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Adherence to a healthy Nordic food index and breast cancer risk: results from a Swedish cohort study.

https://arctichealth.org/en/permalink/ahliterature271574
Source
Cancer Causes Control. 2015 Jun;26(6):893-902
Publication Type
Article
Date
Jun-2015
Author
Yingjun Li
Nina Roswall
Sven Sandin
Peter Ström
Hans-Olov Adami
Elisabete Weiderpass
Source
Cancer Causes Control. 2015 Jun;26(6):893-902
Date
Jun-2015
Language
English
Publication Type
Article
Keywords
Adult
Breast Neoplasms - epidemiology
Cohort Studies
Diet
Female
Health Surveys
Humans
Incidence
Middle Aged
Premenopause
Prospective Studies
Risk
Sweden - epidemiology
Abstract
A healthy Nordic dietary pattern has shown beneficial effects in relation to several chronic diseases. However, no study has evaluated the association between a healthy Nordic food index (HNFI) and risk of breast cancer.
We conducted a prospective cohort study including 44,296 women, aged 29-49 at baseline in 1991-1992, who completed a food frequency questionnaire at baseline, and have been followed up ever since, through the Swedish Cancer Registry and Cause of Death Registry. Each woman was assigned a HNFI score ranging from 0 to 6. We calculated multivariable relative risks (RRs) and 95% confidence intervals (CIs) using Poisson regression models with attained age as the underlying timescale. The association between the HNFI and risk of breast cancer was assessed both overall, by menopausal status and by hormone receptor status.
A total of 1,464 breast cancer cases were diagnosed during a median follow-up time of 20 years. A higher adherence to the HNFI was not associated with a lower risk of breast cancer overall, nor of varied hormone receptor status, or when we examining premenopausal and postmenopausal women separately. The multivariable RRs (95% CI) for breast cancer per 1-point increment in the HNFI were 1.02 (95% CI 0.98-1.06) for all women, 1.01 (95% CI 0.95-1.08) for premenopausal women, and 1.02 (95% CI 0.97-1.07) for postmenopausal women.
Adherence to a HNFI was not associated with breast cancer incidence in this cohort of relatively young women, regardless of menopausal status or hormone receptor status.
PubMed ID
25783459 View in PubMed
Less detail

Adherence to the healthy Nordic food index and total and cause-specific mortality among Swedish women.

https://arctichealth.org/en/permalink/ahliterature268918
Source
Eur J Epidemiol. 2015 Jun;30(6):509-17
Publication Type
Article
Date
Jun-2015
Author
Nina Roswall
Sven Sandin
Marie Löf
Guri Skeie
Anja Olsen
Hans-Olov Adami
Elisabete Weiderpass
Source
Eur J Epidemiol. 2015 Jun;30(6):509-17
Date
Jun-2015
Language
English
Publication Type
Article
Keywords
Adult
Cardiovascular Diseases - mortality
Cause of Death
Diet
Edible Grain
Female
Food Habits
Fruit
Health promotion
Humans
Middle Aged
Mortality
Neoplasms - mortality
Norway
Prospective Studies
Regression Analysis
Sweden - epidemiology
Vegetables
Abstract
Several healthy dietary patterns have been linked to longevity. Recently, a Nordic dietary pattern was associated with a lower overall mortality. No study has, however, investigated this dietary pattern in relation to cause-specific mortality. The aim of the present study was to examine the association between adherence to a healthy Nordic food index (consisting of wholegrain bread, oatmeal, apples/pears, root vegetables, cabbages and fish/shellfish) and overall mortality, and death by cardiovascular disease, cancer, injuries/suicide and other causes. We conducted a prospective analysis in the Swedish Women's Lifestyle and Health cohort, including 44,961 women, aged 29-49 years, who completed a food frequency questionnaire between 1991-1992, and have been followed up for mortality ever since, through Swedish registries. The median follow-up time is 21.3 years, and mortality rate ratios (MRR) were calculated using Cox Proportional Hazards Models. Compared to women with the lowest index score (0-1 points), those with the highest score (4-6 points) had an 18% lower overall mortality (MRR 0.82; 0.71-0.93, p
PubMed ID
25784368 View in PubMed
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Alcohol consumption, body mass index and breast cancer risk by hormone receptor status: Women' Lifestyle and Health Study.

