| 1. |
- Donat-Vargas, Carolina, et al.
(författare)
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Urinary phosphate is associated with cardiovascular disease incidence.
- 2023
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Ingår i: Journal of Internal Medicine. - 0954-6820 .- 1365-2796. ; 294:3, s. 358-369
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Elevated phosphate (P) in urine may reflect a high intake of inorganic P salts from food additives. Elevated P in plasma is linked to vascular dysfunction and calcification.OBJECTIVE: To explore associations between P in urine as well as in plasma and questionnaire-estimated P intake, and incidence of cardiovascular disease (CVD).METHODS: We used the Swedish Mammography Cohort-Clinical, a population-based cohort study. At baseline (2004-2009), P was measured in urine and plasma in 1625 women. Dietary P was estimated via a food-frequency questionnaire. Incident CVD was ascertained via register-linkage. Associations were assessed using Cox proportional hazards regression.RESULTS: After a median follow-up of 9.4 years, 164 composite CVD cases occurred (63 myocardial infarctions [MIs] and 101 strokes). Median P (percentiles 5-95) in urine and plasma were 2.4 (1.40-3.79) mmol/mmol creatinine and 1.13 (0.92-1.36) mmol/L, respectively, whereas dietary P intake was 1510 (1148-1918) mg/day. No correlations were observed between urinary and plasma P (r = -0.07) or dietary P (r = 0.10). Urinary P was associated with composite CVD and MI. The hazard ratio of CVD comparing extreme tertiles was 1.57 (95% confidence interval 1.05, 2.35; P trend 0.037)-independently of sodium excretion, the estimated glomerular filtration rate, both P and calcium in plasma, and diuretic use. Association with CVD for plasma P was 1.41 (0.96, 2.07; P trend 0.077).CONCLUSION: Higher level of urinary P, likely reflecting a high consumption of highly processed foods, was linked to CVD. Further investigation is needed to evaluate the potential cardiovascular toxicity associated with excessive intake of P beyond nutritional requirements.
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| 2. |
- Flam, B, et al.
(författare)
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Authors' Response
- 2015
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Ingår i: Journal of intensive care medicine. - : SAGE Publications. - 1525-1489 .- 0885-0666. ; 52:1, s. 493-4
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 3. |
- Helte, Emilie, et al.
(författare)
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Calcium and magnesium in drinking water and risk of myocardial infarction and stroke-a population-based cohort study
- 2022
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Ingår i: American Journal of Clinical Nutrition. - : Oxford University Press. - 0002-9165 .- 1938-3207. ; 116:4, s. 1091-1100
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The implication of calcium and magnesium in drinking water for cardiovascular disease is unclear.OBJECTIVES: To assess the association of the concentration of calcium and magnesium in drinking water with incidence of myocardial infarction and stroke, accounting for dietary mineral intake.METHODS: We linked drinking water monitoring data to residential information of 26,733 women from the population-based Swedish Mammography Cohort, who completed a 96-item FFQ at baseline. Drinking water was categorized into low (magnesium <10 mg/L and calcium <50 mg/L) or high (magnesium ≥10 mg/L or calcium ≥50 mg/L) mineral concentration. Incident cases of myocardial infarction and stroke types were ascertained 1998-2019 using the National Patient Register.RESULTS: The mean ± SD concentration of calcium and magnesium in drinking water was 29 ± 7 mg/L and 5 ± 1 mg/L in the low-exposed area and 52 ± 20 mg/L and 10 ± 3 mg/L in the high-exposed area, respectively. During 16 years of follow-up, we ascertained 2023, 2279, and 452 cases of myocardial infarction, ischemic stroke, and hemorrhagic stroke, respectively. High drinking water calcium and magnesium was associated with lower risk of ischemic and hemorrhagic stroke HRs of 0.87 (95% CI: 0.80, 0.95) and 0.78 (95% CI: 0.65, 0.95), whereas the HR for myocardial infarction was 0.93 (95% CI: 0.85, 1.02). In separate analyses, only drinking water magnesium, not calcium, remained associated with ischemic stroke (HR: 0.69; 95% CI: 0.54, 0.88).CONCLUSIONS: Drinking water with a high concentration of calcium and magnesium, particularly magnesium, may lower the risk of stroke in postmenopausal women.
