Between Nov 1, 2013, and June 30, 2014, a total of 80 participants were recruited and enrolled (n=40 in both the intervention and control groups). Daily walking time during total time
Published: 2018

156. Change in lifestyle behaviors and diabetes risk: evidence from a population-based cohort study with 10 year follow-up

Author: 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
Subjects: 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.
Published: 2017

157. Distinct effects of acute exercise and breaks in sitting on working memory and executive function in older adults: a three-arm, randomised cross-over trial to evaluate the effects of exercise with and without breaks in sitting on cognition.

Author: Wheeler, Michael J., Green, Daniel J., Ellis, Kathryn A., Cerin, Ester, Heinonen, Ilkka, Naylor, Louise H., Larsen, Robyn, Wennberg, Patrik, Boraxbekk, Carl-Johan, Lewis, Jaye, Eikelis, Nina, Lautenschlager, Nicola T., Kingwe, Bronwyn A., Lambert, Gavin, Owen, Neville, Dunstan, David W., and Kingwell, Bronwyn A
Subjects: EXERCISE & psychology, EXECUTIVE function, OBESITY, RESEARCH, NERVE tissue proteins, RESEARCH methodology, PHARMACOKINETICS, EVALUATION research, MEDICAL cooperation, COMPARATIVE studies, RANDOMIZED controlled trials, SHORT-term memory, WALKING, CROSSOVER trials
Abstract: Background: Sedentary behaviour is associated with impaired cognition, whereas exercise can acutely improve cognition.Objective: We compared the effects of a morning bout of moderate-intensity exercise, with and without subsequent light-intensity walking breaks from sitting, on cognition in older adults.Methods: Sedentary overweight/obese older adults with normal cognitive function (n=67, 67±7 years, 31.2±4.1 kg/m2) completed three conditions (6-day washout): SIT (sitting): uninterrupted sitting (8 hours, control); EX+SIT (exercise + sitting): sitting (1 hour), moderate-intensity walking (30 min), uninterrupted sitting (6.5 hours); and EX+BR (exercise + breaks): sitting (1 hour), moderate-intensity walking (30 min), sitting interrupted every 30 min with 3 min of light-intensity walking (6.5 hours). Cognitive testing (Cogstate) was completed at four time points assessing psychomotor function, attention, executive function, visual learning and working memory. Serum brain-derived neurotrophic growth factor (BDNF) was assessed at six time points. The 8-hour net area under the curve (AUC) was calculated for each outcome.Results: Working memory net AUC z-score·hour (95% CI) was improved in EX+BR with a z-score of +28 (-26 to +81), relative to SIT, -25 (-79 to +29, p=0.04 vs EX+BR). Executive function net AUC was improved in EX+SIT, -8 (- 71 to +55), relative to SIT, -80 (-142 to -17, p=0.03 vs EX+SIT). Serum BDNF net AUC ng/mL·hour (95% CI) was increased in both EX+SIT, +171 (-449 to +791, p=0.03 vs SIT), and EX+BR, +139 (-481 to +759, p=0.045 vs SIT), relative to SIT, -227 (-851 to +396).Conclusion: A morning bout of moderate-intensity exercise improves serum BDNF and working memory or executive function in older adults, depending on whether or not subsequent sitting is also interrupted with intermittent light-intensity walking.Trial Registration Number: ACTRN12614000737639. [ABSTRACT FROM AUTHOR]
Published: 2020
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158. Dairy Products and Cancer Risk in a Northern Sweden Population.

Author: Nilsson, Lena M., Winkvist, Anna, Esberg, Anders, Jansson, Jan-Håkan, Wennberg, Patrik, van Guelpen, Bethany, and Johansson, Ingegerd
Subjects: TUMOR risk factors, CONFIDENCE intervals, DAIRY products, RISK assessment, DESCRIPTIVE statistics
Abstract: The role of dairy products in cancer is unclear. We assessed consumption of fermented milk, non-fermented milk, cheese, and butter, estimated from semi-quantitative food frequency questionnaires, in relation to prospective risk of breast, prostate, colorectal, smoking-, and obesity-related cancers in 101,235 subjects, including 12,552 cancer cases, in the population-based Northern Sweden Health and Disease Study. Most analyses (n = 20) rendered null results. In men, we observed an increased prostate cancer risk among high-consumers of cheese (hazard ratio (HR) for highest vs. lowest quintile (Q5–Q1), 1.11; 95% CI, 0.97–1.27; Ptrend = 0.013). In women, high-consumers of cheese had a decreased risk of overall cancer (HR Q5–Q1, 0.95; 95% CI, 0.88–1.04; Ptrend = 0.039), smoking-related (HR Q5–Q1, 0.84; 95% CI, 0.72–0.97; Ptrend ≤ 0.001), and colorectal cancers (HR Q5–Q1, 0.82; 95% CI, 0.63–1.07; Ptrend = 0.048). Butter yielded a weak decreased obesity-related cancer risk in women (HR Q5–Q1, 0.91; 95% CI, 0.81–1.02; Ptrend = 0.049). Fermented milk yielded HRs below zero in women, but with no clear linear associations. In conclusion, this study does not support any major adverse or beneficial effects of fermented milk, non-fermented milk, cheese, and butter in the diet from a cancer risk perspective. [ABSTRACT FROM AUTHOR]
Published: 2020
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159. Comparison of trends in cardiovascular risk factors between two regions with and without a community and primary care prevention programme

Author: Eliasson, Mats, primary, Eriksson, Marie, additional, Lundqvist, Robert, additional, Wennberg, Patrik, additional, and Söderberg, Stefan, additional
Published: 2018
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160. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies

Author: Wood, Angela M, primary, Kaptoge, Stephen, additional, Butterworth, Adam S, additional, Willeit, Peter, additional, Warnakula, Samantha, additional, Bolton, Thomas, additional, Paige, Ellie, additional, Paul, Dirk S, additional, Sweeting, Michael, additional, Burgess, Stephen, additional, Bell, Steven, additional, Astle, William, additional, Stevens, David, additional, Koulman, Albert, additional, Selmer, Randi M, additional, Verschuren, W M Monique, additional, Sato, Shinichi, additional, Njølstad, Inger, additional, Woodward, Mark, additional, Salomaa, Veikko, additional, Nordestgaard, Børge G, additional, Yeap, Bu B, additional, Fletcher, Astrid, additional, Melander, Olle, additional, Kuller, Lewis H, additional, Balkau, Beverley, additional, Marmot, Michael, additional, Koenig, Wolfgang, additional, Casiglia, Edoardo, additional, Cooper, Cyrus, additional, Arndt, Volker, additional, Franco, Oscar H, additional, Wennberg, Patrik, additional, Gallacher, John, additional, de la Cámara, Agustín Gómez, additional, Völzke, Henry, additional, Dahm, Christina C, additional, Dale, Caroline E, additional, Bergmann, Manuela M, additional, Crespo, Carlos J, additional, van der Schouw, Yvonne T, additional, Kaaks, Rudolf, additional, Simons, Leon A, additional, Lagiou, Pagona, additional, Schoufour, Josje D, additional, Boer, Jolanda M A, additional, Key, Timothy J, additional, Rodriguez, Beatriz, additional, Moreno-Iribas, Conchi, additional, Davidson, Karina W, additional, Taylor, James O, additional, Sacerdote, Carlotta, additional, Wallace, Robert B, additional, Quiros, J Ramon, additional, Tumino, Rosario, additional, Blazer, Dan G, additional, Linneberg, Allan, additional, Daimon, Makoto, additional, Panico, Salvatore, additional, Howard, Barbara, additional, Skeie, Guri, additional, Strandberg, Timo, additional, Weiderpass, Elisabete, additional, Nietert, Paul J, additional, Psaty, Bruce M, additional, Kromhout, Daan, additional, Salamanca-Fernandez, Elena, additional, Kiechl, Stefan, additional, Krumholz, Harlan M, additional, Grioni, Sara, additional, Palli, Domenico, additional, Huerta, José M, additional, Price, Jackie, additional, Sundström, Johan, additional, Arriola, Larraitz, additional, Arima, Hisatomi, additional, Travis, Ruth C, additional, Panagiotakos, Demosthenes B, additional, Karakatsani, Anna, additional, Trichopoulou, Antonia, additional, Kühn, Tilman, additional, Grobbee, Diederick E, additional, Barrett-Connor, Elizabeth, additional, van Schoor, Natasja, additional, Boeing, Heiner, additional, Overvad, Kim, additional, Kauhanen, Jussi, additional, Wareham, Nick, additional, Langenberg, Claudia, additional, Forouhi, Nita, additional, Wennberg, Maria, additional, Després, Jean-Pierre, additional, Cushman, Mary, additional, Cooper, Jackie A, additional, Rodriguez, Carlos J, additional, Sakurai, Masaru, additional, Shaw, Jonathan E, additional, Knuiman, Matthew, additional, Voortman, Trudy, additional, Meisinger, Christa, additional, Tjønneland, Anne, additional, Brenner, Hermann, additional, Palmieri, Luigi, additional, Dallongeville, Jean, additional, Brunner, Eric J, additional, Assmann, Gerd, additional, Trevisan, Maurizio, additional, Gillum, Richard F, additional, Ford, Ian, additional, Sattar, Naveed, additional, Lazo, Mariana, additional, Thompson, Simon G, additional, Ferrari, Pietro, additional, Leon, David A, additional, Smith, George Davey, additional, Peto, Richard, additional, Jackson, Rod, additional, Banks, Emily, additional, Di Angelantonio, Emanuele, additional, Danesh, John, additional, Wood, Angela M, additional, Butterworth, Adam, additional, Verschuren, Monique, additional, Veikko, Salomaa, additional, Flecther, Astrid, additional, Gómez de la Cámara, Agustín, additional, Bergmann, Manuela, additional, Crespo, Carlos, additional, Boer, Jolanda M.A, additional, Quiros, J. Ramon, additional, Rimm, Eric B, additional, Blazer III, Dan G, additional, Dallongeville, Jean-Pierre, additional, Gillumn, Richard F, additional, Ford, Ian Ford, additional, Thompson, Simon, additional, and Davey Smith, George, additional
Published: 2018
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161. Temporal variation in out-of-hospital cardiac arrest with validated cardiac cause

