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21.
  • Khalili, Hamed, et al. (författare)
  • Adherence to a Mediterranean diet is associated with a lower risk of later-onset Crohn's disease : results from two large prospective cohort studies.
  • 2020
  • Ingår i: Gut. - : BMJ Publishing Group Ltd. - 0017-5749 .- 1468-3288. ; 69:9, s. 1637-1644
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To examine the relationship between Mediterranean diet and risk of later-onset Crohn's disease (CD) or ulcerative colitis (UC).DESIGN: We conducted a prospective cohort study of 83 147 participants (age range: 45-79 years) enrolled in the Cohort of Swedish Men and Swedish Mammography Cohort. A validated food frequency questionnaire was used to calculate an adherence score to a modified Mediterranean diet (mMED) at baseline in 1997. Incident diagnoses of CD and UC were ascertained from the Swedish Patient Register. We used Cox proportional hazards modelling to calculate HRs and 95% CI.RESULTS: Through December of 2017, we confirmed 164 incident cases of CD and 395 incident cases of UC with an average follow-up of 17 years. Higher mMED score was associated with a lower risk of CD (Ptrend=0.03) but not UC (Ptrend=0.61). Compared with participants in the lowest category of mMED score (0-2), there was a statistically significant lower risk of CD (HR=0.42, 95% CI 0.22 to 0.80) but not UC (HR=1.08, 95% CI 0.74 to 1.58). These associations were not modified by age, sex, education level, body mass index or smoking (all Pinteraction >0.30). The prevalence of poor adherence to a Mediterranean diet (mMED score=0-2) was 27% in our cohorts, conferring a population attributable risk of 12% for later-onset CD.CONCLUSION: In two prospective studies, greater adherence to a Mediterranean diet was associated with a significantly lower risk of later-onset CD.
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22.
  • Koushik, Anita, et al. (författare)
  • Intake of vitamins A, C, and E and folate and the risk of ovarian cancer in a pooled analysis of 10 cohort studies.
  • 2015
  • Ingår i: Cancer Causes and Control. - : Springer Science and Business Media LLC. - 0957-5243 .- 1573-7225. ; 26:9, s. 1315-27
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: Vitamins A, C, and E and folate have anticarcinogenic properties and thus might protect against cancer. Few known modifiable risk factors for ovarian cancer exist. We examined the associations between dietary and total (food and supplemental) vitamin intake and the risk of invasive epithelial ovarian cancer.METHODS: The primary data from 10 prospective cohort studies in North America and Europe were analyzed. Vitamin intakes were estimated from validated food frequency questionnaires in each study. Study-specific relative risks (RRs) were estimated using the Cox proportional hazards model and then combined using a random-effects model.RESULTS: Among 501,857 women, 1,973 cases of ovarian cancer occurred over a median follow-up period of 7-16 years across studies. Dietary and total intakes of each vitamin were not significantly associated with ovarian cancer risk. The pooled multivariate RRs [95% confidence intervals (CIs)] for incremental increases in total intake of each vitamin were 1.02 (0.97-1.07) for vitamin A (increment: 1,300 mcg/day), 1.01 (0.99-1.04) for vitamin C (400 mg/day), 1.02 (0.97-1.06) for vitamin E (130 mg/day), and 1.01 (0.96-1.07) for folate (250 mcg/day). Multivitamin use (vs. nonuse) was not associated with ovarian cancer risk (pooled multivariate RR = 1.00, 95% CI 0.89-1.12). Associations did not vary substantially by study, or by subgroups of the population. Greater vitamin intakes were associated with modestly higher risks of endometrioid tumors (n = 156 cases), but not with other histological types.CONCLUSION: These results suggest that consumption of vitamins A, C, and E and folate during adulthood does not play a major role in ovarian cancer risk.
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23.