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| 4. |
- Helte, Emilie, et al.
(författare)
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Chlorination by-products in drinking water and risk of bladder cancer : A population-based cohort study
- 2022
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Ingår i: Water Research. - : Elsevier. - 0043-1354 .- 1879-2448. ; 214
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Tidskriftsartikel (refereegranskat)abstract
- Chlorination by-products have been consistently associated with risk of bladder cancer in case-control studies, but confirmation from large-scale cohort studies is lacking. We assessed the association of drinking water trihalomethanes (THM), a proxy for chlorination by-products, with risk of bladder cancer in 58,672 men and women. Data came from two population-based cohorts, parts of the Swedish Infrastructure for Medical Population-Based Life-Course and Environmental Research (SIMPLER). Individual exposure to THM was assessed by combining residential information with tap water monitoring data. Participants were categorized into non-exposed, low (<15 µg/L) or high (≥15 µg/L) THM exposure. Incident cases were ascertained from 1998 through 2019 via register linkage. During 16 years of follow-up (965,590 person-years), 831 bladder cancer cases were ascertained. We observed no overall association of THM with risk of bladder cancer, hazard ratio for the highest exposed compared to the non-exposed 0.90 (95% confidence interval: 0.73 - 1.11). The null association remained after restricting the analysis to long-term residents and across strata of smoking status and cancer stage. Our results indicate that chlorination by-product exposure at THM concentrations representative of chlorinated drinking waters in most European countries, is not associated with an increased risk of bladder cancer.
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| 5. |
- Helte, Emilie, et al.
(författare)
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Disinfection by-products in drinking water and risk of colorectal cancer : a population-based cohort study.
- 2023
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Ingår i: Journal of the National Cancer Institute. - 0027-8874 .- 1460-2105.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Colorectal cancer is the third most common malignancy worldwide, and it is strongly linked to lifestyle and environmental risk factors. While several drinking water disinfection by-products are confirmed rodent carcinogens, there is still inconclusive evidence for human carcinogenicity, including colorectal cancer.METHODS: We assessed the association of long-term exposure to Trihalomethanes (THMs, the most prevalent disinfection by-products in chlorinated drinking water) with incidence of colorectal cancer in 58,672 men and women in two population-based cohorts. Exposure was assessed by combining long-term information of residential history with drinking water monitoring data. Participants were categorized according to no exposure, low exposure (<15µg/L) and high exposure (≥15µg/L). Incident cases of colorectal cancer were ascertained using the Swedish National Cancer Register.RESULTS: During an average follow-up of 16.8 years (988,144 person-years), 1,913 cases of colorectal cancer were ascertained (1,176 and 746 men and women, respectively). High drinking water THM concentrations (≥15 µg/L) was associated with increased risk of colorectal cancer in men (hazard ratio, HR: 1.26, 95% confidence interval, CI: 1.05 to 1.51) compared to no exposure. When assessing subsites, the association was significant for proximal colon cancer (HR: 1.59, 95% CI: 1.11 to 2.27) but not distal colon cancer or rectal cancer. In women, we observed overall no association of THMs with colorectal cancer.CONCLUSION: These results add further support to that disinfection by-products in drinking water may be a possible risk factor for proximal colon cancer in men. This observation was made at THM concentrations lower than in most previous studies.
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| 6. |
- Kippler, Maria, et al.
(författare)
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Associations of dietary polychlorinated biphenyls and long-chain omega-3 fatty acids with stroke risk.