Author: Jallow, Tim, primary, Wennberg, Patrik, additional, and Forslund, Ann-Sofie, additional
Published: 2018
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162. Moist smokeless tobacco (Snus) use and risk of Parkinson's disease

Author: Yang, Fei, Pedersen, Nancy L., Ye, Weimin, Liu, Zhiwei, 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, Pedersen, Nancy L., Ye, Weimin, Liu, Zhiwei, 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, and Wirdefeldt, Karin
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.
Published: 2017
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163. A client-centred programme focusing energy conservation for people with heart failure

Author: Norberg, Eva-Britt, Löfgren, Britta, Boman, Kurt, Wennberg, Patrik, Brännström, Margareta, Norberg, Eva-Britt, Löfgren, Britta, Boman, Kurt, Wennberg, Patrik, and Brännström, Margareta
Abstract: AIM: The purpose of this study was to describe clients and occupational therapists (OTs) experiences of a home-based programme focusing energy conservation strategies (ECS) for clients with chronic heart failure (CHF). METHODS: The programme, based on occupational therapy intervention process model (OTIPM), was led by two OTs in primary health care. Five clients' self-reported activities of daily living (ADL), fatigue, depression, goal achievements and use of ECS. Furthermore, both clients and OTs were individually interviewed. RESULTS: The clients reported mild depression, severe fatigue and both increased and decreased independence in ADL. Most goals were achieved, and multiple ECS were used. Clients perceived that they worked collaboratively with the OTs and gained professional support to enhance daily activities. The OTs experienced knowledge and structure and found benefits from the programme, but doubted the possibility of using it in clinical practice. CONCLUSIONS: This study, despite having few participants, indicates that both the OTs and the clients experienced that the specialized programme gave structure to the OTs work, provided knowledge about CHF and valuable energy conservation strategies. The programme supported the OTs in working in a more comprehensive client-centred way. However, its feasibility needs to be further evaluated.
Published: 2017
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164. Impact of weight maintenance and loss on diabetes risk and burden : a population-based study in 33,184 participants

Author: Feldman, Adina L, Griffin, Simon J, Ahern, Amy L, Long, Grainne H, Weinehall, Lars, Fhärm, Eva, Norberg, Margareta, Wennberg, Patrik, Feldman, Adina L, Griffin, Simon J, Ahern, Amy L, Long, Grainne H, Weinehall, Lars, Fhärm, Eva, Norberg, Margareta, and Wennberg, Patrik
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/m(2). 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/m(2)), weight gain of > +1.0 kg/m(2) 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/m(2)) 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.
Published: 2017
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165. Use of moist oral snuff (snus) and pancreatic cancer : pooled analysis of nine prospective observational studies

Author: Araghi, Marzieh, Galanti, Maria Rosaria, Lundberg, Michael, Lager, Anton, Engström, Gunnar, Alfredsson, Lars, Knutsson, Anders, Norberg, Margareta, Sund, Malin, Wennberg, Patrik, Trolle Lagerros, Ylva, Bellocco, Rino, Pedersen, Nancy L., Östergren, Per-Olof, Magnusson, Cecilia, Araghi, Marzieh, Galanti, Maria Rosaria, Lundberg, Michael, Lager, Anton, Engström, Gunnar, Alfredsson, Lars, Knutsson, Anders, Norberg, Margareta, Sund, Malin, Wennberg, Patrik, Trolle Lagerros, Ylva, Bellocco, Rino, Pedersen, Nancy L., Östergren, Per-Olof, and Magnusson, Cecilia
Abstract: While smoking is a well-established risk factor for pancreatic cancer, the effect of smokeless tobacco is less well understood. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess the association between Swedish snus use and the risk of pancreatic cancer. A total of 424,152 male participants from nine cohort studies were followed up for risk of pancreatic cancer through linkage to health registers. We used shared frailty models with random effects at the study level, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for confounding factors. During 9,276,054 person-years of observation, 1,447 men developed pancreatic cancer. Compared to never-snus use, current snus use was not associated with risk of pancreatic cancer (HR 0.96, 95% CI 0.83–1.11) after adjustment for smoking. Swedish snus use does not appear to be implicated in the development of pancreatic cancer in men. Tobacco smoke constituents other than nicotine or its metabolites may account for the relationship between smoking and pancreatic cancer.
Published: 2017
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166. Time trends of comparative self-rated health in adults aged 25–34 in the Northern Sweden MONICA study, 1990–2014

Author: Waller Lidström, Mattias, Wennberg, Patrik, Lundqvist, Robert, Forssén, Annika, Waller, Göran, Waller Lidström, Mattias, Wennberg, Patrik, Lundqvist, Robert, Forssén, Annika, and Waller, Göran
Abstract: Self-rated health (SRH) accounts comprehensively for many health domains. The aim of this paper was to investigate time trends and associations between age-comparative self-rated health and some known determinants in a general population aged 24-34 years. Population- based cross-sectional surveys were performed in 1990, 1994, 1999, 2004, 2009 and 2014 in Northern Sweden. Out of 3500 invited persons, 1811 responded. Comparative SRH was measured on a three-grade ordinal scale by the question: "How would you assess your general health condition compared to persons of your own age?" with the alternatives-better/worse/similar". Over the period 1990 to 2014, the percentage of women rating comparative SRH as "worse" increased steadily, from 8.5% in 1990 reaching 20% in 2014 (p for trend 0.007). Among men, this pattern was almost the opposite, with increasing proportions rating "better" (p for trend <0.000). Time trends for physical activity in leisure time; length of education; Body Mass Index; anxiety; depressive emotions and satisfaction with economy showed a similar pattern for men and women. Factors that might contribute to the development of time trends for comparative SRH are discussed.
Published: 2017
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167. Physical activity, mediating factors and risk of colon cancer: Insights into adiposity and circulating biomarkers from the EPIC cohort

Author: UMC Utrecht, MS MDL 1, Epi Kanker Team 1, Cancer, JC onderzoeksprogramma Kanker, Epi Kanker Team B, Aleksandrova, Krasimira, Jenab, Mazda, Leitzmann, Michael F., Bueno-de-Mesquita, Bas, Kaaks, Rudolf, Trichopoulou, Antonia, Bamia, Christina, Lagiou, Pagona, Rinaldi, Sabina, Freisling, Heinz, Carayol, Marion, Pischon, Tobias, 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, Borch, Kristin Benjaminsen, Oyeyemi, Sunday Oluwafemi, Quirós, José Ramón, Bonet, Catalina, Sánchez, Mariá José, Dorronsoro, Miren, Navarro, Carmen, Barricarte, Aurelio, Van Guelpen, Bethany, Wennberg, Patrik, Key, Timothy J., Khaw, Kay Tee, Wareham, Nicholas J., Assi, Nada, Ward, Heather A., Aune, Dagfinn, Riboli, Elio, Boeing, Heiner, UMC Utrecht, MS MDL 1, Epi Kanker Team 1, Cancer, JC onderzoeksprogramma Kanker, Epi Kanker Team B, Aleksandrova, Krasimira, Jenab, Mazda, Leitzmann, Michael F., Bueno-de-Mesquita, Bas, Kaaks, Rudolf, Trichopoulou, Antonia, Bamia, Christina, Lagiou, Pagona, Rinaldi, Sabina, Freisling, Heinz, Carayol, Marion, Pischon, Tobias, 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, Borch, Kristin Benjaminsen, Oyeyemi, Sunday Oluwafemi, Quirós, José Ramón, Bonet, Catalina, Sánchez, Mariá José, Dorronsoro, Miren, Navarro, Carmen, Barricarte, Aurelio, Van Guelpen, Bethany, Wennberg, Patrik, Key, Timothy J., Khaw, Kay Tee, Wareham, Nicholas J., Assi, Nada, Ward, Heather A., Aune, Dagfinn, Riboli, Elio, and Boeing, Heiner
Published: 2017