https://arctichealth.org/en/permalink/ahliterature273881
Source
BMC Cancer. 2015;15:881
Publication Type
Article
Date
2015
Author
Aesun Shin
Sven Sandin
Marie Lof
Karen L Margolis
Kyeezu Kim
Elisabeth Couto
Hans Olov Adami
Elisabete Weiderpass
Source
BMC Cancer. 2015;15:881
Date
2015
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Drinking - adverse effects - pathology
Body mass index
Breast Neoplasms - epidemiology - genetics - pathology
Female
Humans
Life Style
Middle Aged
Postmenopause
Receptors, Estrogen - blood - genetics
Receptors, Progesterone - genetics
Risk factors
Sweden
Abstract
We aimed to estimate the effect of alcohol consumption on breast cancer risk and to test whether overweight and obesity modifies this association.
We included in the analysis 45,233 women enrolled in the Swedish Women's Lifestyle and Health study between 1991 and 1992. Participants were followed for occurrence of breast cancer and death until December 2009. Poisson regression models were used, and analyses were done for overall breast cancer and for estrogen receptor positive or negative (ER+, ER-) and progesterone receptor positive and negative (PR+, PR-) tumors separately.
A total of 1,385 breast cancer cases were ascertained during the follow-up period. Overall, we found no statistically significant association between alcohol intake and breast cancer risk after adjustment for confounding, with an estimated relative risk (RR) of 1.01 (95 % CI: 0.98-1.04) for an increment in alcohol consumption of 5 g/day. A statistically significant elevated breast cancer risk associated with higher alcohol consumption was found only among women with BMI =25 (RR 1.03, 95 % CI 1.0-1.05 per 5 g/day increase).
An increase in breast cancer risk with higher alcohol consumption was found for breast cancers in women with a BMI =25 kg/m(2).
Notes
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PubMed ID
26552431 View in PubMed
Less detail

Alcohol consumption over time and mortality in the Swedish Women's Lifestyle and Health cohort.

https://arctichealth.org/en/permalink/ahliterature287321
Source
BMJ Open. 2016 11 02;6(11):e012862
Publication Type
Article
Date
11-02-2016
Author
Idlir Licaj
Sven Sandin
Guri Skeie
Hans-Olov Adami
Nina Roswall
Elisabete Weiderpass
Source
BMJ Open. 2016 11 02;6(11):e012862
Date
11-02-2016
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Drinking - mortality
Cardiovascular Diseases - mortality
Female
Humans
Life Style
Middle Aged
Multivariate Analysis
Myocardial Ischemia - mortality
Neoplasms - mortality
Proportional Hazards Models
Prospective Studies
Registries
Risk factors
Sweden - epidemiology
Abstract
Alcohol consumption is steadily increasing in high-income countries but the harm and possible net benefits of light-to-moderate drinking remain controversial. We prospectively investigated the association between time-varying alcohol consumption and overall and cause-specific mortality among middle-aged women.
Among 48 249 women at baseline (33 404 at follow-up) in the prospective Swedish Women's Lifestyle and Health cohort, age 30-49 years at baseline, we used repeated information on alcohol consumption and combined this method with multiple imputation in order to maximise the number of participants and deaths included in the analyses. Multivariable Cox regression models were used to calculate HRs for overall and cause-specific mortality.
During >900 000 person/years, a total of 2100 deaths were recorded through Swedish registries. The median alcohol consumption increased from 2.3 g/day in 1991/1992 (baseline) to 4.7 g/day in 2004 (follow-up). Compared with light drinkers (0.1-1.5 g/day), a null association was observed for all categories of alcohol consumption with the exception of never drinkers. The HR comparing never with light drinkers was 1.46 (95% CI 1.22 to 1.74). There was a statistically significant negative trend between increasing alcohol consumption and cardiovascular and ischaemic heart diseases mortality. The results were similar when women with prevalent conditions were excluded.
In conclusion, in a cohort of young women, light alcohol consumption was protective for cardiovascular and ischaemic heart disease mortality but not for cancer and overall mortality.
Notes
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PubMed ID
27807087 View in PubMed
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The association between alcohol consumption and mortality: the Swedish women's lifestyle and health study.

