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- Beral, V, et al.
(författare)
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Alcohol, tobacco and breast cancer - collaborative reanalysis of individual data from 53 epidemiological studies, including 58515 women with breast cancer and 95067 women without the disease
- 2002
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Ingår i: British Journal of Cancer. - : Springer Science and Business Media LLC. - 1532-1827 .- 0007-0920. ; 87, s. 1234-45
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Tidskriftsartikel (refereegranskat)abstract
- Alcohol and tobacco consumption are closely correlated and published results on their association with breast cancer have not always allowed adequately for confounding between these exposures. Over 80% of the relevant information worldwide on alcohol and tobacco consumption and breast cancer were collated, checked and analysed centrally. Analyses included 58515 women with invasive breast cancer and 95067 controls from 53 studies. Relative risks of breast cancer were estimated, after stratifying by study, age, parity and, where appropriate, women's age when their first child was born and consumption of alcohol and tobacco. The average consumption of alcohol reported by controls from developed countries was 6.0 g per day, i.e. about half a unit/drink of alcohol per day, and was greater in ever-smokers than never-smokers, (8.4 g per day and 5.0 g per day, respectively). Compared with women who reported drinking no alcohol, the relative risk of breast cancer was 1.32 (1.19 - 1.45, P < 0.00001) for an intake of 35 - 44 g per day alcohol, and 1.46 (1.33 - 1.61, P < 0.00001) for greater than or equal to 45 g per day alcohol. The relative risk of breast cancer increased by 7.1% (95% CI 5.5-8.7%; P<0.00001) for each additional 10 g per day intake of alcohol, i.e. for each extra unit or drink of alcohol consumed on a daily basis. This increase was the same in ever-smokers and never-smokers (7.1 % per 10 g per day, P < 0.00001, in each group). By contrast, the relationship between smoking and breast cancer was substantially confounded by the effect of alcohol. When analyses were restricted to 22 255 women with breast cancer and 40 832 controls who reported drinking no alcohol, smoking was not associated with breast cancer (compared to never-smokers, relative risk for ever-smokers= 1.03, 95% CI 0.98 - 1.07, and for current smokers=0.99, 0.92 - 1.05). The results for alcohol and for tobacco did not vary substantially across studies, study designs, or according to 15 personal characteristics of the women; nor were the findings materially confounded by any of these factors. If the observed relationship for alcohol is causal, these results suggest that about 4% of the breast cancers in developed countries are attributable to alcohol. In developing countries, where alcohol consumption among controls averaged only 0.4 g per day, alcohol would have a negligible effect on the incidence of breast cancer. In conclusion, smoking has little or no independent effect on the risk of developing breast cancer; the effect of alcohol on breast cancer needs to be interpreted in the context of its beneficial effects, in moderation, on cardiovascular disease and its harmful effects on cirrhosis and cancers of the mouth, larynx, oesophagus and liver. (C) 2002 Cancer Research UK.
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- Söderström, Lisa, 1982-
(författare)
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Nutritional status among older people : Risk factors and consequences of malnutrition
- 2013
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Despite the high frequency and serious consequences of protein–energy malnutrition, prevention and treatment of malnutrition do not currently receive appropriate attention. Increased awareness of the importance of nutritional screening among older people is needed. The overall aim of this thesis was to extend our current knowledge about malnutrition and the consequences of a poor nutritional status in relation to preterm death, and to identify possible risk factors for developing malnutrition among older people. The aim of Paper I was to estimate the prevalence of malnutrition and to examine the associations between mealtime habits, meal provision, and malnutrition among older people admitted to a Swedish hospital. The aim of Paper II was to examine whether nutritional status, defined according to the three categories in the full Mini Nutritional Assessment (MNA) instrument, is an independent predictor of preterm death in older people.The baseline survey was a cross-sectional study of 1771 patients aged ³65 years who were admitted to hospital. Nutritional status was assessed using the MNA instrument, and possible risk factors associated with malnutrition were recorded during the hospital stay (Paper I). Overall survival was followed up after 35–50 months in a cohort study of 1767 participants (Paper II).Of the 1771 participants, 35.5% were well-nourished, 55.1% were at risk of malnutrition, and 9.4% were malnourished at baseline. An overnight fast >11 hours was associated with risk of malnutrition (odds ratio (OR) 1.46; 95% confidence interval (CI) 1.14–1.87) and being malnourished (OR 1.67; 95% CI 1.04–2.69). Fewer than four eating episodes a day was associated with both risk of malnutrition (OR 1.88, 95% CI 1.52–2.32) and being malnourished (OR 3.10; 95% CI 2.14–4.49). Not cooking independently was also associated with both risk of malnutrition (OR 1.9; 95% CI 1.30–2.93) and being malnourished (OR 5.04; 95% CI 2.95–8.61). At the 50-month follow-up, the survival rates were 75.2% for well-nourished participants, 60.0% for those at risk of malnutrition, and 33.7% for malnourished participants. After adjusting for confounders, the hazard ratios (95% CI) for all-cause mortality were 1.56 (1.18–2.07) in the group at risk of malnutrition and 3.71 (2.28–6.04) in the malnourished group. Nutritional status defined according to the three categories in the full MNA independently predicted preterm death in people aged 65 years and older.This thesis provides additional knowledge of the current nutritional situation among older people admitted to hospital. The high prevalence and serious consequences of malnutrition demonstrated in this thesis underline the importance of screening and taking actions to counteract malnutrition among older people. The data showing that the length of overnight fasting and number of eating episodes per day are possible risk factors for malnutrition are consistent with the current nutritional recommendations. This knowledge may stimulate care providers to decrease the length of overnight fasting and increase the number of eating episodes per day among older people at risk of malnutrition.
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- Hellsten, Torbjörn, et al.
(författare)
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Fast wave current drive in JET ITB-plasma
- 2005
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Ingår i: AIP Conference Proceedings. - : AIP. - 0094-243X. ; , s. 273-278
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Konferensbidrag (refereegranskat)abstract
- Fast wave current drive has been performed in JET plasmas with internal transport barriers, ITBs, and strongly reversed magnetic shear. Although the current drive efficiency of the power absorbed on the electrons is fairly high, only small effects are seen in the central current density. The main reasons are the parasitic absorption of RF power, the strongly inductive nature of the plasma and the interplay between the fast wave driven current and bootstrap current. The direct electron heating in the FWCD experiments is found to be strongly degraded compared to that with the dipole phasing.
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