168. Rare Variant Analysis of Human and Rodent Obesity Genes in Individuals with Severe Childhood Obesity

Author: UMC Utrecht, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Hendricks, Audrey E., Bochukova, Elena G., Marenne, Gaëlle, Keogh, Julia M., Atanassova, Neli, Bounds, Rebecca, Wheeler, Eleanor, Mistry, Vanisha, Henning, Elana, Körner, Antje, Muddyman, Dawn, McCarthy, Shane, Hinney, Anke, Hebebrand, Johannes, Scott, Robert A., Langenberg, Claudia, Wareham, Nick J., Surendran, Praveen, Howson, Joanna M M, Butterworth, Adam S., Danesh, John, Nordestgaard, Børge G., Nielsen, Sune F., Afzal, Shoaib, Papadia, Sofia, Ashford, Sofie, Garg, Sumedha, Millhauser, Glenn L., Palomino, Rafael I., Kwasniewska, Alexandra, Tachmazidou, Ioanna, O'Rahilly, Stephen, Zeggini, Eleftheria, Barroso, Inês, Farooqi, I. Sadaf, Benzeval, Michaela, Burton, Jonathan, Buck, Nicholas, Jäckle, Annette, Kumari, Meena, Laurie, Heather, Lynn, Peter, Pudney, Stephen, Rabe, Birgitta, Wolke, Dieter, Overvad, Kim, Tjønneland, Anne, Clavel-Chapelon, Francoise, Kaaks, Rudolf, Boeing, Heiner, Trichopoulou, Antonia, Ferrari, Pietro, Palli, Domenico, Krogha, Vittorio, Panico, Salvatore, Tuminoa, Rosario, Matullo, Giuseppe, Boer, Jolanda Ma, Van Der Schouw, Yvonne, Weiderpass, Elisabete, Quiros, J. Ramon, Sánchez, María José, Navarro, Carmen, Moreno-Iribas, Conchi, Arriola, Larraitz, Melander, Olle, Wennberg, Patrik, Key, Timothy J., Riboli, Elio, Al-Turki, Saeed, Anderson, Carl A, Anney, Richard, Antony, Dinu, Soler Artigas, María, Ayub, Muhammad, Bala, Senduran, Barrett, Jeffrey C, Beales, Phil, Bentham, Jamie, Bhattacharyaa, Shoumo, Birney, Ewan, Blackwooda, Douglas, Bobrow, Martin, Bolton, Patrick F., Boustred, Chris, Breen, Gerome, Calissanoa, Mattia, Carss, Keren, Charlton, Ruth, Chatterjee, Krishna, Chen, Lu, Ciampia, Antonio, Cirak, Sebahattin, Clapham, Peter, Clement, Gail, Coates, Guy, Coccaa, Massimiliano, Collier, David A, Cosgrove, Catherine, Coxa, Tony, Craddock, Nick, Crooks, Lucy, Curran, Sarah, Curtis, David, Daly, Allan, Danecek, Petr, Day, Ian N M, Day-Williams, Aaron G, Dominiczak, Anna, Down, Thomas, Du, Yuanping, Dunham, Ian, Durbin, Richard, Edkins, Sarah, Ekong, Rosemary, Ellis, Peter, Evansa, David M., FitzPatrick, David R., Flicek, Paul, Floyd, James S., Foley, A. Reghan, Franklin, Christopher S., Futema, Marta, Gallagher, Louise, Gaunt, Tom R., Geihs, Matthias, Geschwind, Daniel H., Greenwood, Celia M.T., Griffin, Heather, Grozeva, Detelina, Guo, Xiaosen, Guo, Xueqin, Gurling, Hugh, Hart, Deborah J., Holmans, Peter A, Howie, Bryan, Huang, Jie, Huang, Liren, Hubbard, Tim, Humphries, Steve E., Hurles, Matthew E., Hysi, Pirro G., Iotchkova, Valentina, Jackson, David K., Jamshidi, Yalda, Joyce, Chris, Karczewski, Konrad J., Kaye, Jane, Keane, Thomas, Kemp, John P., Kennedy, Karen, Kent, Alastair, Khawaja, Farrah, Van Kogelenberg, Margriet, Kolb-Kokocinski, Anja, Lachance, Genevieve, Langford, Cordelia, Lawson, Daniel, Lee, Irene, Lek, Monkol, Li, Rui, Li, Yingrui, Liang, Jieqin, Lin, Hong, Liu, Ryan, Lönnqvist, Jouko, Lopes, Luis R., Lopes, Margarida, MacArthur, Daniel G., Mangino, Massimo, Marchini, Jonathan, Maslen, John, Mathieson, Iain, McGuffin, Peter, McIntosh, Andrew M., McKechanie, Andrew G., McQuillin, Andrew, Memari, Yasin, Metrustry, Sarah, Migone, Nicola, Min, Josine L., Mitchison, Hannah M, Moayyeri, Alireza, Morris, Andrew D., Morris, James, Muntoni, Francesco, Northstone, Kate, O'Donovan, Michael C., Onoufriadis, Alexandros, Oualkacha, Karim, Owen, Michael J, Palotie, Aarno, Panoutsopoulou, Kalliope, Parker, Victoria, Parr, Jeremy R., Paternoster, Lavinia, Paunio, Tiina, Payne, Felicity, Payne, Stewart J., Perry, John R. B., Pietilainen, Olli, Plagnol, Vincent, Pollitt, Rebecca C., Porteous, David J., Povey, Sue, Quail, Michael A., Quaye, Lydia, Raymond, F. Lucy, Rehnström, Karola, Richards, J Brent, Ridout, Cheryl K., Ring, Susan M., Ritchie, Graham R.S., Roberts, Nicola, Robinson, Rachel L., Savage, David B., Scambler, Peter, Schiffels, Stephan, Schmidts, Miriam, Schoenmakers, Nadia, Scott, Richard H., Semple, Robert K., Serra, Eva, Sharp, Sally I., Shaw, Adam, Shihab, Hashem A., Shin, So Youn, Skuse, David, Small, Kerrin S, Smee, Carol, Smith, Blair H., Davey Smith, George, Soranzo, Nicole, Southam, Lorraine, Spasic-Boskovic, Olivera, Spector, Timothy D, St Clair, David, St Pourcain, Beate, Stalker, Jim, Stevens, Elizabeth, Sun, Jianping, Surdulescu, Gabriela L, Suvisaari, Jaana, Syrris, Petros, Taylor, Rohan, Tian, Jing, Timpson, Nicholas J., Tobin, Martin D, Valdes, Ana M., Vandersteen, Anthony M., Vijayarangakannan, Parthiban, Visscher, Peter M., Wain, Louise V., Walter, Klaudia, Walters, James T.R., Wang, Guangbiao, Wang, Jun, Wang, Nai-Yu, Ward, Kirsten, Whyte, Tamieka, Williams, Hywel J., Williamson, Kathleen A., Wilson, Crispian, Wilson, Scott G., Wong, Kim, Xu, Changjiang, Yang, Jian, Zhang, Feng, Zhang, Pingbo, Zheng, Hou Feng, UMC Utrecht, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Hendricks, Audrey E., Bochukova, Elena G., Marenne, Gaëlle, Keogh, Julia M., Atanassova, Neli, Bounds, Rebecca, Wheeler, Eleanor, Mistry, Vanisha, Henning, Elana, Körner, Antje, Muddyman, Dawn, McCarthy, Shane, Hinney, Anke, Hebebrand, Johannes, Scott, Robert A., Langenberg, Claudia, Wareham, Nick J., Surendran, Praveen, Howson, Joanna M M, Butterworth, Adam S., Danesh, John, Nordestgaard, Børge G., Nielsen, Sune F., Afzal, Shoaib, Papadia, Sofia, Ashford, Sofie, Garg, Sumedha, Millhauser, Glenn L., Palomino, Rafael I., Kwasniewska, Alexandra, Tachmazidou, Ioanna, O'Rahilly, Stephen, Zeggini, Eleftheria, Barroso, Inês, Farooqi, I. Sadaf, Benzeval, Michaela, Burton, Jonathan, Buck, Nicholas, Jäckle, Annette, Kumari, Meena, Laurie, Heather, Lynn, Peter, Pudney, Stephen, Rabe, Birgitta, Wolke, Dieter, Overvad, Kim, Tjønneland, Anne, Clavel-Chapelon, Francoise, Kaaks, Rudolf, Boeing, Heiner, Trichopoulou, Antonia, Ferrari, Pietro, Palli, Domenico, Krogha, Vittorio, Panico, Salvatore, Tuminoa, Rosario, Matullo, Giuseppe, Boer, Jolanda Ma, Van Der Schouw, Yvonne, Weiderpass, Elisabete, Quiros, J. Ramon, Sánchez, María José, Navarro, Carmen, Moreno-Iribas, Conchi, Arriola, Larraitz, Melander, Olle, Wennberg, Patrik, Key, Timothy J., Riboli, Elio, Al-Turki, Saeed, Anderson, Carl A, Anney, Richard, Antony, Dinu, Soler Artigas, María, Ayub, Muhammad, Bala, Senduran, Barrett, Jeffrey C, Beales, Phil, Bentham, Jamie, Bhattacharyaa, Shoumo, Birney, Ewan, Blackwooda, Douglas, Bobrow, Martin, Bolton, Patrick F., Boustred, Chris, Breen, Gerome, Calissanoa, Mattia, Carss, Keren, Charlton, Ruth, Chatterjee, Krishna, Chen, Lu, Ciampia, Antonio, Cirak, Sebahattin, Clapham, Peter, Clement, Gail, Coates, Guy, Coccaa, Massimiliano, Collier, David A, Cosgrove, Catherine, Coxa, Tony, Craddock, Nick, Crooks, Lucy, Curran, Sarah, Curtis, David, Daly, Allan, Danecek, Petr, Day, Ian N M, Day-Williams, Aaron G, Dominiczak, Anna, Down, Thomas, Du, Yuanping, Dunham, Ian, Durbin, Richard, Edkins, Sarah, Ekong, Rosemary, Ellis, Peter, Evansa, David M., FitzPatrick, David R., Flicek, Paul, Floyd, James S., Foley, A. Reghan, Franklin, Christopher S., Futema, Marta, Gallagher, Louise, Gaunt, Tom R., Geihs, Matthias, Geschwind, Daniel H., Greenwood, Celia M.T., Griffin, Heather, Grozeva, Detelina, Guo, Xiaosen, Guo, Xueqin, Gurling, Hugh, Hart, Deborah J., Holmans, Peter A, Howie, Bryan, Huang, Jie, Huang, Liren, Hubbard, Tim, Humphries, Steve E., Hurles, Matthew E., Hysi, Pirro G., Iotchkova, Valentina, Jackson, David K., Jamshidi, Yalda, Joyce, Chris, Karczewski, Konrad J., Kaye, Jane, Keane, Thomas, Kemp, John P., Kennedy, Karen, Kent, Alastair, Khawaja, Farrah, Van Kogelenberg, Margriet, Kolb-Kokocinski, Anja, Lachance, Genevieve, Langford, Cordelia, Lawson, Daniel, Lee, Irene, Lek, Monkol, Li, Rui, Li, Yingrui, Liang, Jieqin, Lin, Hong, Liu, Ryan, Lönnqvist, Jouko, Lopes, Luis R., Lopes, Margarida, MacArthur, Daniel G., Mangino, Massimo, Marchini, Jonathan, Maslen, John, Mathieson, Iain, McGuffin, Peter, McIntosh, Andrew M., McKechanie, Andrew G., McQuillin, Andrew, Memari, Yasin, Metrustry, Sarah, Migone, Nicola, Min, Josine L., Mitchison, Hannah M, Moayyeri, Alireza, Morris, Andrew D., Morris, James, Muntoni, Francesco, Northstone, Kate, O'Donovan, Michael C., Onoufriadis, Alexandros, Oualkacha, Karim, Owen, Michael J, Palotie, Aarno, Panoutsopoulou, Kalliope, Parker, Victoria, Parr, Jeremy R., Paternoster, Lavinia, Paunio, Tiina, Payne, Felicity, Payne, Stewart J., Perry, John R. B., Pietilainen, Olli, Plagnol, Vincent, Pollitt, Rebecca C., Porteous, David J., Povey, Sue, Quail, Michael A., Quaye, Lydia, Raymond, F. Lucy, Rehnström, Karola, Richards, J Brent, Ridout, Cheryl K., Ring, Susan M., Ritchie, Graham R.S., Roberts, Nicola, Robinson, Rachel L., Savage, David B., Scambler, Peter, Schiffels, Stephan, Schmidts, Miriam, Schoenmakers, Nadia, Scott, Richard H., Semple, Robert K., Serra, Eva, Sharp, Sally I., Shaw, Adam, Shihab, Hashem A., Shin, So Youn, Skuse, David, Small, Kerrin S, Smee, Carol, Smith, Blair H., Davey Smith, George, Soranzo, Nicole, Southam, Lorraine, Spasic-Boskovic, Olivera, Spector, Timothy D, St Clair, David, St Pourcain, Beate, Stalker, Jim, Stevens, Elizabeth, Sun, Jianping, Surdulescu, Gabriela L, Suvisaari, Jaana, Syrris, Petros, Taylor, Rohan, Tian, Jing, Timpson, Nicholas J., Tobin, Martin D, Valdes, Ana M., Vandersteen, Anthony M., Vijayarangakannan, Parthiban, Visscher, Peter M., Wain, Louise V., Walter, Klaudia, Walters, James T.R., Wang, Guangbiao, Wang, Jun, Wang, Nai-Yu, Ward, Kirsten, Whyte, Tamieka, Williams, Hywel J., Williamson, Kathleen A., Wilson, Crispian, Wilson, Scott G., Wong, Kim, Xu, Changjiang, Yang, Jian, Zhang, Feng, Zhang, Pingbo, and Zheng, Hou Feng
Published: 2017

