| 1. |
- Friberg, Emilie, et al.
(författare)
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Coffee drinking and risk of endometrial cancer-A population-based cohort study
- 2009
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Ingår i: International Journal of Cancer. - : WILEY. - 0020-7136 .- 1097-0215. ; 125:10, s. 2413-2417
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Tidskriftsartikel (refereegranskat)abstract
- Coffee drinking has been reported to have beneficial effects on insulin resistance, which has been directly associated with endometrial cancer. Although I relationship between coffee consumption and endometrial cancer risk is biologically plausible, this hypothesis has been previously explored in only 2 prospective studies, with a small number of cases. We used data from the Swedish Mammography Cohort, a population-based prospective cohort study of 60,634 women. During 17.6 years of follow-up 677 participants were diagnosed with incident endometrial cancer (adenocarcinoma). We examined the association between self-reported coffee consumption (at baseline 1987-90 and in 1997) and endometrial cancer risk using Cox proportional hazards models. Each additional cut) (200 g) of coffee per day was associated with 11 rate ratio (RR) of 0.90 [95% confidence interval (CI), 0.83-0.97]. In women drinking 4 or more cups of coffee a day, file RR For the risk reduction of endometrial cancer was 0.75 (95% CL 0.58-0.97) when compared with those who drank I cup or less. The association seemed largely confined to overweight and obese women, who showed a respective risk reduction of 12% (95% Cl, 0-23%) and 20% (95% CI, 7-31%) for every cup or coffee. but was not observed among normal-weight women. There,vas I statistically significant interaction between coffee consumption and body mass index (p(interaction) < 0.001). These data indicate that coffee consumption may be associated with decreased risk of endometrial cancer. especially among women with excessive body weight. If confirmed by other prospective studies. these results are of major public health significance. (C) 2009 UICC
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| 2. |
- Larsson, Susanna C., et al.
(författare)
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Body mass index and pancreatic cancer risk : A meta-analysis of prospective studies
- 2007
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Ingår i: International Journal of Cancer. - Karolinska Inst, Natl Inst Environm Med, Div Nutrit Epidemiol, S-17177 Stockholm, Sweden. : WILEY. - 0020-7136 .- 1097-0215. ; 120:9, s. 1993-1998
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Tidskriftsartikel (refereegranskat)abstract
- A number of studies have examined the association between body mass index (BMI) and risk of pancreatic cancer, but uncertainty about the relationship remains. We performed a meta-analysis to summarize the evidence from prospective studies investigating this association. We searched MEDLINE for studies published in any language from 1966 to November 2006. Prospective studies were included if they reported relative risks (RRs) with 95% confidence intervals (CIs) for the association between BMI and pancreatic cancer incidence or mortality. Study-specific RR estimates were combined by use of a random-effects model. A total of 21 independent prospective studies, involving 3,495,981 individuals and 8,062 pancreatic cancer cases, met the inclusion criteria. The estimated summary RR of pancreatic cancer per 5 kg/m(2) increase in BMT was 1.12 (95% CI, 1.06-1.17; p-heterogeneity = 0.13) in men and women combined, 1.16 (95% CI, 1.05-1.28; p-heterogeneity = 0.001) in men, and 1.10 (95% CI, 1.02-1.19; p-heterogeneity = 0.12) in women. There was no evidence of publication bias (p = 0.58). Findings from this meta-analysis of prospective studies support a positive association between BMI and risk of pancreatic cancer in men and women. (c) 2007 Wilely-Liss, Inc.
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| 3. |
- Larsson, Susanna C., et al.