- 2016
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Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 94, s. 706-711
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Little is known about joint exposure to polychlorinated biphenyls (PCBs) and long-chain omega-3 fatty acids [eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA)], through fish consumption, on cerebrovascular disease risk.OBJECTIVE: To explore associations of dietary PCB exposure and EPA-DHA intake with risk of different stroke subtypes.METHODS: This was assessed in the prospective population-based Cohort of Swedish Men including 39,948, middle-aged and elderly men, who were free of cardiovascular disease and cancer at baseline in 1997. Validated estimates of dietary PCBs and EPA-DHA were obtained via a food frequency questionnaire.RESULTS: During 12years of follow-up, 2286 and 474 incident cases of ischemic stroke and hemorrhagic stroke, respectively, were ascertained through register linkage. Dietary PCB exposure and EPA-DHA intake were associated with hemorrhagic stroke but not ischemic stroke. Men in the highest quartile of dietary PCB exposure (median 412ng/day) had a multivariable- and EPA-DHA-adjusted RR of hemorrhagic stroke of 2.77 [95% confidence interval (CI), 1.48-5.19] compared with men in the lowest quartile (median 128ng/day; p for trend <0.01). The corresponding RRs in men with and without hypertension were 5.45 (95% CI, 1.34-22.1) and 2.37 (95% CI 1.17-4.79), respectively. The multivariable- and PCB-adjusted RR of hemorrhagic stroke for the highest quartile of EPA-DHA intake (median 0.73g/day) versus the lowest quartile (median 0.18g/day) was 0.42 (95% CI, 0.22-0.79).CONCLUSION: Dietary PCB exposure was associated with an increased risk of hemorrhagic stroke, whereas a protective association was observed for dietary EPA-DHA intake.
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| 7. |
- Larsson, Susanna C., et al.
(författare)
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Chocolate consumption and risk of myocardial infarction : a prospective study and meta-analysis.
- 2016
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Ingår i: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 102:13, s. 1017-22
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine whether chocolate consumption is associated with a reduced risk of ischaemic heart disease, we used data from a prospective study of Swedish adults and we performed a meta-analysis of available prospective data.METHODS AND RESULTS: The Swedish prospective study included 67 640 women and men from the Cohort of Swedish Men and the Swedish Mammography Cohort who had completed a food-frequency questionnaire and were free of cardiovascular disease at baseline. Myocardial infarction (MI) cases were ascertained through linkage with the Swedish National Patient and Cause of Death Registers. PubMed and EMBASE databases were searched from inception until 4 February 2016 to identify prospective studies on chocolate consumption and risk of ischaemic heart disease.RESULTS: The results from eligible studies were combined using a random-effects model. During follow-up (1998-2010), 4417 MI cases were ascertained in the Swedish study. Chocolate consumption was inversely associated with MI risk. Compared with non-consumers, the multivariable relative risk for those who consumed ≥3-4 servings/week of chocolate was 0.87 (95% CI 0.77 to 0.98; p for trend =0.04). Five prospective studies on chocolate consumption and ischaemic heart disease were identified. Together with the Swedish study, the meta-analysis included six studies with a total of 6851 ischaemic heart disease cases. The overall relative risk for the highest versus lowest category of chocolate consumption was 0.90 (95% CI 0.82 to 0.97), with little heterogeneity among studies (I(2)=24.3%).CONCLUSIONS: Chocolate consumption is associated with lower risk of MI and ischaemic heart disease.
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| 8. |
- Larsson, Susanna C., et al.
(författare)
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Dietary acrylamide intake and risk of colorectal cancer in a prospective cohort of men
- 2009
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Ingår i: European Journal of Cancer. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 45:4, s. 513-516
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Tidskriftsartikel (refereegranskat)abstract
- Acrylamide is a probable human carcinogen that causes cancer at multiple sites in animal models. However, whether dietary acrylamide intake increases the risk of colorectal cancer in humans is unclear. We examined the association between dietary acrylamide intake and colorectal cancer incidence in the Cohort of Swedish Men, a population-based prospective cohort of 45 306 men who completed a food-freuency questionnaire at enrolment in 1997. During a mean follow-up of 9.3 years, we ascertained 676 incident colorectal cancer cases. Compared with the lowest quartile of acrylamide intake (<29.6 mu g/d), the multivariate rate ratios for the highest quartile (>= 41.7 mu g/d) were 0.95 (95% confidence interval (CI) 0.74-1.20) for colorectal cancer, 0.97 (95% CI 0.71-1.31) for colon cancer and 0.91 (95% CI 0.62-1.34) for rectal cancer. in conclusion, this study provides no evidence that dietary acrylamide in amounts typically consumed by Swedish men is associated with risk of colorectal cancer.