169. Smokeless tobacco (snus) use and colorectal cancer incidence and survival : Results from nine pooled cohorts

Author: Araghi, Marzieh, Galanti, Maria Rosaria, Lundberg, Michael, Liu, Zhiwei, Ye, Weimin, Lager, Anton, Engström, Gunnar, Manjer, Jonas, Alfredsson, Lars, Knutsson, Anders, Norberg, Margareta, Palmqvist, Richard, Gylling, Björn, Wennberg, Patrik, Lagerros, Ylva Trolle, Bellocco, Rino, Pedersen, Nancy L., Östergren, Per-Olof, Magnusson, Cecilia, Araghi, Marzieh, Galanti, Maria Rosaria, Lundberg, Michael, Liu, Zhiwei, Ye, Weimin, Lager, Anton, Engström, Gunnar, Manjer, Jonas, Alfredsson, Lars, Knutsson, Anders, Norberg, Margareta, Palmqvist, Richard, Gylling, Björn, Wennberg, Patrik, Lagerros, Ylva Trolle, Bellocco, Rino, Pedersen, Nancy L., Östergren, Per-Olof, and Magnusson, Cecilia
Abstract: Aims: Although smoking is considered to be an established risk factor for colorectal cancer, the current evidence on the association between smokeless tobacco and colorectal cancer is scant and inconclusive. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess this association. Methods: A total of 417,872 male participants from nine cohort studies across Sweden were followed up for incidence of colorectal cancer and death. Outcomes were ascertained through linkage to health registers. We used shared frailty models with random effects at the study level to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During 7,135,504 person-years of observation, 4170 men developed colorectal cancer. There was no clear association between snus use and colorectal cancer overall. Exclusive current snus users, however, had an increased risk of rectal cancer (HR 1.40: 95% CI 1.09, 1.79). There were no statistically significant associations between snus use and either all-cause or colorectal cancer-specific mortality after colorectal cancer diagnosis. Conclusions: Our findings, from a large sample, do not support any strong relationships between snus use and colorectal cancer risk and survival among men. However, the observed increased risk of rectal cancer is noteworthy, and in merit of further attention.
Published: 2017
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170. 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

Author: Engberg, Isak, Segerstedt, Johan, Waller, Göran, Wennberg, Patrik, Eliasson, Mats, Engberg, Isak, Segerstedt, Johan, Waller, Göran, Wennberg, Patrik, and Eliasson, Mats
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.
Published: 2017
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171. Natriuretic peptides and integrated risk assessment for cardiovascular disease: an individual-participant-data meta-analysis

Author: Ballantyne, Christie M., Levy, Daniel, Hofman, Albert, Devereux, Richard B., Barrett-Connor, Elizabeth, Gansevoort, Ron T., Maisel, Alan S., Nordestgaard, Børge G., Cook, Nancy R., Lima, João A., Nambi, Vijay, Olsen, Michael Hecht, Yarnell, John W.G., Whincup, Peter H., Raymond, Ilan, Casas, Juan-Pablo, Manson, JoAnn E., Jukema, J. Wouter, Ikram, M. Arfan, Luchner, Andreas, Zethelius, Björn, Pradhan, Aruna D., Hoogeveen, Ron C., Safford, Monika M., Franco, Oscar H., Andersson, Jonas, Stark, Klaus, Salonen, Jukka T., Dehghan, Abbas, Kavousi, Maryam, Santer, Peter, Lindahl, Bertil, Rubattu, Speranza, Kistorp, Caroline N., Jørgensen, Torben, Schou, Morten, Peters, Annette, van den Meiracker, Anton H., Lind, Lars, Dieplinger, Benjamin, Haltmayer, Meinhard, Ruskoaho, Heikki, Kizer, Jorge R., Strazzullo, Pasquale, Kiechl, Stefan, Everett, Brendan M., de Craen, Anton J.M., Agarwal, Sunil K., Panagiotakos, Demosthenes B., Ridker, Paul M., Wannamethee, S. Goya, McGuire, Darren K., Willeit, Johann, Kee, Frank, Melander, Olle, Das, Sandeep R., Ford, Ian, Wennberg, Patrik, Zakai, Neil A., Best, Lyle G., Lawlor, Debbie A., Zeller, Tanja, Rosenberg, Jens, Psaty, Bruce M., Gudnason, Vilmundur, Trompet, Stella, Andresdottir, Margret B., Stott, David J., Drazner, Mark H., Cushman, Mary, Gustafsson, Finn, Hildebrandt, Per R., Ninomiya, Toshiharu, Agnarsson, Uggi, Hata, Jun, Bakker, Stephan J.L., Welsh, Paul, de Boer, Rudolf A., Mueller, Thomas, Giedraitis, Vilmantas, Howard, Virginia J., Kauhanen, Jussi, DeFilippi, Christopher, Laukkanen, Jari A., Willeit, Peter, Volpe, Massimo, de Lemos, James A., Kiyohara, Yutaka, Evans, Alun, van Rooij, Frank J.A., Venge, Per, Salomaa, Veikko, Jansson, Jan-Håkan, Heid, Iris M., Aspelund, Thor, Kronmal, Richard A., Eiriksdottir, Gudny, Lannfelt, Lars, Harald, Kennet, Schett, Georg, Tuomainen, Tomi-Pekka, Vartiainen, Erkki, Judd, Suzanne, Packard, Chris J., Daniels, Lori B., Ärnlöv, Johan, Sattar, Naveed, Umans, Jason G., Ligthart, Symen, and Heckbert, Susan R.
Abstract: BACKGROUND: Guidelines for primary prevention of cardiovascular diseases focus on prediction of coronary heart disease and stroke. We assessed whether or not measurement of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentration could enable a more integrated approach than at present by predicting heart failure and enhancing coronary heart disease and stroke risk assessment. METHODS: In this individual-participant-data meta-analysis, we generated and harmonised individual-participant data from relevant prospective studies via both de-novo NT-proBNP concentration measurement of stored samples and collection of data from studies identified through a systematic search of the literature (PubMed, Scientific Citation Index Expanded, and Embase) for articles published up to Sept 4, 2014, using search terms related to natriuretic peptide family members and the primary outcomes, with no language restrictions. We calculated risk ratios and measures of risk discrimination and reclassification across predicted 10 year risk categories (ie
Published: 2016
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172. Parity, breastfeeding and risk of coronary heart disease: A pan-European case-cohort study

Author: Peters, Sanne A. E. van der Schouw, Yvonne T. Wood, Angela M. and Sweeting, Michael J. Moons, Karel G. M. Weiderpass, Elisabete Arriola, Larraitz Benetou, Vassiliki Boeing, Heiner Bonnet, Fabrice Butt, Salma T. Clavel-Chapelon, Francoise Drake, Isabel Gavrila, Diana Key, Timothy J. and Klinaki, Eleni Krogh, Vittorio Kuehn, Tilman Lassale, Camille Masala, Giovanna Matullo, Giuseppe Merritt, Melissa and Molina-Portillo, Elena Moreno-Iribas, Conchi Nost, Therese H. Olsen, Anja Onland-Moret, N. Charlotte Overvad, Kim and Panico, Salvatore Redondo, M. Luisa Tjonneland, Anne and Trichopoulou, Antonia Tumino, Rosario Turzanski-Fortner, Renee and Tzoulaki, Ioanna Wennberg, Patrik Winkvist, Anna and Thompson, Simon G. Di Angelantonio, Emanuele Riboli, Elio and Wareham, Nicholas J. Danesh, John Butterworth, Adam S.
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

