We examined the hypothesis that high adherence to a Mediterranean diet reduces the risk of developing heart failure (HF) as well as the risk of death from HF.
The study population comprised 37 308 men from the Cohort of Swedish Men who were free from cardiovascular disease at baseline. The modified Mediterranean diet (mMED) score was created from a self-administered food frequency questionnaire, based on consumption of presumed beneficial/detrimental foods, on a 0-8 scale. Incident HF events were ascertained by linkage to the Swedish National Patient and the Cause of Death Registers. Relative risks (RR) with 95% confidence intervals (CI), adjusted for potential confounders, were estimated by Cox proportional hazards regression models. We identified 146 deaths from HF and 1269 incident HF events over a median follow-up of 10.9 years (1998-2008). The mMED score was inversely associated with risk of HF (multivariable RR for the highest vs. lowest quartile 0.69, 95% CI 0.57, 0.83); the corresponding RR of HF mortality was 0.55 (95% CI 0.31, 0.98). The multivariable RR for every two-point increment in the mMED score was 0.85 (95% CI 0.78, 0.91) for incidence of HF and 0.78 (95% CI 0.62, 0.98) for mortality from HF, respectively.
High adherence to a Mediterranean diet was associated with a lower risk of HF and mortality from HF in men. Further studies are needed to replicate these findings in other populations.
Although high alcohol consumption has been associated with increased risk of atrial fibrillation (AF), the role of light to moderate drinking remains unclear.
The study sought to investigate the association between alcohol consumption and AF risk in a prospective study of Swedish men and women and to conduct a meta-analysis of prospective studies to summarize available evidence.
We followed 79,019 men and women who, at baseline, were free from AF and had completed a questionnaire about alcohol consumption and other risk factors for chronic diseases. Incident AF cases were ascertained by linkage to the Swedish Inpatient Register. For the meta-analysis, studies were identified by searching PubMed through January 10, 2014, and by reviewing references of pertinent publications. Study-specific relative risks (RRs) were combined using a random effects model.
Over 859,420 person-years of follow-up (1998 to 2009), 7,245 incident AF cases were identified in our own cohort study. The association between alcohol consumption and AF did not differ by sex (p for interaction = 0.74). Compared with current drinkers of 21 drinks/week. Results were similar after excluding binge drinkers. In a meta-analysis of 7 prospective studies, including 12,554 AF cases, the RRs were 1.08 (95% CI: 1.06 to 1.10) for 1 drink/day, 1.17 (95% CI: 1.13 to 1.21) for 2 drinks/day, 1.26 (95% CI: 1.19 to 1.33) for 3 drinks/day, 1.36 (95% CI: 1.27 to 1.46) for 4 drinks/day, and 1.47 (95% CI: 1.34 to 1.61) for 5 drinks/day, compared with nondrinkers.
These findings indicate that alcohol consumption, even at moderate intakes, is a risk factor for atrial fibrillation.
Comment In: J Am Coll Cardiol. 2014 Jul 22;64(3):290-225034066
The relation between dairy foods, particularly specific foods, and risk of cardiovascular disease (CVD) remains unclear. We examined the association between total, as well as specific, dairy food intakes and incidence of myocardial infarction (MI) in a prospective population-based cohort. We followed 33,636 women (aged 48-83 y), free from CVD, cancer, and diabetes at baseline (1997), in the Swedish Mammography Cohort. Consumption of milk, cultured milk/yogurt, cheese, cream, crème fraiche, and butter was obtained from a validated self-administered FFQ at baseline. We used Cox proportional hazards regression models to estimate HRs and 95% CIs, adjusted for relevant CVD risk factors. MI incidence was ascertained from national registries. Over 11.6 y of follow-up, we ascertained 1392 cases of MI. When the highest quintile was compared with the lowest quintile, total dairy food intake was inversely associated with MI risk [multivariable adjusted HR: 0.77 (95% CI: 0.63, 0.95)]. Among specific dairy food products, total cheese was inversely associated [HR: 0.74 (95% CI: 0.60, 0.91)] and butter used on bread but not on cooking was positively associated [HR: 1.34 (95% CI: 1.02, 1.75)] with MI risk. Other specific dairy food products were not significantly associated with MI risk. No differences were observed between consumption of specific low-fat and high-fat dairy foods, expressed as either absolute intakes or intakes relative to the total, and MI risk. Failure to consider dairy foods as a heterogeneous group in future studies could hamper important insights of relevance for the development of dietary guidelines.