https://arctichealth.org/en/permalink/ahliterature137602
Source
Eur J Epidemiol. 2011 Feb;26(2):81-90
Publication Type
Article
Date
Feb-2011
Author
Gundula Behrens
Michael F Leitzmann
Sven Sandin
Marie Löf
Iris M Heid
Hans-Olov Adami
Elisabete Weiderpass
Author Affiliation
Department of Epidemiology and Preventive Medicine, Regensburg University Medical Center, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany. gundula.behrens@klinik.uni-regensburg.de
Source
Eur J Epidemiol. 2011 Feb;26(2):81-90
Date
Feb-2011
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Drinking - mortality
Cardiovascular Diseases - mortality
Cohort Studies
Female
Follow-Up Studies
Humans
Middle Aged
Neoplasms - mortality
Proportional Hazards Models
Prospective Studies
Risk
Risk factors
Self Report
Sweden
Women's health
Abstract
Although light to moderate alcohol intake may reduce cardiovascular disease (CVD) mortality, the effect on total mortality requires further study, particularly among young and middle-aged women. We studied the association between alcohol consumption and mortality from all causes, from cancer, and from CVD in the Swedish Women's Lifestyle and Health Study, a cohort of 47,921 female residents of Sweden aged 30-49 years at baseline in 1991/1992 and followed up to 2006. We estimated the relative risk (RR) of mortality associated with alcohol intake using Cox regression adjusted for age, smoking, BMI, saturated fat intake, physical activity, and education. During 713,295 person-years of follow-up, 1,119 deaths occurred, including 158 deaths from CVD, 673 deaths from cancer, and 288 deaths from other causes. Compared with non-drinking, light to moderate drinking (0.1-19.9 g of alcohol per day) showed a statistically significant inverse association with total mortality (RR = 0.83, 95% CI = 0.71-0.98). Analyses of cause-specific mortality revealed an RR for CVD mortality of 0.69 (95% CI = 0.46-1.01) and an RR for cancer mortality of 0.92 (95% CI = 0.75-1.15). These results suggest that in younger women, a possibly beneficial effect of light to moderate drinking on future risk of mortality is limited to a prevention of CVD mortality but not cancer mortality.
PubMed ID
21267637 View in PubMed
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Association between class III obesity (BMI of 40-59 kg/m2) and mortality: a pooled analysis of 20 prospective studies.