173. Association ofLPAVariants With Risk of Coronary Disease and the Implications for Lipoprotein(a)-Lowering Therapies

Author: Burgess, Stephen, Ference, Brian A., Staley, James R., Freitag, Daniel F., Mason, Amy M., Nielsen, Sune F., Willeit, Peter, Young, Robin, Surendran, Praveen, Karthikeyan, Savita, Bolton, Thomas R., Peters, James E., Kamstrup, Pia, Tybjærg-Hansen, Anne, Benn, Marianne, Langsted, Anne, Schnohr, Peter, Vedel-Krogh, Signe, Kobylecki, Camilla J., Ford, Ian, Packard, Chris, Trompet, Stella, Jukema, J. Wouter, Sattar, Naveed, Di Angelantonio, Emanuele, Saleheen, Danish, Howson, Joanna M.M., Nordestgaard, Børge G., Butterworth, Adam S., Danesh, John, Bargess, Stephen, Overvad, Kim, Tjønneland, Anne, Clavel-Chapelon, Francoise, Kaaks, Rudolf, Boeing, Heiner, Trichopoulou, Antonia, Ferrari, Pietro, Palli, Domenico, Krogh, Vittorio, Panico, Salvatore, Tumino, Rosario, Matullo, Giuseppe, Boer, Jolanda, Van Der Schouw, Yvonne, Weiderpass, Elisabete, Quiros, J. Ramon, Sánchez, María José, Navarro, Carmen, Moreno-Iribas, Conchi, Arriola, Larraitz, Melander, Olle, Wennberg, Patrik, Wareham, Nicholas J., Key, Timothy J., Riboli, Elio, Burgess, Stephen [0000-0001-5365-8760], Mason, Amy [0000-0002-8019-0777], Surendran, Praveen [0000-0002-4911-6077], Karthikeyan, Savita [0000-0002-4798-5746], Di Angelantonio, Emanuele [0000-0001-8776-6719], Howson, Joanna [0000-0001-7618-0050], Butterworth, Adam [0000-0002-6915-9015], Danesh, John [0000-0003-1158-6791], and Apollo - University of Cambridge Repository
Subjects: Male, medicine.medical_specialty, Population, Coronary Disease, Coronary Artery Disease, 030204 cardiovascular system & hematology, Polymorphism, Single Nucleotide, Article, law.invention, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Randomized controlled trial, Ezetimibe, Risk Factors, law, Internal medicine, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Precision Medicine, Prospective cohort study, education, Hypolipidemic Agents, education.field_of_study, biology, Cholesterol, business.industry, Genetic Variation, Mendelian Randomization Analysis, Cholesterol, LDL, Lipoprotein(a), Odds ratio, Middle Aged, Prognosis, Phenotype, chemistry, biology.protein, Female, Cardiology and Cardiovascular Medicine, business, Biomarkers, Follow-Up Studies, medicine.drug
Abstract: Importance: Human genetic studies have indicated that plasma lipoprotein(a) (Lp[a]) is causally associated with the risk of coronary heart disease (CHD), but randomized trials of several therapies that reduce Lp(a) levels by 25% to 35% have not provided any evidence that lowering Lp(a) level reduces CHD risk.Objective: To estimate the magnitude of the change in plasma Lp(a) levels needed to have the same evidence of an association with CHD risk as a 38.67-mg/dL (ie, 1-mmol/L) change in low-density lipoprotein cholesterol (LDL-C) level, a change that has been shown to produce a clinically meaningful reduction in the risk of CHD.Design, Setting, and Participants: A mendelian randomization analysis was conducted using individual participant data from 5 studies and with external validation using summarized data from 48 studies. Population-based prospective cohort and case-control studies featured 20 793 individuals with CHD and 27 540 controls with individual participant data, whereas summarized data included 62 240 patients with CHD and 127 299 controls. Data were analyzed from November 2016 to March 2018.Exposures: Genetic LPA score and plasma Lp(a) mass concentration.Main Outcomes and Measures: Coronary heart disease.Results: Of the included study participants, 53% were men, all were of white European ancestry, and the mean age was 57.5 years. The association of genetically predicted Lp(a) with CHD risk was linearly proportional to the absolute change in Lp(a) concentration. A 10-mg/dL lower genetically predicted Lp(a) concentration was associated with a 5.8% lower CHD risk (odds ratio [OR], 0.942; 95% CI, 0.933-0.951; P = 3 × 10-37), whereas a 10-mg/dL lower genetically predicted LDL-C level estimated using an LDL-C genetic score was associated with a 14.5% lower CHD risk (OR, 0.855; 95% CI, 0.818-0.893; P = 2 × 10-12). Thus, a 101.5-mg/dL change (95% CI, 71.0-137.0) in Lp(a) concentration had the same association with CHD risk as a 38.67-mg/dL change in LDL-C level. The association of genetically predicted Lp(a) concentration with CHD risk appeared to be independent of changes in LDL-C level owing to genetic variants that mimic the relationship of statins, PCSK9 inhibitors, and ezetimibe with CHD risk.Conclusions and Relevance: The clinical benefit of lowering Lp(a) is likely to be proportional to the absolute reduction in Lp(a) concentration. Large absolute reductions in Lp(a) of approximately 100 mg/dL may be required to produce a clinically meaningful reduction in the risk of CHD similar in magnitude to what can be achieved by lowering LDL-C level by 38.67 mg/dL (ie, 1 mmol/L).
Published: 2018

174. Time trends of comparative self-rated health in adults aged 25-34 in the Northern Sweden MONICA study, 1990-2014

Author: Waller Lidström, Mattias, primary, Wennberg, Patrik, additional, Lundqvist, Robert, additional, Forssén, Annika, additional, and Waller, Göran, additional
Published: 2017
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175. Smokeless tobacco (snus) use and colorectal cancer incidence and survival: Results from nine pooled cohorts

Author: Araghi, Marzieh, primary, Galanti, Maria Rosaria, additional, Lundberg, Michael, additional, Liu, Zhiwei, additional, Ye, Weimin, additional, Lager, Anton, additional, Engström, Gunnar, additional, Manjer, Jonas, additional, Alfredsson, Lars, additional, Knutsson, Anders, additional, Norberg, Margareta, additional, Palmqvist, Richard, additional, Gylling, Björn, additional, Wennberg, Patrik, additional, Lagerros, Ylva trolle, additional, Bellocco, Rino, additional, Pedersen, Nancy L., additional, Östergren, Per-olof, additional, and Magnusson, Cecilia, additional
Published: 2017
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176. Physical activity, mediating factors and risk of colon cancer: insights into adiposity and circulating biomarkers from the EPIC cohort

Author: Aleksandrova, Krasimira, primary, Jenab, Mazda, additional, Leitzmann, Michael, additional, Bueno-de-Mesquita, Bas, additional, Kaaks, Rudolf, additional, Trichopoulou, Antonia, additional, Bamia, Christina, additional, Lagiou, Pagona, additional, Rinaldi, Sabina, additional, Freisling, Heinz, additional, Carayol, Marion, additional, Pischon, Tobias, additional, Drogan, Dagmar, additional, Weiderpass, Elisabete, additional, Jakszyn, Paula, additional, Overvad, Kim, additional, Dahm, Christina C, additional, Tjønneland, Anne, additional, Bouton-Ruault, Marie-Christine, additional, Kühn, Tilman, additional, Peppa, Eleni, additional, Valanou, Elissavet, additional, La Vecchia, Carlo, additional, Palli, Domenico, additional, Panico, Salvatore, additional, Sacerdote, Carlotta, additional, Agnoli, Claudia, additional, Tumino, Rosario, additional, May, Anne, additional, van Vulpen, Jonna, additional, Benjaminsen Borch, Kristin, additional, Oluwafemi Oyeyemi, Sunday, additional, Quirós, J Ramón, additional, Bonet, Catalina, additional, Sánchez, María-José, additional, Dorronsoro, Miren, additional, Navarro, Carmen, additional, Barricarte, Aurelio, additional, van Guelpen, Bethany, additional, Wennberg, Patrik, additional, Key, Timothy J, additional, Khaw, Kay-Tee, additional, Wareham, Nicholas, additional, Assi, Nada, additional, Ward, Heather A, additional, Aune, Dagfinn, additional, Riboli, Elio, additional, and Boeing, Heiner, additional
Published: 2017
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177. Screening for type 2 diabetes: do screen-detected cases fare better?

Author: Feldman, Adina L., primary, Griffin, Simon J., additional, Fhärm, Eva, additional, Norberg, Margareta, additional, Wennberg, Patrik, additional, Weinehall, Lars, additional, and Rolandsson, Olov, additional
Published: 2017
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178. 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

Author: Engberg, Isak, primary, Segerstedt, Johan, additional, Waller, Göran, additional, Wennberg, Patrik, additional, and Eliasson, Mats, additional
Published: 2017
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179. Separate and combined associations of obesity and metabolic health with coronary heart disease: a pan-European case-cohort analysis

Author: Lassale, Camille, primary, Tzoulaki, Ioanna, additional, Moons, Karel G M, additional, Sweeting, Michael, additional, Boer, Jolanda, additional, Johnson, Laura, additional, Huerta, José María, additional, Agnoli, Claudia, additional, Freisling, Heinz, additional, Weiderpass, Elisabete, additional, Wennberg, Patrik, additional, van der A, Daphne L, additional, Arriola, Larraitz, additional, Benetou, Vassiliki, additional, Boeing, Heiner, additional, Bonnet, Fabrice, additional, Colorado-Yohar, Sandra M, additional, Engström, Gunnar, additional, Eriksen, Anne K, additional, Ferrari, Pietro, additional, Grioni, Sara, additional, Johansson, Matthias, additional, Kaaks, Rudolf, additional, Katsoulis, Michail, additional, Katzke, Verena, additional, Key, Timothy J, additional, Matullo, Giuseppe, additional, Melander, Olle, additional, Molina-Portillo, Elena, additional, Moreno-Iribas, Concepción, additional, Norberg, Margareta, additional, Overvad, Kim, additional, Panico, Salvatore, additional, Quirós, J Ramón, additional, Saieva, Calogero, additional, Skeie, Guri, additional, Steffen, Annika, additional, Stepien, Magdalena, additional, Tjønneland, Anne, additional, Trichopoulou, Antonia, additional, Tumino, Rosario, additional, van der Schouw, Yvonne T, additional, Verschuren, W M Monique, additional, Langenberg, Claudia, additional, Di Angelantonio, Emanuele, additional, Riboli, Elio, additional, Wareham, Nicholas J, additional, Danesh, John, additional, and Butterworth, Adam S, additional
Published: 2017
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180. Snus use during the life-course and risk of the metabolic syndrome and its components

Author: Byhamre, Marja Lisa, primary, Gustafsson, Per E, additional, Jansson, Jan-Håkan, additional, Wennberg, Maria, additional, Hammarström, Anne, additional, and Wennberg, Patrik, additional
Published: 2017
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181. Use of moist oral snuff (snus) and pancreatic cancer: Pooled analysis of nine prospective observational studies

Author: Araghi, Marzieh, primary, Rosaria Galanti, Maria, additional, Lundberg, Michael, additional, Lager, Anton, additional, Engström, Gunnar, additional, Alfredsson, Lars, additional, Knutsson, Anders, additional, Norberg, Margareta, additional, Sund, Malin, additional, Wennberg, Patrik, additional, Trolle Lagerros, Ylva, additional, Bellocco, Rino, additional, Pedersen, Nancy L., additional, Östergren, Per-Olof, additional, and Magnusson, Cecilia, additional
Published: 2017
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182. Change in lifestyle behaviors and diabetes risk: evidence from a population-based cohort study with 10 year follow-up