(författare)
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Processed meat consumption and stomach cancer risk : A meta-analysis
- 2006
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Ingår i: Journal of the National Cancer Institute. - Karolinska Inst, Natl Inst Environm Med, Div Nutrit Epidemiol, SE-17177 Stockholm, Sweden. : OXFORD UNIV PRESS INC. - 0027-8874 .- 1460-2105. ; 98:15, s. 1078-1087
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Tidskriftsartikel (refereegranskat)abstract
- Background. The relationship between processed meat consumption and the risk of stomach cancer is controversial. We conducted a meta-analysis to summarize available evidence from cohort and case-control studies on this issue. Methods: We searched Medline for studies of processed meat consumption and stomach cancer published from January 1966 through March 2006. Random-effects models were used to pool the relative risks from individual studies. All statistical tests were two-sided. Results: Six prospective cohort studies (involving 2209 stomach cancer patients) and nine case-control studies (2495 case patients) were eligible for inclusion in the dose-response meta-analysis of processed meat consumption. The estimated summary relative risks of stomach cancer for an increase in processed meat consumption of 30 g/day, approximately half of an average serving, were 1.15 (95% confidence interval [CI] = 1.04 to 1.27) for the cohort studies and 1.38 (95% CI = 1.19 to 1.60) for the case-control studies. There was no statistically significant heterogeneity among the cohort studies (P = .42) or among the case-control studies (P = .19). In three cohort and four case-control studies that examined the association between bacon consumption and stomach cancer, the summary relative risk was 1.37 (95% CI = 1.17 to 1.61) for the highest versus lowest intake categories of bacon, without heterogeneity among these studies (P = .66). Conclusion: Increased consumption of processed meat is associated with an increased risk of stomach cancer. However, the possibility that the association may be confounded or modified by other factors cannot be ruled out.
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| 4. |
- Laven, Brett A., et al.
(författare)
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Birth weight, abdominal obesity and the risk of lower urinary tract symptoms in a population based study of Swedish men
- 2008
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Ingår i: Journal of Urology. - Amsterdam : Elsevier. - 0022-5347 .- 1527-3792. ; 179:5, s. 1891-1896
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Tidskriftsartikel (refereegranskat)abstract
- PurposeLower urinary tract symptoms and obesity are prominent health problems. Low birth weight increases the adult risk of adiposity and insulin resistance, which may increase sympathetic activity and potentially lower urinary tract symptoms. Results of obesity and lower urinary tract symptoms studies are conflicting, and low birth weight and lower urinary tract symptoms relationships have not been investigated.Materials and MethodsThis cross-sectional study examines lower urinary tract symptoms, body measures, activity, birth weight and lifestyle data collected by questionnaire from 1997 to 1998. Overall 27,858 men were analyzed and odds ratios calculated after excluding those with cancer, cerebrovascular accident, diabetes and incomplete information.ResultsAfter adjustment for age, activity level, smoking, alcohol, coffee intake and body mass index, a significant positive association was seen between abdominal obesity (waist-to-hip ratio) and moderate to severe lower urinary tract symptoms. The risks of moderate to severe and severe lower urinary tract symptoms were 22% (95% CI 1.09–1.37) and 28% (95% CI 1.01–1.63) higher, respectively, for the top vs the lowest abdominal obesity quartile. The risk of nocturia (twice or more per night) was 1.16 (95% CI 1.02–1.33) in men in the top compared to the bottom waist-to-hip ratio quartile. Men with low birth weight (less than 2,500 gm) had a 61% (95% CI 1.12–2.30) higher risk of severe lower urinary tract symptoms compared to men with normal birth weight (2,500 to 3,999 gm). Men in the top waist-to-hip ratio quartile who had low birth weight had twice the risk of severe lower urinary tract symptoms (95% CI 1.29–3.02) compared to men with normal birth weight and in the lowest waist-to-hip ratio quartile.ConclusionsLow birth weight and abdominal adiposity are associated with increased risk of moderate to severe lower urinary tract symptoms in adults. Further investigations are needed to determine if decreases in obesity can ameliorate lower urinary tract symptoms.
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| 5. |
- Orsini, Nicola, et al.
(författare)
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Combined effects of obesity and physical activity in predicting mortality among men
- 2008
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 264:5, s. 442-51
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: We evaluated the hypothesis that higher levels of total daily physical activity can eliminate the increased mortality rate associated with overweight and obesity. DESIGN: Population-based prospective cohort study. SETTING: Central Sweden. SUBJECTS: A total of 37,633 men at baseline 45-79 years of age and free of known cancer and cardiovascular disease and diabetes completed a self-administered life-style questionnaire, which included questions on body-mass index (BMI) and physical activity. During 9.7 years of follow-up, we identified a total of 4086 deaths. MAIN OUTCOME MEASURES: Mortality rate ratios (RRs). RESULTS: Compared to men who were lean (BMI < 25 kg m(-2)) and active (top tertile of total physical activity level) the multivariable adjusted RRs (95% confidence interval) of death from all causes were 1.44 (1.11-1.86) for obese (BMI > or = 30 kg m(-2)) and active men, 1.54 (1.34-1.77) for lean (BMI < 25 kg m(-2)) but inactive (bottom tertile) men, and 1.81 (1.48-2.23) for obese-inactive men. After excluding the first 3 years of follow-up, current and former smokers, those who had lost weight from age 20 years to age at baseline, and heavy manual workers, the adjusted RRs of death from all causes were 1.65 (1.20-2.27) for overweight-to-obese and active men, 2.15 (1.59-2.91) for lean-inactive men, and 2.04 (1.52-2.74) for overweight-to-obese and inactive men compared to lean-active men. CONCLUSIONS: We conclude that both overweight and physical inactivity are important predictors of mortality. Our findings do not support the hypothesis that a higher level of physical activity compensates the excess mortality associated with overweight and obesity.