https://arctichealth.org/en/permalink/ahliterature267096
Source
PLoS Med. 2014 Jul;11(7):e1001673
Publication Type
Article
Date
Jul-2014
Author
Cari M Kitahara
Alan J Flint
Amy Berrington de Gonzalez
Leslie Bernstein
Michelle Brotzman
Robert J MacInnis
Steven C Moore
Kim Robien
Philip S Rosenberg
Pramil N Singh
Elisabete Weiderpass
Hans Olov Adami
Hoda Anton-Culver
Rachel Ballard-Barbash
Julie E Buring
D Michal Freedman
Gary E Fraser
Laura E Beane Freeman
Susan M Gapstur
John Michael Gaziano
Graham G Giles
Niclas Håkansson
Jane A Hoppin
Frank B Hu
Karen Koenig
Martha S Linet
Yikyung Park
Alpa V Patel
Mark P Purdue
Catherine Schairer
Howard D Sesso
Kala Visvanathan
Emily White
Alicja Wolk
Anne Zeleniuch-Jacquotte
Patricia Hartge
Source
PLoS Med. 2014 Jul;11(7):e1001673
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Australia - epidemiology
Body mass index
Humans
Life expectancy
Obesity - mortality
Prospective Studies
Risk factors
Sweden - epidemiology
United States - epidemiology
Abstract
The prevalence of class III obesity (body mass index [BMI]=40 kg/m2) has increased dramatically in several countries and currently affects 6% of adults in the US, with uncertain impact on the risks of illness and death. Using data from a large pooled study, we evaluated the risk of death, overall and due to a wide range of causes, and years of life expectancy lost associated with class III obesity.
In a pooled analysis of 20 prospective studies from the United States, Sweden, and Australia, we estimated sex- and age-adjusted total and cause-specific mortality rates (deaths per 100,000 persons per year) and multivariable-adjusted hazard ratios for adults, aged 19-83 y at baseline, classified as obese class III (BMI 40.0-59.9 kg/m2) compared with those classified as normal weight (BMI 18.5-24.9 kg/m2). Participants reporting ever smoking cigarettes or a history of chronic disease (heart disease, cancer, stroke, or emphysema) on baseline questionnaires were excluded. Among 9,564 class III obesity participants, mortality rates were 856.0 in men and 663.0 in women during the study period (1976-2009). Among 304,011 normal-weight participants, rates were 346.7 and 280.5 in men and women, respectively. Deaths from heart disease contributed largely to the excess rates in the class III obesity group (rate differences?=?238.9 and 132.8 in men and women, respectively), followed by deaths from cancer (rate differences?=?36.7 and 62.3 in men and women, respectively) and diabetes (rate differences?=?51.2 and 29.2 in men and women, respectively). Within the class III obesity range, multivariable-adjusted hazard ratios for total deaths and deaths due to heart disease, cancer, diabetes, nephritis/nephrotic syndrome/nephrosis, chronic lower respiratory disease, and influenza/pneumonia increased with increasing BMI. Compared with normal-weight BMI, a BMI of 40-44.9, 45-49.9, 50-54.9, and 55-59.9 kg/m2 was associated with an estimated 6.5 (95% CI: 5.7-7.3), 8.9 (95% CI: 7.4-10.4), 9.8 (95% CI: 7.4-12.2), and 13.7 (95% CI: 10.5-16.9) y of life lost. A limitation was that BMI was mainly ascertained by self-report.
Class III obesity is associated with substantially elevated rates of total mortality, with most of the excess deaths due to heart disease, cancer, and diabetes, and major reductions in life expectancy compared with normal weight. Please see later in the article for the Editors' Summary.
Notes
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PubMed ID
25003901 View in PubMed
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The association between lifetime smoking exposure and breast cancer mortality--results from a Norwegian cohort.

https://arctichealth.org/en/permalink/ahliterature264292
Source
Cancer Med. 2014 Oct;3(5):1448-57
Publication Type
Article
Date
Oct-2014
Author
Eivind Bjerkaas
Ranjan Parajuli
Anders Engeland
Gertraud Maskarinec
Elisabete Weiderpass
Inger Torhild Gram
Source
Cancer Med. 2014 Oct;3(5):1448-57
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - epidemiology - etiology - mortality
Cohort Studies
Female
Humans
Middle Aged
Norway - epidemiology
Proportional Hazards Models
Risk factors
Smoking - adverse effects
Young Adult
Abstract
Several recent cohort studies have found an association between smoking and breast cancer, but the association between lifetime smoking exposure and breast cancer mortality is less well described. We examined whether smoking before breast cancer diagnosis is a predictor of breast cancer mortality in a large cohort with more than 4.1 million years of follow-up, with a special focus on women who initiated smoking before first childbirth. Information on smoking status was collected before breast cancer diagnosis and used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of breast cancer mortality in a cohort of 302,865 Norwegian women with 1106 breast cancer deaths. Women were enrolled between 1974 and 2003 and followed up through linkages to national registries until 31 December 2007. We found that breast cancer mortality was slightly but significantly increased for current (HR = 1.15, 95% CI 1.01-1.32) and ever (HR = 1.15, 95% CI 1.02-1.30) smokers as compared to never smokers. No statistically significantly increased mortality was found for women who initiated smoking before first childbirth, and no dose-response association was revealed for any of the different measures of smoking exposure. A large proportion of heavy smokers may have died from other causes than breast cancer during follow-up, possibly diluting our results. This study found that lifetime smoking exposure had a significantly increased risk of breast cancer mortality compared with never smokers.
Notes
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PubMed ID
25073713 View in PubMed
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Body dissatisfaction and disordered eating symptoms in Finnish preadolescents.