Author: Feldman, Adina L., primary, Long, Gráinne H., additional, Johansson, Ingegerd, additional, Weinehall, Lars, additional, Fhärm, Eva, additional, Wennberg, Patrik, additional, Norberg, Margareta, additional, Griffin, Simon J., additional, and Rolandsson, Olov, additional
Published: 2017
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183. Impact of weight maintenance and loss on diabetes risk and burden: a population-based study in 33,184 participants

Author: Feldman, Adina L., primary, Griffin, Simon J., additional, Ahern, Amy L., additional, Long, Grainne H., additional, Weinehall, Lars, additional, Fhärm, Eva, additional, Norberg, Margareta, additional, and Wennberg, Patrik, additional
Published: 2017
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184. A client-centred programme focusing energy conservation for people with heart failure

Author: Norberg, Eva-Britt, primary, Löfgren, Britta, additional, Boman, Kurt, additional, Wennberg, Patrik, additional, and Brännström, Margareta, additional
Published: 2017
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185. Moist smokeless tobacco (Snus) use and risk of Parkinson’s disease

Author: Yang, Fei, primary, Pedersen, Nancy L., additional, Ye, Weimin, additional, Liu, Zhiwei, additional, Norberg, Margareta, additional, Forsgren, Lars, additional, Trolle Lagerros, Ylva, additional, Bellocco, Rino, additional, Alfredsson, Lars, additional, Knutsson, Anders, additional, Jansson, Jan-Håkan, additional, Wennberg, Patrik, additional, Galanti, Maria Rosaria, additional, Lager, Anton C.J., additional, Araghi, Marzieh, additional, Lundberg, Michael, additional, Magnusson, Cecilia, additional, and Wirdefeldt, Karin, additional
Published: 2016
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186. Physical activity and risk of Amyotrophic Lateral Sclerosis in a prospective cohort study

Author: Gallo, Valentina, Vanacore, Nicola, Bueno-de-Mesquita, H Bas, Vermeulen, Roel, Brayne, Carol, Pearce, Neil, Wark, Petra A, Ward, Heather A, Ferrari, Pietro, Jenab, Mazda, Andersen, Peter M, Wennberg, Patrik, Wareham, Nicholas, Katzke, Verena, Kaaks, Rudolf, Weiderpass, Elisabete, Peeters, Petra H, Mattiello, Amalia, Pala, Valeria, Barricante, Aurelio, Chirlaque, Maria-Dolores, Travier, Noémie, Travis, Ruth C, Sanchez, Maria-Jose, Pessah-Rasmussen, Hélène, Petersson, Jesper, Tjønneland, Anne, Tumino, Rosario, Quiros, Jose Ramon, Trichopoulou, Antonia, Kyrozis, Andreas, Oikonomidou, Despoina, Masala, Giovanna, Sacerdote, Carlotta, Arriola, Larraitz, Boeing, Heiner, Vigl, Matthaeus, Claver-Chapelon, Francoise, Middleton, Lefkos, Riboli, Elio, Vineis, Paolo, Gallo, Valentina, Vanacore, Nicola, Bueno-de-Mesquita, H Bas, Vermeulen, Roel, Brayne, Carol, Pearce, Neil, Wark, Petra A, Ward, Heather A, Ferrari, Pietro, Jenab, Mazda, Andersen, Peter M, Wennberg, Patrik, Wareham, Nicholas, Katzke, Verena, Kaaks, Rudolf, Weiderpass, Elisabete, Peeters, Petra H, Mattiello, Amalia, Pala, Valeria, Barricante, Aurelio, Chirlaque, Maria-Dolores, Travier, Noémie, Travis, Ruth C, Sanchez, Maria-Jose, Pessah-Rasmussen, Hélène, Petersson, Jesper, Tjønneland, Anne, Tumino, Rosario, Quiros, Jose Ramon, Trichopoulou, Antonia, Kyrozis, Andreas, Oikonomidou, Despoina, Masala, Giovanna, Sacerdote, Carlotta, Arriola, Larraitz, Boeing, Heiner, Vigl, Matthaeus, Claver-Chapelon, Francoise, Middleton, Lefkos, Riboli, Elio, and Vineis, Paolo
Abstract: Previous case-control studies have suggested a possible increased risk of Amyotrophic Lateral Sclerosis (ALS) with physical activity (PA), but this association has never been studied in prospective cohort studies. We therefore assessed the association between PA and risk of death from ALS in the European Prospective Investigation into Cancer and Nutrition. A total of 472,100 individuals were included in the analysis, yielding 219 ALS deaths. At recruitment, information on PA was collected thorough standardised questionnaires. Total PA was expressed by the Cambridge Physical Activity Index (CPAI) and analysed in relation to ALS mortality, using Cox hazard models. Interactions with age, sex, and anthropometric measures were assessed. Total PA was weakly inversely associated with ALS mortality with a borderline statistically significant trend across categories (p = 0.042), with those physically active being 33% less likely to die from ALS compared to those inactive: HR = 0.67 (95% CI 0.42-1.06). Anthropometric measures, sex, and age did not modify the association with CPAI. The present study shows a slightly decreased-not increased like in case-control studies-risk of dying from ALS in those with high levels of total PA at enrolment. This association does not appear confounded by age, gender, anthropometry, smoking, and education. Ours was the first prospective cohort study on ALS and physical activity.
Published: 2016

187. Diabetes mellitus, high BMI and low education level predict sudden cardiac death within 24 hours of incident myocardial infarction

Author: Andersson, Jonas, Wennberg, Patrik, Lundblad, Dan, Escher, Stefan A, Jansson, Jan-Håkan, Andersson, Jonas, Wennberg, Patrik, Lundblad, Dan, Escher, Stefan A, and Jansson, Jan-Håkan
Abstract: BACKGROUND: More than half of cardiovascular mortality occurs outside the hospital, mainly due to consistently low survival rates from out-of-hospital cardiac arrest. METHODS: This is a prospective, nested, case-control study derived from the Västerbotten Intervention Programme and the World Health Organization's Multinational Monitoring of Trends and Determinants in Cardiovascular Disease study in northern Sweden (1986-2006). To determine predictors for sudden cardiac death risk factors for cardiovascular disease were compared between incident myocardial infarction with sudden cardiac death (n = 363) and survivors of incident myocardial infarction (n = 1998) using multivariate logistic regression analysis. RESULTS: Diabetes had the strongest association with sudden cardiac death out of all evaluated risk factors (odds ratio (OR) 1.83, 95% confidence interval (CI) 1.30-2.59), followed by low education (OR 1.55, 95% CI 1.19-2.01), high body mass index (OR 1.05, 95% CI 1.02-1.08) and male sex (OR 1.42, 95% CI 1.001-2.01). CONCLUSIONS: The pattern of risk factors for incident myocardial infarction is different among survivors and those who die within 24 hours. The risk factors that contribute the most to death within 24 hours are diabetes mellitus, high body mass index and low education level, and can be addressed at both the public health level and by general practitioners.
Published: 2016
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188. Irregular eating of meals in adolescence and the metabolic syndrome in adulthood : results from a 27-year prospective cohort

Author: Wennberg, Maria, Gustafsson, Per, Wennberg, Patrik, Hammarström, Anne, Wennberg, Maria, Gustafsson, Per, Wennberg, Patrik, and Hammarström, Anne
Abstract: Objective: The objective was to investigate whether irregular eating of meals in adolescence predicts the metabolic syndrome and its components in adulthood, and if any specific meal is of particular importance. Design: Prospective cohort study with 27 years of follow-up. Information on meals (breakfast, school lunch and dinner with family), lifestyle (alcohol consumption, smoking habits, physical activity, consumption of sweets and pastries) at age 16 years was assessed from questionnaires, and presence or not of the metabolic syndrome and its components were defined at age 43 years in 889 participants (82.1 % of total cohort). Logistic regression was used to calculate odds ratios and confidence intervals. Setting: The Northern Swedish Cohort; all school-leavers of the 9th grade in the town Lulea in 1981. Subjects: Adolescents (age 16 years). Results: Irregular eating of meals at age 16 years was associated with higher prevalence of the metabolic syndrome at age 43 years (OR=1.74; 95 % CI 1.12, 2.71), but this was explained by concurrent unhealthy lifestyle at age 16 years. Poor breakfast at age 16 years was the only meal associated with the metabolic syndrome at age 43 years, independent of other meals, BMI (kg/m2) and lifestyle at age 16 years (OR = 1.67; 95 % CI 1.00, 2.80). Conclusions: Irregular eating of meals in adolescence predicted the metabolic syndrome in adulthood, but not independently of BMI and lifestyle in adolescence. Poor breakfast in adolescence was the only specific meal associated with future metabolic syndrome, even after adjustments. Breakfast eating should be encouraged in adolescence.
Published: 2016
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189. Bicycling to work and primordial prevention of cardiovascular and type 2 diabetes risk : a cohort study from Northern Sweden

Author: Koivula, R. W., Grontved, A., Johansson, Ingegerd, Wennberg, Patrik, Ostergaard, L., Hallmans, Göran, Renstrom, Frida, Franks, Paul W., Koivula, R. W., Grontved, A., Johansson, Ingegerd, Wennberg, Patrik, Ostergaard, L., Hallmans, Göran, Renstrom, Frida, and Franks, Paul W.
Abstract: Supplement: 1, Meeting Abstract: 298
Published: 2016

190. Bicycling to Work and Primordial Prevention of Cardiovascular Risk : A Cohort Study Among Swedish Men and Women

Author: Grøntved, Anders, Koivula, Robert W, Johansson, Ingegerd, Wennberg, Patrik, Østergaard, Lars, Hallmans, Göran, Renström, Frida, Franks, Paul W, Grøntved, Anders, Koivula, Robert W, Johansson, Ingegerd, Wennberg, Patrik, Østergaard, Lars, Hallmans, Göran, Renström, Frida, and Franks, Paul W
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.
Published: 2016
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191. Acute effects of breaking up prolonged sitting on fatigue and cognition : a pilot study