Division of Nutritional Epidemiology, The National Institute of Environmental Medicine and Molecular Medicine, Unit of Endocrinology and Diabetes, Karolinska Institutet, Stockholm, Sweden. email@example.com
BACKGROUND: Insulin-like growth factor I (IGF-I) has been implicated in several chronic diseases, including cancer, heart disease, and osteoporosis. OBJECTIVE: Our aim was to assess whether intakes of total energy, alcohol, vitamins, minerals, and foods rich in protein and minerals (including red meat, fish and seafood, poultry, and milk) are associated with serum IGF-I concentrations in middle-aged and elderly men. DESIGN: We measured serum IGF-I concentrations in 226 free-living healthy men aged 42-76 y. The average of fourteen 24-h dietary telephone interviews performed over 1 y was used to estimate long-term dietary intake. RESULTS: We observed statistically significant positive associations between intakes of protein (P for trend = 0.001) and zinc (P for trend = 0.002) and serum IGF-I concentrations after adjusting for age. The difference in mean IGF-I concentrations for the highest compared with the lowest quintile of intake was approximately 17% (162 microg/L compared with 139 microg/L) for protein and approximately 16% (166 microg/L compared with 143 microg/L) for zinc. Consumption of red meat (P for trend = 0.05) and fish and seafood (P for trend = 0.07) was modestly positively associated with IGF-I concentrations. Other dietary factors were not associated with IGF-I concentrations. CONCLUSION: In this population of healthy well-nourished men, greater dietary intakes of protein, zinc, red meat, and fish and seafood were associated with higher IGF-I concentrations.
This study examines the influence of physical activity at different ages and of different types, on the risk of developing atrial fibrillation (AF) in a large cohort of Swedish men.
Information about physical activity was obtained from 44 410 AF-free men, aged 45-79 years (mean age=60), who had completed a self-administered questionnaire at baseline in 1997. Participants reported retrospectively their time spent on leisure-time exercise and on walking or bicycling throughout their lifetime (at 15, 30 and 50 years of age, and at baseline (mean age=60)). Participants were followed-up in the Swedish National Inpatient Register for ascertainment of AF. Cox proportional hazards regression models were used to estimate relative risks (RR) with 95% CIs, adjusted for potential confounders.
During a median follow-up of 12 years, 4568 cases of AF were diagnosed. We observed a RR of 1.19 (95% CI 1.05 to 1.36) of developing AF in men who at the age of 30 years had exercised for >5 h/week compared with 5 h/week at age 30 and quit exercising later in life (1 h/day vs almost never) and the association was similar after excluding men with previous coronary heart disease or heart failure at baseline (corresponding RR 0.88, 95% CI 0.77 to 0.998).
Leisure-time exercise at younger age is associated with an increased risk of AF, whereas walking/bicycling at older age is associated with a decreased risk.
Our aim was examine the association between black tea consumption and risk of total stroke and stroke types in a prospective study.
A total of 74,961 Swedish women and men who were free of cardiovascular disease and cancer at baseline in 1997 were followed up through December 2008. Tea consumption was assessed with a questionnaire at baseline. Stroke cases were ascertained from the Swedish Hospital Discharge Registry.
During a mean follow-up of 10.2 years, we ascertained 4089 cases of first stroke, including 3159 cerebral infarctions, 435 intracerebral hemorrhages, 148 subarachnoid hemorrhages, and 347 unspecified strokes. After adjustment for other risk factors, high tea consumption was associated with a significantly lower risk of total stroke; however, there was no dose-response relation (P for trend = .36). Compared with no tea consumption, the multivariable relative risk for four or more cups per day (median, 5) was 0.79 (95% confidence interval [CI], 0.62-0.998). The corresponding relative risks were 0.80 (95% CI, 0.61-1.04) for cerebral infarction and 0.68 (95% CI, 0.35-1.30) for hemorrhagic stroke.
These findings suggest that daily consumption of four or more cups of black tea is inversely associated with risk of stroke.
BACKGROUND: Recent epidemiologic studies have generally reported a modest inverse association between calcium intake and the risk of colorectal cancer. However, findings pertaining to specific subsites in the colorectum have been conflicting. OBJECTIVE: Our objective was to prospectively examine the relations between intakes of calcium and dairy foods and the risk of colorectal cancer, overall and by anatomic subsite, in men from the Cohort of Swedish Men. DESIGN: In 1997, 45 306 men aged 45-79 y and without a history of cancer completed a food-frequency questionnaire. The men were followed through 31 December 2004. RESULTS: During a mean follow-up of 6.7 y, we ascertained 449 incident cases of colorectal cancer. After adjustment for age and other known or potential risk factors, the multivariate rate ratio (RR) of colorectal cancer for men in the highest quartile of total calcium intake compared with those in the lowest quartile was 0.68 (95% CI: 0.51, 0.91; P for trend = 0.01). A high consumption of dairy foods was also associated with a lower risk of colorectal cancer. The multivariate RR of colorectal cancer for > or = 7 servings/d of total dairy foods compared with
Comment In: Am J Clin Nutr. 2006 Mar;83(3):527-816522897
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.
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.
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%).
Chocolate consumption is associated with lower risk of MI and ischaemic heart disease.
Coffee and tea consumption has been inconsistently associated with the risk of breast cancer. We examined the associations of caffeinated coffee and black tea consumption with the incidence of breast cancer, overall and by estrogen receptor (ER) and progesterone receptor (PR) status of the tumor, in the Swedish Mammography Cohort.
We prospectively followed up 61,433 women who were cancer free at baseline in 1987-1990. Coffee and tea consumption was assessed with a food-frequency questionnaire administered at baseline and in 1997. Incident invasive breast cancer cases were ascertained by linkage with Swedish Cancer registers.
Over a mean follow-up of 17.4 years, through December 2007, there were 2,952 incident cases of invasive breast cancer identified. Coffee consumption was not associated with risk of overall breast cancer (multivariate relative risk (RR) for = 4 cups/day versus