  • Larsson, Susanna C., et al. (författare)
  • Dietary cysteine and other amino acids and stroke incidence in women
  • 2015
  • Ingår i: Stroke. - 0039-2499 .- 1524-4628. ; 46:4, s. 922-926
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND AND PURPOSE: Cysteine could potentially lower the risk of stroke through antihypertensive and antioxidant effects. Our aim was to evaluate the hypothesis that cysteine intake is inversely associated with stroke incidence.METHODS: We used data from the Swedish Mammography Cohort, a population-based prospective cohort of 34 250 women who were free of cardiovascular disease and cancer and had completed a food-frequency questionnaire about diet and other risk factors for stroke in the autumn of 1997. Stroke cases were identified by linkage of the study population with the Swedish Inpatient Register and the Swedish Cause of Death Register. Relative risks (RR) with 95% confidence intervals, adjusted for potential confounders, were estimated by using Cox proportional hazards regression model.RESULTS: We ascertained 1751 incident cases of stroke during 10.4 years of follow-up. Dietary cysteine intake (mean, 635 mg/d) was inversely associated with stroke risk. The multivariable RR of total stroke comparing the highest with the lowest quintile of cysteine intake was 0.79 (95% confidence interval, 0.65-0.97; P for trend=0.04). The corresponding RR was 0.82 (95% confidence interval, 0.65-1.03; P for trend=0.12) for cerebral infarction and 0.54 (95% confidence interval, 0.29-1.03; P for trend=0.08) for intracerebral hemorrhage. Dietary intake of other amino acids showed no independent (after adjustment for cysteine intake) association with stroke risk.CONCLUSIONS: These findings suggest that dietary cysteine intake may be inversely associated with risk of stroke.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01127698.
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24.
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25.
  • Larsson, Susanna C, et al. (författare)
  • Healthy dietary patterns and incidence of biliary tract and gallbladder cancer in a prospective study of women and men.
  • 2017
  • Ingår i: European Journal of Cancer. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 70, s. 42-47
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Whether diet influences the risk of biliary tract cancer (BTC) is unknown. We examined the associations of two healthy dietary patterns, including a modified Dietary Approach to Stop Hypertension (mDASH) diet and a modified Mediterranean (mMED) diet, with the incidence of BTC in a population-based prospective study.METHODS: The study population comprised 76,014 Swedish adults who were 45-83 years of age and cancer-free at baseline. The mDASH and mMED diets were calculated from self-reported dietary data collected by a validated food-frequency questionnaire. Cox proportional hazards regression models were used to estimate hazard ratios (HR) with 95% confidence intervals (CI) adjusted for potential confounders.RESULTS: Over 1,010,777 person-years (mean 13.3 years) of follow-up, 140 extrahepatic BTC cases (including 77 gallbladder cancers) and 23 intrahepatic BTC cases were ascertained by linkage with the Swedish Cancer Register. Adherence to the mDASH and mMED diets was statistically significantly inversely associated with risk of extrahepatic BTC (Ptrend ≤ 0.0003) and gallbladder cancer (Ptrend ≤ 0.005) but not intrahepatic BTC (Ptrend ≥ 0.11). The multivariable HRs (95% CI) for the highest versus lowest tertile of the mDASH diet were 0.41 (0.26-0.64) for extrahepatic BTC and 0.36 (0.20-0.64) for gallbladder cancer. The corresponding HRs (95% CI) for the mMED diet were respectively 0.41 (0.25-0.67) and 0.42 (0.23-0.79).CONCLUSION: Adherence to a healthy diet may play a role in reducing the risk of extrahepatic BTC.
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26.
  • Larsson, Susanna C, et al. (författare)
  • Overall and abdominal obesity and incident aortic valve stenosis : two prospective cohort studies.
  • 2017
  • Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 38:28, s. 2192-2197
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: The aim of this study was to examine the association of overall and abdominal obesity with aortic valve stenosis (AVS) incidence in two prospective cohorts.Methods and results: We used data from the Cohort of Swedish Men and the Swedish Mammography Cohort, involving 71 817 men and women who were free of cardiovascular disease and had reported their anthropometric measures in 1997. Aortic valve stenosis cases were ascertained through linkage with nationwide registers on hospitalization and causes of death. Data were analysed using Cox proportional hazards regression. During a mean follow-up of 15.3 years, 1297 incident AVS cases (771 in men; 526 in women) were ascertained. Both overall and abdominal obesity, measured as body mass index (BMI) and waist circumference, respectively, was associated with AVS incidence, with similar associations in men and women. Compared with BMI 18.5-22.5 kg/m2, the multivariable hazard ratios were 1.24 (95% confidence interval [CI] 1.05-1.48) for overweight (BMI 25.0-29.9 kg/m2) and 1.81 (95% CI 1.47-2.23) for obesity (BMI ≥30 kg/m2). The hazard ratio for substantially increased waist circumference (men: ≥102 cm; women: ≥88 cm) compared with normal waist circumference (men: <94 cm; women: <80 cm) was 1.30 (95% CI 1.12-1.51). The proportion of AVS cases estimated to be attributed to overweight and obesity combined (BMI ≥25 kg/m2) was 10.8% (95% CI 5.2-16.4%).Conclusion: These findings indicate that obesity is associated with an increased risk of AVS and that a large proportion of the cases may be prevented if the population maintained a healthy BMI.