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| 6. |
- Orsini, Nicola, et al.
(författare)
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Correlates of total physical activity among middle-aged and elderly women
- 2007
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Ingår i: International Journal of Behavioral Nutrition and Physical Activity. - Karolinska Inst, Inst Environm Med, Div Nutr Epidemiol, S-10401 Stockholm, Sweden. Karolinska Inst, Dept Med Epidemiol & Biostats, S-10401 Stockholm, Sweden. Univ S Carolina, Arnold Sch Publ Hlth, Dept Epidemiol & Biostat, Columbia, SC 29208 USA. Harvard Univ, Sch Publ Hlth, Dept Biostat, Cambridge, MA 02138 USA. Univ Milan, Dept Stat, I-20122 Milan, Italy. : BMC. - 1479-5868. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Information on correlates of total physical activity ( PA) levels among middle- aged and elderly women is limited. This article aims to investigate whether total daily PA levels are associated with age, body mass index, smoking, drinking status, and sociodemographic factors. In a cross- sectional study of 38,988 women between the ages of 48 and 83 years residing in central Sweden, information on PA, weight, height, smoking, drinking, and sociodemographic factors was collected through a self- administered questionnaire. Total daily PA levels were measured as metabolic equivalents ( MET- h/ day). Odds ratios ( OR) and 95% confidence intervals ( CI) were estimated by ordinal logistic regression models. We observed decreasing level of total PA with increasing age ( for 5- year increase: OR = 0.87; 95% CI: 0.85 - 0.89) and body mass index ( for 5- unit, kg/ m(2), increase: OR = 0.81; 95% CI: 0.79 - 0.84). Multivariable adjusted correlates of total PA level were smoking ( current vs. never: OR = 0.83; 95% CI: 0.79 - 0.88), drinking ( current vs. never: OR = 0.88; 95% CI: 0.82 - 0.94), educational level ( university vs. primary: OR = 0.54; 95% CI: 0.51 - 0.58), employment status ( housewife vs. full- work: OR = 2.59; 95% CI: 2.25 - 2.98), and childhood environment ( city vs. countryside: OR = 0.62; 95% CI: 0.59 - 0.65). In the present investigation, among middle- aged and elderly women, the likelihood of engaging in higher total daily PA levels decreased with age, body mass index, educational level, smoking, drinking, and growing up in urban places.
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| 7. |
- Orsini, Nicola, et al.
(författare)
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Long-term physical activity and lower urinary tract symptoms in men
- 2006
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Ingår i: Journal of Urology. - Karolinska Inst, Natl Inst Environm Med, Div Nutr Epidemiol, SE-17177 Stockholm, Sweden. Univ Hosp Orebro, Dept Urol, Orebro, Sweden. Univ Hosp Orebro, Ctr Assessment Med Technol, Orebro, Sweden. Vasteras Hosp, Dept Urol, Vasteras, Sweden. : ELSEVIER SCIENCE INC. - 0022-5347 .- 1527-3792. ; 176:6, s. 2546-2550
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: We assessed the association between physical activity, and the risk of moderate and severe lower urinary tract symptoms. Materials and Methods: A cross-sectional representative sample of 30,377 men 45 to 79 years old in central Sweden who completed a self-administered life-style questionnaire, including International Prostate Symptom Score questions, physical activity currently and recalled at age 30 years (total, work/occupation, walking/bicycling, inactivity and exercise) and demographic data. A total of 6,905 men (23%) who scored 8 or more points on International Prostate Symptom Score questions were considered to have moderate or severe lower urinary tract symptoms. Results: After controlling for subject age, waist-to-hip ratio, diabetes, smoking and drinking status, and educational level total physical activity was significantly inversely related to moderate and severe lower urinary tract symptoms (highest vs lowest quartile OR 0.72, 95% CI 0.66 to 0.79, p trend < 0.001). Men who were physically active at work as well as during leisure time were at half the risk of lower urinary tract symptoms compared to inactive men (OR 0.49, 95% CI 0.40 to 0.60). Long-term high inactivity (5 hours daily at age 30 years plus currently) was associated with a 2-fold increased risk compared with the risk in men who were more active at the 2 periods (OR 1.90, 95% CI 1.41 to 2.59). Conclusions: Our results suggest that physical activity in young and late adulthood may be associated with a lower risk of moderate and severe lower urinary tract symptoms.