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| 9. |
- Larsson, Susanna C., et al.
(författare)
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Egg consumption and risk of heart failure, myocardial infarction, and stroke : results from 2 prospective cohorts.
- 2015
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Ingår i: American Journal of Clinical Nutrition. - : Elsevier BV. - 0002-9165 .- 1938-3207. ; 102:5, s. 1007-1013
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Some studies have found that egg consumption is associated with a higher risk of ischemic heart disease in patients with diabetes. Epidemiologic studies of egg consumption in relation to risk of heart failure (HF) and stroke types are scarce.OBJECTIVE: The aim of this study was to examine whether egg consumption is associated with incidence of HF, myocardial infarction (MI), or stroke types.DESIGN: In prospective cohorts of 37,766 men (Cohort of Swedish Men) and 32,805 women (Swedish Mammography Cohort) who were free of cardiovascular disease (CVD), egg consumption was assessed at baseline with a food-frequency questionnaire. Incident CVD cases were identified through linkage with the Swedish National Patient and Cause of Death Registers. The data were analyzed with the use of a Cox proportional hazards regression model.RESULTS: During 13 y of follow-up, we ascertained 1628 HFs, 3262 MIs, 2039 ischemic strokes, and 405 hemorrhagic strokes in men and 1207 HFs, 1504 MIs, 1561 ischemic strokes, and 294 hemorrhagic strokes in women. There was no statistically significant association between egg consumption and risk of MI or any stroke type in either men or women or HF in women. In men, consumption of ≤6 eggs/wk was not associated with HF risk; however, daily egg consumption (≥1/d) was associated with a 30% higher risk of HF (RR: 1.30; 95% CI: 1.01, 1.67). Egg consumption was not associated with any CVD outcome in individuals with diabetes.CONCLUSIONS: Daily egg consumption was not associated with risk of MI or any stroke type in either men or women or with HF in women. Consumption of eggs ≥1 time/d, but not less frequent consumption, was associated with an elevated risk of HF in men.
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| 10. |
- Larsson, Susanna C., et al.
(författare)
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Healthy Lifestyle and Risk of Heart Failure : Results From 2 Prospective Cohort Studies
- 2016
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Ingår i: Circulation Heart Failure. - 1941-3289 .- 1941-3297. ; 9:4
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The joint impact of multiple healthy lifestyle factors on heart failure (HF) risk is unclear. We investigated the separate and collective associations of healthy lifestyle factors with HF incidence in 2 population-based prospective cohort studies.METHODS AND RESULTS: This study consisted of 33,966 men (Cohort of Swedish Men) and 30,713 women (Swedish Mammography Cohort) who were 45 to 83 years of age and free of HF and ischemic heart disease at baseline. A healthy lifestyle was defined as being a nonsmoker and physically active (≥150 min/wk), and having body mass index between 18.5 and 25 kg/m(2) and a healthy diet (defined as adherence to a modified Mediterranean diet). Incident HF cases were ascertained by linkage with the Swedish National Patient Register and the Swedish Cause of Death Register. Cox proportional hazards regression was used to analyze the data. During 13 years of follow-up, HF was diagnosed in 1488 men and 1096 women. Each healthy lifestyle factor was associated with a statistically significant lower risk of HF in both men and women, and the risk decreased with increasing number of healthy behaviors. The greatest reduction in HF risk was observed for combinations that included nonsmoking. Compared with men and women with none of the healthy lifestyle factors, the multivariable relative risks (95% confidence interval) of HF for those with all 4 healthy behaviors were 0.38 (0.28-0.53) in men and 0.28 (0.19-0.41) in women.CONCLUSIONS: Adhering to a healthy lifestyle is associated with a substantially lower HF risk.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifiers: NCT01127698 and NCT01127711.
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