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27.
  • Larsson, Susanna C., et al. (författare)
  • Type 1 and type 2 diabetes mellitus and incidence of seven cardiovascular diseases
  • 2018
  • Ingår i: International Journal of Cardiology. - : ELSEVIER IRELAND LTD. - 0167-5273 .- 1874-1754. ; 262, s. 66-70
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The association between type 1 diabetes mellitus (T1DM) and specific cardiovascular diseases (CVD) is uncertain. Furthermore, data on type 2 diabetes mellitus (T2DM) in relation to risk of aortic valve stenosis, atrial fibrillation, abdominal aortic aneurysm, and intracerebral hemorrhage are scarce and inconclusive. We examined the associations of T1DM and T2DM with incidence of seven CVD outcomes.Methods: This study comprised 71,483 Swedish adults from two population-based prospective cohorts. T1DM and T2DM diagnosis and incident CVD cases were ascertained through linkage with the population-based registers.Results: T1DM was associated with myocardial infarction (hazard ratio [HR] 3.26; 95% confidence interval [CI] 2.47-4.30), heart failure (HR 2.68; 95% CI 1.76-4.09), and ischemic stroke (HR 2.61; 95% CI 1.80-3.79). Increased risk of myocardial infarction, ischemic stroke, and heart failure was also observed in T2DM patients and the magnitude of the associations increased with longer T2DM duration. T2DM was also associated with an increased risk of aortic valve stenosis (HR 1.34; 95% CI 1.05-1.71) and with lower risk of abdominal aortic aneurysm (HR 0.57; 95% CI 0.40-0.82) and intracerebral hemorrhage (HR 0.51; 95% CI 0.30-0.88). Only long-term T2DM(>= 20 years) was associated with an increased risk of atrial fibrillation (HR 1.44; 95% CI 1.02-2.04).Conclusion: T1DM and T2DM are associated with increased risk of major CVD outcomes. Trial registration: The Cohort of Swedish Men and the Swedish Mammography Cohort are registered at clinicaltrials.gov as NCT01127711 and NCT01127698, respectively.
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28.
  • Levitan, Emily B, et al. (författare)
  • Dietary glycemic index, dietary glycemic load, and cardiovascular disease in middle-aged and older Swedish men.
  • 2007
  • Ingår i: American Journal of Clinical Nutrition. - : Elsevier BV. - 0002-9165 .- 1938-3207. ; 85:6, s. 1521-6
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: In women, dietary glycemic index (GI) and dietary glycemic load (GL) have been associated with cardiovascular disease; in men, however, the evidence for an association is weaker.OBJECTIVE: We tested the hypothesis that men consuming diets high in GI or GL have a greater risk of cardiovascular disease.DESIGN: At baseline, we assessed dietary GI and dietary GL by using food-frequency questionnaires in 36 246 Swedish men aged 45-79 y without diabetes or prior cardiovascular disease. Participants were followed through inpatient, cause-of-death, and death registries from 1 January 1998 until 31 December 2003 for myocardial infarction, ischemic stroke, hemorrhagic stroke, and cardiovascular mortality and until 31 December 2005 for all-cause mortality. We used Cox models with age as the time scale to estimate relative risks adjusted for cigarette smoking, body mass index, physical activity, demographic characteristics, and nutritional factors.RESULTS: Dietary GI and dietary GL were not associated with myocardial infarction (n = 1324), ischemic stroke (n = 692), cardiovascular mortality (n = 785), or all-cause mortality (n = 2959). Dietary GL was associated with hemorrhagic stroke [n = 165; relative risk = 1.44 comparing extreme quartiles (95% CI: 0.91, 2.27); P for trend = 0.047].CONCLUSIONS: Dietary GI and dietary GL were not associated with ischemic cardiovascular disease or mortality, but dietary GL was associated with a greater risk of hemorrhagic stroke. Discrepancies between these findings and those of previous studies may be due to variations in the associations by sex or to differences in dietary contributions to GI and GL.