Author: Wennberg, Patrik, Boraxbekk, Carl-Johan, Wheeler, Michael, Howard, Bethany, Dempsey, Paddy C., Lambert, Gavin, Eikelis, Nina, Larsen, Robyn, Sethi, Parneet, Occleston, Jessica, Hernestål-Boman, Jenny, Ellis, Kathryn A., Owen, Neville, Dunstan, David W., Wennberg, Patrik, Boraxbekk, Carl-Johan, Wheeler, Michael, Howard, Bethany, Dempsey, Paddy C., Lambert, Gavin, Eikelis, Nina, Larsen, Robyn, Sethi, Parneet, Occleston, Jessica, Hernestål-Boman, Jenny, Ellis, Kathryn A., Owen, Neville, and Dunstan, David W.
Abstract: Objectives: To compare the acute effects of uninterrupted sitting with sitting interrupted by brief bouts of light-intensity walking on self-reported fatigue, cognition, neuroendocrine biomarkers and cardiometabolic risk markers in overweight/obese adults. Design: Randomised two-condition crossover trial. Setting: Laboratory study conducted in Melbourne, Australia. Participants: 19 overweight/obese adults (45–75 years). Interventions: After an initial 2 h period seated, participants consumed a meal-replacement beverage and completed (on 2 days separated by a 6-day washout period) each condition over the next 5 h: uninterrupted sitting (sedentary condition) or sitting with 3 min bouts of light-intensity walking every 30 min (active condition). Primary outcome measures: Self-reported fatigue, executive function and episodic memory at 0 h, 4 h and 7 h. Secondary outcome measures: Neuroendocrine biomarkers and cardiometabolic risk markers (blood collections at 0 h, 4 h and 7 h, blood pressure and heart rate measured hourly and interstitial glucose measured using a continuous glucose monitoring system). Results: During the active condition, fatigue levels were lower at 4 h (−13.32 (95% CI −23.48 to −3.16)) and at 7 h (−10.73 (95% CI −20.89 to −0.58)) compared to the sedentary condition. Heart rate was higher at 4 h (4.47 (95% CI 8.37 to 0.58)) and at 7 h (4.32 (95% CI 8.21 to 0.42)) during the active condition compared to the sedentary condition. There were no significant differences between conditions by time for other variables. In the sedentary condition, changes in fatigue scores over time correlated with a decrease in heart rate and plasma dihydroxyphenylalanine (DOPA) and an increase in plasma dihydroxyphenylglycol (DHPG). Conclusions: Interrupting prolonged sitting with light-intensity walking breaks may be an effective fatigue countermeasure acutely. Fatigue levels corresponded with the heart rate and neuroendocrine biomarker changes in uninterrupted sitting in t
Published: 2016
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192. Parity, breastfeeding and risk of coronary heart disease : A pan-European case-cohort study

Author: Peters, Sanne A. E., van der Schouw, Yvonne T., Wood, Angela M., Sweeting, Michael J., Moons, Karel G. M., Weiderpass, Elisabete, Arriola, Larraitz, Benetou, Vassiliki, Boeing, Heiner, Bonnet, Fabrice, Butt, Salma T., Clavel-Chapelon, Francoise, Drake, Isabel, Gavrila, Diana, Key, Timothy J., Klinaki, Eleni, Krogh, Vittorio, Kuehn, Tilman, Lassale, Camille, Masala, Giovanna, Matullo, Giuseppe, Merritt, Melissa, Molina-Portillo, Elena, Moreno-Iribas, Conchi, Nost, Therese H., Olsen, Anja, Onland-Moret, N. Charlotte, Overvad, Kim, Panico, Salvatore, Redondo, M. Luisa, Tjonneland, Anne, Trichopoulou, Antonia, Tumino, Rosario, Turzanski-Fortner, Renee, Tzoulaki, Ioanna, Wennberg, Patrik, Winkvist, Anna, Thompson, Simon G., Di Angelantonio, Emanuele, Riboli, Elio, Wareham, Nicholas J., Danesh, John, Butterworth, Adam S., Peters, Sanne A. E., van der Schouw, Yvonne T., Wood, Angela M., Sweeting, Michael J., Moons, Karel G. M., Weiderpass, Elisabete, Arriola, Larraitz, Benetou, Vassiliki, Boeing, Heiner, Bonnet, Fabrice, Butt, Salma T., Clavel-Chapelon, Francoise, Drake, Isabel, Gavrila, Diana, Key, Timothy J., Klinaki, Eleni, Krogh, Vittorio, Kuehn, Tilman, Lassale, Camille, Masala, Giovanna, Matullo, Giuseppe, Merritt, Melissa, Molina-Portillo, Elena, Moreno-Iribas, Conchi, Nost, Therese H., Olsen, Anja, Onland-Moret, N. Charlotte, Overvad, Kim, Panico, Salvatore, Redondo, M. Luisa, Tjonneland, Anne, Trichopoulou, Antonia, Tumino, Rosario, Turzanski-Fortner, Renee, Tzoulaki, Ioanna, Wennberg, Patrik, Winkvist, Anna, Thompson, Simon G., Di Angelantonio, Emanuele, Riboli, Elio, Wareham, Nicholas J., Danesh, John, and Butterworth, Adam S.
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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193. Self-Reported Sitting Time, Physical Activity and Fibrinolytic and Other Novel Cardio-Metabolic Biomarkers in Active Swedish Seniors

Author: Howard, Bethany J., Hurtig-Wennlof, Anita, Olsson, Lovisa A., Nilsson, Torbjorn K., Dunstan, David W., Wennberg, Patrik, Howard, Bethany J., Hurtig-Wennlof, Anita, Olsson, Lovisa A., Nilsson, Torbjorn K., Dunstan, David W., and Wennberg, Patrik
Abstract: Background: Too much sitting is linked with an increased risk of cardiovascular disease and mortality. The mediating mechanisms for these associations are largely unknown, however dysregulated fibrinolysis have emerged as a possible contributor. Objective: We examined the associations of self-reported overall sitting time and physical activity with fibrinolytic and other novel cardio-metabolic biomarkers in older adults. Materials and Methods: Data was analysed for 364 participants (74±7 yrs) of the Active Seniors group (retired, living independently in their own homes). Linear regression analyses examined associations of categories of categories of sitting time (≤3, 3–6, >6 hrs/day) and overall physical activity (Low, Moderate and High) with biomarkers in serum or plasma, adjusting for age, gender and smoking (with further adjustment for either overall physical activity or sitting time and BMI in secondary analyses). Results: Compared to sitting ≤ 3 hrs/day, sitting >6 hrs/day was associated with higher tissue plasminogen activator (tPA) and tissue plasminogen activator/plasminogen activator inhibitor-1 complex (tPA-PAI-1 complex). These associations were not independent of overall physical activity or BMI. Compared to those in the high physical activity, low physical activity was associated with a higher BMI, high-sensitivity C-reactive protein (hs-CRP) and tPA-PAI-1 complex levels. Only the associations of BMI and hs-CRP were independent of sitting time. Conclusions: These findings provide preliminary cross-sectional evidence for the relationships of sitting time with fibrinolytic markers in older adults. They also reinforce the importance of regular physical activity for cardio-metabolic health.
Published: 2016
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194. Parity, breastfeeding and risk of coronary heart disease : A pan-European case-cohort study

Author: Peters, Sanne A E, Van Der Schouw, Yvonne T., Wood, Angela M., Sweeting, Michael J., Moons, Karel G M, 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., Peters, Sanne A E, Van Der Schouw, Yvonne T., Wood, Angela M., Sweeting, Michael J., Moons, Karel G M, 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, and Butterworth, Adam S.
Published: 2016

195. Physical activity and risk of Amyotrophic Lateral Sclerosis in a prospective cohort study

Author: University of Helsinki, Department of Medical Genetics, Gallo, Valentina, Vanacore, Nicola, Bueno-de-Mesquita, H. Bas, Vermeulen, Roel, Brayne, Carol, Pearce, Neil, Wark, Petra A., Ward, Heather A., Ferrari, Pietro, Jenab, Mazda, Andersen, Peter M., Wennberg, Patrik, Wareham, Nicholas, Katzke, Verena, Kaaks, Rudolf, Weiderpass, Elisabete, Peeters, Petra H., Mattiello, Amalia, Pala, Valeria, Barricante, Aurelio, Chirlaque, Maria-Dolores, Travier, Noemie, Travis, Ruth C., Sanchez, Maria-Jose, Pessah-Rasmussen, Helene, Petersson, Jesper, Tjonneland, Anne, Tumino, Rosario, Ramon Quiros, Jose, Trichopoulou, Antonia, Kyrozis, Andreas, Oikonomidou, Despoina, Masala, Giovanna, Sacerdote, Carlotta, Arriola, Larraitz, Boeing, Heiner, Vigl, Matthaeus, Claver-Chapelon, Francoise, Middleton, Lefkos, Riboli, Elio, Vineis, Paolo, University of Helsinki, Department of Medical Genetics, Gallo, Valentina, Vanacore, Nicola, Bueno-de-Mesquita, H. Bas, Vermeulen, Roel, Brayne, Carol, Pearce, Neil, Wark, Petra A., Ward, Heather A., Ferrari, Pietro, Jenab, Mazda, Andersen, Peter M., Wennberg, Patrik, Wareham, Nicholas, Katzke, Verena, Kaaks, Rudolf, Weiderpass, Elisabete, Peeters, Petra H., Mattiello, Amalia, Pala, Valeria, Barricante, Aurelio, Chirlaque, Maria-Dolores, Travier, Noemie, Travis, Ruth C., Sanchez, Maria-Jose, Pessah-Rasmussen, Helene, Petersson, Jesper, Tjonneland, Anne, Tumino, Rosario, Ramon Quiros, Jose, Trichopoulou, Antonia, Kyrozis, Andreas, Oikonomidou, Despoina, Masala, Giovanna, Sacerdote, Carlotta, Arriola, Larraitz, Boeing, Heiner, Vigl, Matthaeus, Claver-Chapelon, Francoise, Middleton, Lefkos, Riboli, Elio, and Vineis, Paolo
Abstract: Previous case-control studies have suggested a possible increased risk of Amyotrophic Lateral Sclerosis (ALS) with physical activity (PA), but this association has never been studied in prospective cohort studies. We therefore assessed the association between PA and risk of death from ALS in the European Prospective Investigation into Cancer and Nutrition. A total of 472,100 individuals were included in the analysis, yielding 219 ALS deaths. At recruitment, information on PA was collected thorough standardised questionnaires. Total PA was expressed by the Cambridge Physical Activity Index (CPAI) and analysed in relation to ALS mortality, using Cox hazard models. Interactions with age, sex, and anthropometric measures were assessed. Total PA was weakly inversely associated with ALS mortality with a borderline statistically significant trend across categories (p = 0.042), with those physically active being 33 % less likely to die from ALS compared to those inactive: HR = 0.67 (95 % CI 0.42-1.06). Anthropometric measures, sex, and age did not modify the association with CPAI. The present study shows a slightly decreased-not increased like in case-control studies-risk of dying from ALS in those with high levels of total PA at enrolment. This association does not appear confounded by age, gender, anthropometry, smoking, and education. Ours was the first prospective cohort study on ALS and physical activity.
Published: 2016