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| 8. |
- Orsini, Nicola
(författare)
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Physical activity and health benefits
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Physical activity (PA), due to its role in health promotion and disease prevention, is of particular interest to be investigated. The aims of this thesis were: to assess the associations between PA and different health outcomes (lower urinary tract symptoms, cancer incidence, and mortality) in the Cohort of Swedish Men (COSM); to perform a dose-response meta- analysis of published associations between walking and incidence of coronary heart disease (CHD); and to provide user-friendly software packages for dose-response meta-analysis and for sensitivity analysis of biases in observational studies. The COSM is a population-based prospective cohort of 45,906 men between 45 to 79 years of age in central Sweden who were cancer-free and completed a questionnaire about current and historical PA, diet, and other life- style factors at enrollment in 1997. At baseline 6905 men reported moderate to severe lower urinary tract symptoms (LUTS). A significant inverse relationship was seen between total PA and moderate and severe LUTS (highest vs lowest quartile odds ratio=0.72; 95% confidence interval (CI)=0.66-0.79). Men who were physically active at work as well as during leisure-time showed 50% reduction in risk of moderate to severe LUTS (95% CI=0.40-0.60) compared to those who were sedentary. Conversely, men with long-term sedentary lifestyles (5 hours/day watching TV both at age 30 years and current) reported a 2-fold increase (95% CI=1.41-2.59) risk to these symptoms when compared to men more active at both time periods. After 7 years of study enrollment 3714 men of the COSM were diagnosed with cancer and 1153 of them died due to the disease. We observed a strong inverse linear association between total daily PA and death from any form of cancer. For each increment of 4 metabolic equivalent (MET)-hours/day of total PA (approximately 1 hour daily of moderate effort) cancer incidence tended to be decreased by 2% and cancer mortality decreased significantly by 12% (95% CI = 6-18%). During 9.7 years of follow-up, we identified a total of 4086 deaths from all causes. Compared to men who were lean and active (BMI < 25 kg/m2; top tertile total PA) the adjusted rate ratios of death from all causes were 1.44 (95% CI=1.11-1.86) for obese-active men (BMI 30 kg/m2), 1.54 (95% CI=1.34-1.77) for lean but inactive men (bottom tertile total PA), and 1.81 (95% CI=1.48-2.23) for obese-inactive men. After excluding the first 3 years of follow-up, current and former smokers, those who had lost weight from age 20 years to baseline, and heavy manual workers, the adjusted rate ratios of death from all causes were 1.65 (95% CI=1.20-2.27) for overweight-to-obese and active men, 2.15 (95% CI=1.59-2.91) for lean-inactive men, and 2.04 (95% CI=1.52-2.74) for overweight-to-obese and inactive men compared to lean-active men. During 10 years of follow-up a total of 2735 men were diagnosed with prostate cancer, of which 190 were fatal. We observed an inverse linear association between lifetime (average of age 30, 50 and baseline) walking/bicycling duration and incidence of total prostate cancer risk. The multivariable-adjusted rate ratio decreased by 8% (95% CI=2-13%) for every 30 min/day increment of lifetime walking/bicycling in the range of 30 to 120 min/day. The fatal prostate cancer rate among those men who hardly ever walked or biked was two-fold that of men in the highest average lifetime walking/bicycling of 120 min/day, although this increased rate was not significant. In the dose-response meta-analysis of eight epidemiological studies we found that every increment of 8 MET-hours/week of walking (moderate-intensity about 30 min/day on 5 days of the week) was associated with 19% decrease (95% CI=14-23%) of CHD risk. In conclusion, we observed that increased PA levels may lower the risk of LUTS, all-cause and cancer mortality, prostate cancer, and CHD. Furthermore, the two statistical components developed for Stata® software can greatly facilitate dose-response meta-analyses (glst) and support sensitivity analysis (episens) of epidemiological findings.