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29.
  • Lindblad, Birgitta Ejdervik, 1955-, et al. (författare)
  • Alcohol consumption and risk of cataract extraction : a prospective cohort study of women
  • 2007
  • Ingår i: Ophthalmology. - Sundsvall Hosp, Dept Ophthalmol, SE-85186 Sundsvall, Sweden. Karolinska Inst, Inst Environm Med, Stockholm, Sweden. HM Queen Sophia Hosp, Stockholm Eye Clin, Stockholm, Sweden. : Elsevier. - 0161-6420 .- 1549-4713. ; 114:4, s. 680-685
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To investigate the association between alcohol consumption and the risk of cataract extraction.DESIGN: Population-based prospective cohort study.PARTICIPANTS: A total of 34,713 women participating in the Swedish Mammography Cohort, age 49 to 83 years, completed in 1997 a self-administered questionnaire about alcohol, smoking, and other lifestyle factors.METHODS: The women were followed from September 1997 through September 2004. The cohort was matched with registers of cataract extraction from the study area.MAIN OUTCOME MEASURES: Incident surgical extraction of age-related cataract.RESULTS: During 84 months of follow-up, we found 3587 incident cases of age-related cataract extraction. Compared with never drinkers, the relative risk of cataract extraction among current drinkers was 1.11 (95% confidence interval [CI] 1.02-1.21) after adjustment for age and other potential risk factors. In multivariate analysis, an increment of 13 g alcohol intake per day (corresponding to 1 drink = 330 ml of beer, 150 ml of wine, or 45 ml of liquor) was associated with a 7% increased risk of cataract extraction (relative risk, 1.07; 95% CI 1.02-1.12). Mean age at cataract extraction among nonsmoking women who used alcohol was 75 years, compared with 77.6 years among never drinkers.CONCLUSIONS: These prospective data suggest that daily use of >/=1 alcoholic drinks was associated with a modest increase of risk for cataract extraction. The risk increased with increasing alcohol consumption.
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30.
  • Lindblad, Birgitta Ejdervik, 1955-, et al. (författare)
  • Hormone replacement therapy in relation to risk of cataract extraction : a prospective study of women
  • 2010
  • Ingår i: Ophthalmology. - : Elsevier. - 0161-6420 .- 1549-4713. ; 117:3, s. 424-430
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To investigate the association between hormone replacement therapy (HRT) and the incidence of cataract extraction among postmenopausal women.DESIGN: Population-based, prospective cohort study.PARTICIPANTS: A total of 30 861 postmenopausal women participating in the Swedish Mammography Cohort, age 49 to 83 years, who completed a self-administered questionnaire in 1997 about hormone status, HRT, and lifestyle factors.METHODS: The women were followed from September 1997 through October 2005. The cohort was matched with registers of cataract extraction in the study area.MAIN OUTCOME MEASURES: Incident operative extraction of age-related cataract.RESULTS: We identified 4324 incident cases of cataract extractions during 98 months of follow-up. In multivariate adjusted analysis, ever use of HRT was associated with a 14% increased risk of cataract extraction (rate ratio [RR], 1.14; 95% confidence interval [CI], 1.07-1.21) compared with those who never used HRT. Current use of HRT was associated with an 18% increased risk of cataract extraction (RR, 1.18; 95% CI, 1.10-1.26). A significant linear trend was observed where increasing duration of HRT usage resulted in an increased risk of cataract extraction (P for trend = 0.006). Multivariate RR for current HRT usage for >10 years was 1.20 (95% CI, 1.06-1.36; P for trend = 0.001). Among women drinking on average >1 drink of alcohol per day, current HRT users had a 42% increased risk (RR, 1.42; 95% CI, 1.11-1.80) for cataract extraction, compared with women who neither used HRT nor alcohol. The risk of cataract extraction among current users of HRT was similar among current smokers and those who never smoked.CONCLUSIONS: Our prospective, population-based study indicates that postmenopausal women using HRT for a long period of time may be at an increased risk for cataract extraction, especially those drinking >1 alcoholic drink daily.
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