196. Physical activity and risk of Amyotrophic Lateral Sclerosis in a prospective cohort study

Author: LS IRAS EEPI GRA (Gezh.risico-analyse), dIRAS RA-I&I RA, dIRAS RA-2, Gallo, Valentina, Vanacore, Nicola, Bueno-de-Mesquita, H Bas, Vermeulen, Roel, Brayne, Carol, Pearce, Neil, Wark, Petra A, Ward, Heather A, Ferrari, Pietro, Jenab, Mazda, Andersen, Peter M, Wennberg, Patrik, Wareham, Nicholas, Katzke, Verena, Kaaks, Rudolf, Weiderpass, Elisabete, Peeters, Petra H, Mattiello, Amalia, Pala, Valeria, Barricante, Aurelio, Chirlaque, Maria-Dolores, Travier, Noémie, Travis, Ruth C, Sanchez, Maria-Jose, Pessah-Rasmussen, Hélène, Petersson, Jesper, Tjønneland, Anne, Tumino, Rosario, Quiros, Jose Ramon, Trichopoulou, Antonia, Kyrozis, Andreas, Oikonomidou, Despoina, Masala, Giovanna, Sacerdote, Carlotta, Arriola, Larraitz, Boeing, Heiner, Vigl, Matthaeus, Claver-Chapelon, Francoise, Middleton, Lefkos, Riboli, Elio, Vineis, Paolo, LS IRAS EEPI GRA (Gezh.risico-analyse), dIRAS RA-I&I RA, dIRAS RA-2, Gallo, Valentina, Vanacore, Nicola, Bueno-de-Mesquita, H Bas, Vermeulen, Roel, Brayne, Carol, Pearce, Neil, Wark, Petra A, Ward, Heather A, Ferrari, Pietro, Jenab, Mazda, Andersen, Peter M, Wennberg, Patrik, Wareham, Nicholas, Katzke, Verena, Kaaks, Rudolf, Weiderpass, Elisabete, Peeters, Petra H, Mattiello, Amalia, Pala, Valeria, Barricante, Aurelio, Chirlaque, Maria-Dolores, Travier, Noémie, Travis, Ruth C, Sanchez, Maria-Jose, Pessah-Rasmussen, Hélène, Petersson, Jesper, Tjønneland, Anne, Tumino, Rosario, Quiros, Jose Ramon, Trichopoulou, Antonia, Kyrozis, Andreas, Oikonomidou, Despoina, Masala, Giovanna, Sacerdote, Carlotta, Arriola, Larraitz, Boeing, Heiner, Vigl, Matthaeus, Claver-Chapelon, Francoise, Middleton, Lefkos, Riboli, Elio, and Vineis, Paolo
Published: 2016

197. Parity, breastfeeding and risk of coronary heart disease: A pan-European case-cohort study

Author: JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Circulatory Health, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Epi Methoden, Cancer, Child Health, JC onderzoeksprogramma Methodologie, Cardiovasculaire Epi Team 1, Cardiovasculaire Epi Team 3, Brain, JC onderzoeksprogramma Kanker, Peters, Sanne A E, Van Der Schouw, Yvonne T., Wood, Angela M., Sweeting, Michael J., Moons, Karel G M, 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., JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Circulatory Health, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Epi Methoden, Cancer, Child Health, JC onderzoeksprogramma Methodologie, Cardiovasculaire Epi Team 1, Cardiovasculaire Epi Team 3, Brain, JC onderzoeksprogramma Kanker, Peters, Sanne A E, Van Der Schouw, Yvonne T., Wood, Angela M., Sweeting, Michael J., Moons, Karel G M, 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, and Butterworth, Adam S.
Published: 2016

198. Physical activity and risk of Amyotrophic Lateral Sclerosis in a prospective cohort study

Author: Infection & Immunity, Cancer, Epi Kanker Team 1, JC onderzoeksprogramma Kanker, Gallo, Valentina, Vanacore, Nicola, Bueno-de-Mesquita, H. Bas, Vermeulen, Roel, Brayne, Carol, Pearce, Neil, Wark, Petra A., Ward, Heather A., Ferrari, Pietro, Jenab, Mazda, Andersen, Peter M., Wennberg, Patrik, Wareham, Nicholas, Katzke, Verena, Kaaks, Rudolf, Weiderpass, Elisabete, Peeters, Petra H., Mattiello, Amalia, Pala, Valeria, Barricante, Aurelio, Chirlaque, Maria Dolores, Travier, Noémie, Travis, Ruth C., Sanchez, Maria Jose, Pessah-Rasmussen, Hélène, Petersson, Jesper, Tjønneland, Anne, Tumino, Rosario, Quiros, Jose Ramon, Trichopoulou, Antonia, Kyrozis, Andreas, Oikonomidou, Despoina, Masala, Giovanna, Sacerdote, Carlotta, Arriola, Larraitz, Boeing, Heiner, Vigl, Matthaeus, Claver-Chapelon, Francoise, Middleton, Lefkos, Riboli, Elio, Vineis, Paolo, Infection & Immunity, Cancer, Epi Kanker Team 1, JC onderzoeksprogramma Kanker, Gallo, Valentina, Vanacore, Nicola, Bueno-de-Mesquita, H. Bas, Vermeulen, Roel, Brayne, Carol, Pearce, Neil, Wark, Petra A., Ward, Heather A., Ferrari, Pietro, Jenab, Mazda, Andersen, Peter M., Wennberg, Patrik, Wareham, Nicholas, Katzke, Verena, Kaaks, Rudolf, Weiderpass, Elisabete, Peeters, Petra H., Mattiello, Amalia, Pala, Valeria, Barricante, Aurelio, Chirlaque, Maria Dolores, Travier, Noémie, Travis, Ruth C., Sanchez, Maria Jose, Pessah-Rasmussen, Hélène, Petersson, Jesper, Tjønneland, Anne, Tumino, Rosario, Quiros, Jose Ramon, Trichopoulou, Antonia, Kyrozis, Andreas, Oikonomidou, Despoina, Masala, Giovanna, Sacerdote, Carlotta, Arriola, Larraitz, Boeing, Heiner, Vigl, Matthaeus, Claver-Chapelon, Francoise, Middleton, Lefkos, Riboli, Elio, and Vineis, Paolo
Published: 2016

199. Acute effects of breaking up prolonged sitting on fatigue and cognition:A pilot study

Author: Wennberg, Patrik, Boraxbekk, Carl Johan, Wheeler, Michael, Howard, Bethany, Dempsey, Paddy C., Lambert, Gavin, Eikelis, Nina, Larsen, Robyn, Sethi, Parneet, Occleston, Jessica, Hernestål-Boman, Jenny, Ellis, Kathryn A., Owen, Neville, Dunstan, David W., Wennberg, Patrik, Boraxbekk, Carl Johan, Wheeler, Michael, Howard, Bethany, Dempsey, Paddy C., Lambert, Gavin, Eikelis, Nina, Larsen, Robyn, Sethi, Parneet, Occleston, Jessica, Hernestål-Boman, Jenny, Ellis, Kathryn A., Owen, Neville, and Dunstan, David W.
Abstract: Objectives: To compare the acute effects of uninterrupted sitting with sitting interrupted by brief bouts of light-intensity walking on self-reported fatigue, cognition, neuroendocrine biomarkers and cardiometabolic risk markers in overweight/obese adults. Design: Randomised two-condition crossover trial. Setting: Laboratory study conducted in Melbourne, Australia. Participants: 19 overweight/obese adults (45-75 years). Interventions: After an initial 2 h period seated, participants consumed a meal-replacement beverage and completed (on 2 days separated by a 6-day washout period) each condition over the next 5 h: uninterrupted sitting (sedentary condition) or sitting with 3 min bouts of light-intensity walking every 30 min (active condition). Primary outcome measures: Self-reported fatigue, executive function and episodic memory at 0 h, 4 h and 7 h. Secondary outcome measures: Neuroendocrine biomarkers and cardiometabolic risk markers (blood collections at 0 h, 4 h and 7 h, blood pressure and heart rate measured hourly and interstitial glucose measured using a continuous glucose monitoring system). Results: During the active condition, fatigue levels were lower at 4 h (-13.32 (95% CI -23.48 to -3.16)) and at 7 h (-10.73 (95% CI -20.89 to -0.58)) compared to the sedentary condition. Heart rate was higher at 4 h (4.47 (95% CI 8.37 to 0.58)) and at 7 h (4.32 (95% CI 8.21 to 0.42)) during the active condition compared to the sedentary condition. There were no significant differences between conditions by time for other variables. In the sedentary condition, changes in fatigue scores over time correlated with a decrease in heart rate and plasma dihydroxyphenylalanine (DOPA) and an increase in plasma dihydroxyphenylglycol (DHPG). Conclusions: Interrupting prolonged sitting with lightintensity walking breaks may be an effective fatigue countermeasure acutely. Fatigue levels corresponded with the heart rate and neuroendocrine biomarker changes in uninterrupted sitting in
Published: 2016

200. Bicycling to Work and Primordial Prevention of Cardiovascular Risk: A Cohort Study Among Swedish Men and Women

Author: Grøntved, Anders, primary, Koivula, Robert W., additional, Johansson, Ingegerd, additional, Wennberg, Patrik, additional, Østergaard, Lars, additional, Hallmans, Göran, additional, Renström, Frida, additional, and Franks, Paul W., additional
Published: 2016
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