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| 9. |
- Orsini, Nicola, et al.
(författare)
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Reproducibility of the past year and historical self-administered total physical activity questionnaire among older women.
- 2007
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 22:6, s. 363-8
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have evaluated the reliability of a self-administered current and historical physical activity questionnaire (PAQ) among middle-aged and elderly women. We evaluated the reliability of a self-administered PAQ designed to assess total (24 h) current and historical physical activity at age 15, 30, and 50 years, which was completed by a subgroup of 303 women aged 56-75 years from the Swedish Mammography Cohort (SMC). Total physical activity covered occupational and household activity as well as walking/bicycling, exercise, and inactivity (sitting watching TV/reading). Reliabilities (1-year test-retest) of continuous activity measures in metabolic equivalents were evaluated using an intraclass correlation coefficient (ICC); classification consistency was evaluated using sensitivity and specificity statistics. The ICC for total current physical activity was 0.69; for specific types of activities the ICC ranged from 0.49 to 0.59; for historical physical activity, the reliabilities for total activity ranged from 0.75 for age 50 to 0.81 for age 30 years, being substantial for occupational activities (ICC = 0.73-0.75), and fair to moderate for inactivity (ICC = 0.31-0.60). These data indicate that the PAQ used in the SMC is a satisfactory and reproducible measure of current and historical physical activity, for total as well as for different types of activities.
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| 10. |
- Orsini, Nicola
(författare)
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Total physical activity in middle-aged and elderly women from a population-based cohort
- 2006
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Regularly performed physical activity (PA) is associated with a reduced risk of coronary heart disease, stroke, type 2 diabetes, some forms of cancer, osteoporosis, and all-cause mortality. Due to its role in health promotion and disease prevention, PA is a particularly important health behavior to be investigated. The first aim of this thesis was to investigate temporal trends and correlates of total PA using data from the Swedish Mammography Cohort (SMC). The second aim was to evaluate the reproducibility and validity of self-reported PA and to make a profile of PA behaviors using accelerometer data from a subset of the SMC. The SMC is a population-based prospective cohort established between 1987 and 1990 in Uppsala and Västmanland Counties. In our analyses among 38,988 women between the ages of 48 and 83 years, we observed a decreasing trend of total PA by calendar time between the 1930s and the 1990s. Total activity level decreased in all age groups (15, 30, and 50 years of age) by an average of 3 MET-hours/day corresponding to about 45 minutes of brisk walking. The likelihood of engaging in higher total daily PA levels linearly decreased with age (for 5-year increase: odds ratio (OR) = 0.87; 95% confidence interval (Cl): 0.85-0.89) and body mass index (for 5-unit, kg/m2, increase: OR= 0.81; 95% Cl: 0.79-0.84). Total PA levels were inversely associated with smoking (OR= 0.83; 95% Cl: 0.79-0,88), drinking (OR= 0.88 95% Cl: 0.82-0.94), educational level (university vs. primary: OR=0.54, 95% Cl: 0.51-0.58), and childhood environment (city vs. countryside: OR= O.62, 95% Cl: 0.59-0.65). Reproducibility, as measured among 303 women by intraclass correlation (ICC) for total current PA, was 0.69. For historical PA, the reliabilities for total activity were from 0.75 for age 50 to 0.81 for age 30 years, being substantial for occupational activities (ICC=0.73-0.75), and fair to moderate for inactivity (ICC=0.31-0.60). Validity, as measured among 116 women by de-attenuated concordance correlations comparing total daily activity estimated by the questionnaire with the accelerometers and the records were 0.72 and 0.67, respectively. According to the PA recommendation to accumulate at least 30 minutes per day (in either 1 continuous bout or several shorter bouts lasting 8-10 minutes) of moderate-to-vigorous activity 5 days per week or more, we found that among 133 women the proportion who met this recommendation was 31% which decreased to 18% among obese women. In conclusion, our findings from a large population-based prospective cohort of middle-aged and elderly women show that total PA has been decreasing by calendar time during the last 60 years of the 20th century. The likelihood of engaging in higher total daily PA levels decreased with age, body mass index, educational level, smoking, drinking, and growing up in urban places. Our short self-administered PA questionnaire was reasonably reproducible and valid. The fact that only a third of the women were not meeting the PA recommendation suggests that counselling messages may need to Place more emphasis on the correct number of days per week and in which way moderate activity should be obtained to achieve health benefits.
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