https://arctichealth.org/en/permalink/ahliterature300942
Source
Eat Disord. 2019 Jan-Feb; 27(1):34-51
Publication Type
Journal Article
Author
Rejane Augusta de Oliveira Figueiredo
Sabina Simola-Ström
Rasmus Isomaa
Elisabete Weiderpass
Author Affiliation
a Genetic Epidemiology Group, Folkhälsan Research Center , Helsinki , Finland.
Source
Eat Disord. 2019 Jan-Feb; 27(1):34-51
Language
English
Publication Type
Journal Article
Keywords
Body Image - psychology
Body mass index
Child
Cross-Sectional Studies
Emotions
Feeding and Eating Disorders - prevention & control - psychology
Female
Finland
Humans
Male
Self Concept
Sex Factors
Surveys and Questionnaires
Abstract
To evaluate whether body dissatisfaction is associated with disordered eating symptoms in Finnish preadolescents, and to assess the moderator effects of gender and body mass index on this association. We included 10,526 9- to 12-year-old preadolescents at baseline from the Finnish Health in Teens cohort. We used the Children's Eating Attitudes Test for assessing disordered eating symptoms and a pictoral instrument for evaluating body dissatisfaction, comparing self-assessment of wanted and current body shape. Odds ratio (OR) for disordered eating symptoms were estimated using unconditional logistic regression. A high percentage of preadolescents reported body dissatisfaction: 30.0% wanted a smaller body and 9.3% wanted a larger body. Only 2.2% of the participants had disordered eating symptoms. Preadolescents who wanted a larger (OR = 2.83; 95% confidence intervals (CI): 1.68-4.78) or smaller body (OR = 4.48; 95% CI: 3.20-6.26) had a higher risk of having disordered eating symptoms, compared to preadolescents satisfied with their body. Among preadolescents who wanted a smaller body, the effect of body dissatisfaction was more pronounced among girls (OR = 5.00; 95% CI: 3.25-7.70) than boys, and among normal-weight (OR = 6.82; 95% CI: 4.53-10.25) and underweight (OR = 23.23; 95% CI: 5.31-101.61) than overweight preadolescents. Body dissatisfaction is associated with disordered eating symptoms especially among girls, and those who are underweight and normal-weight. Our study suggests that, in the prevention of eating disorders, special attention should be given to preadolescents with body dissatisfaction.
PubMed ID
30040544 View in PubMed
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Body mass index and mortality in a prospectively studied cohort of Scandinavian women: the women's lifestyle and health cohort study.

https://arctichealth.org/en/permalink/ahliterature16752
Source
Eur J Epidemiol. 2005;20(9):747-54
Publication Type
Article
Date
2005
Author
Anette Hjartåker
Hans-Olov Adami
Eiliv Lund
Elisabete Weiderpass
Author Affiliation
Department of Biostatistics, Institute for Basic Medical Sciences, University of Oslo, PO Box 1122, N-0317 Oslo, Blindern, Norway. anette.hjartaker@medisin.uio.no
Source
Eur J Epidemiol. 2005;20(9):747-54
Date
2005
Language
English
Publication Type
Article
Keywords
Adult
Body mass index
Female
Humans
Middle Aged
Mortality - trends
Norway - epidemiology
Obesity - epidemiology
Postmenopause
Premenopause
Proportional Hazards Models
Prospective Studies
Questionnaires
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Risk factors
Sweden - epidemiology
Abstract
Overweight and obesity increase the risk of numerous chronic diseases, including several forms of cancer. However, the association between excess body weight and all-cause mortality among young and middle-aged women is incompletely known, and the impact of menopausal status on the association has hardly been investigated. We studied prospectively a cohort comprising a population sample of 102,446 women from Norway and Sweden aged 30-50 years when they answered an extensive questionnaire in 1991/1992. During follow-up through year 2000, 1187 women in the cohort died. We used Cox proportional hazard models to estimate multivariate Hazard rate ratios (HRR) with 95% confidence intervals (CI) of death in relation to body mass index (BMI, weight (kg)/height (m(2))) at start of follow-up. Both in age-adjusted models and in models adjusting for several variables (including smoking and physical activity) mortality increased with increasing BMI among premenopausal women, whereas a U-shaped relationship was seen among the postmenopausal women. Among premenopausal women obesity (BMI 30.0) doubled the mortality (HRR = 2.2, 95% CI: 1.7-3.0) when compared to women of normal weight (BMI 18.5-24.9), whilst the association was modest after menopause. Although we had limited power to analyze women who were underweight (BMI
PubMed ID
16170657 View in PubMed
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