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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
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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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Adult Overweight and Survival from Breast and Colorectal Cancer in Swedish Women.

https://arctichealth.org/en/permalink/ahliterature310431
Source
Cancer Epidemiol Biomarkers Prev. 2019 09; 28(9):1518-1524
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
09-2019
Author
Melina Arnold
Hadrien Charvat
Heinz Freisling
Hwayoung Noh
Hans-Olov Adami
Isabelle Soerjomataram
Elisabete Weiderpass
Author Affiliation
Section of Cancer Surveillance, International Agency for Research on Cancer (IARC/WHO), Lyon, France. arnoldm@iarc.fr.
Source
Cancer Epidemiol Biomarkers Prev. 2019 09; 28(9):1518-1524
Date
09-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Breast Neoplasms - epidemiology - mortality
Colorectal Neoplasms - epidemiology - mortality
Female
Humans
Male
Middle Aged
Overweight
Survival Analysis
Sweden
Abstract
The impact of overweight duration and intensity during adulthood on the prognosis after a cancer diagnosis remains largely unknown. We investigated this association in Swedish women with breast and colorectal cancer.
A cohort of 47,051 women from the Swedish Lifestyle and Health Study was included, of whom 1,241 developed postmenopausal breast (mean age at diagnosis, 57.5 years) and 259 colorectal (mean age at diagnosis, 59.1 years) cancer. Trajectories of body mass index (BMI) between ages 20 and 50 years were estimated for the full cohort using a quadratic growth model and studied in relation to risk of death from any cause using multivariate Cox regression models among cancer survivors.
Compared with patients with cancer who were never overweight (BMI
PubMed ID
31201224 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
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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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An observational study comparing HPV prevalence and type distribution between HPV-vaccinated and -unvaccinated girls after introduction of school-based HPV vaccination in Norway.

https://arctichealth.org/en/permalink/ahliterature308690
Source
PLoS One. 2019; 14(10):e0223612
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Date
2019
Author
Espen Enerly
Ragnhild Flingtorp
Irene Kraus Christiansen
Suzanne Campbell
Mona Hansen
Tor Åge Myklebust
Elisabete Weiderpass
Mari Nygård
Author Affiliation
Department of Research, Cancer Registry of Norway, Oslo, Norway.
Source
PLoS One. 2019; 14(10):e0223612
Date
2019
Language
English
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Female
Humans
Norway - epidemiology
Papillomavirus Infections - epidemiology - immunology
Papillomavirus Vaccines
Prevalence
Sexual Behavior
Surveys and Questionnaires
Vaccination
Young Adult
Abstract
Many countries have initiated school-based human papillomavirus (HPV) vaccination programs. The real-life effectiveness of HPV vaccines has become increasingly evident, especially among girls vaccinated before HPV exposure in countries with high vaccine uptake. In 2009, Norway initiated a school-based HPV vaccination program for 12-year-old girls using the quadrivalent HPV vaccine (Gardasil®), which targets HPV6, 11, 16, and 18. Here, we aim to assess type-specific vaginal and oral HPV prevalence in vaccinated compared with unvaccinated girls in the first birth cohort eligible for school-based vaccination (born in 1997).
This observational, cross-sectional study measured the HPV prevalence ratio (PR) between vaccinated and unvaccinated girls in Norway. Facebook advertisement was used to recruit participants and disseminate information about the study. Participants self-sampled vaginal and oral specimens using an Evalyn® Brush and a FLOQSwabâ„¢, respectively. Sexual behavior was ascertained through a short questionnaire.
Among the 312 participants, 239 (76.6%) had received at least one dose of HPV vaccine prior to sexual debut. 39.1% of vaginal samples were positive for any HPV type, with similar prevalence among vaccinated and unvaccinated girls (38.5% vs 41.1%, PR: 0.93, 95% confidence interval [CI]: 0.62-1.41). For vaccine-targeted types there was some evidence of lower prevalence in the vaccinated (0.4%) compared to the unvaccinated (6.8%) group (PR: 0.06, 95%CI: 0.01-0.52). This difference remained after adjusting for sexual behavior (PR: 0.04, 95%CI: 0.00-0.42). Only four oral samples were positive for any HPV type, and all of these participants had received at least one dose of HPV vaccine at least 1 year before oral sexual debut.
There is evidence of a lower prevalence of vaccine-targeted HPV types in the vagina of vaccinated girls from the first birth cohort eligible for school-based HPV vaccination in Norway; this was not the case when considering all HPV types or types not included in the quadrivalent HPV vaccine.
Notes
ErratumIn: PLoS One. 2019 Dec 12;14(12):e0226706 PMID 31830145
PubMed ID
31600341 View in PubMed
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Antimicrobial drug use in the first decade of life influences saliva microbiota diversity and composition.

https://arctichealth.org/en/permalink/ahliterature311272
Source
Microbiome. 2020 08 21; 8(1):121
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Video-Audio Media
Date
08-21-2020
Author
Sajan C Raju
Heli Viljakainen
Rejane A O Figueiredo
Pertti J Neuvonen
Johan G Eriksson
Elisabete Weiderpass
Trine B Rounge
Author Affiliation
Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland.
Source
Microbiome. 2020 08 21; 8(1):121
Date
08-21-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Video-Audio Media
Keywords
Adolescent
Anti-Bacterial Agents - administration & dosage - pharmacology
Child
Female
Finland
Humans
Male
Microbiota - drug effects - genetics
Prospective Studies
RNA, Ribosomal, 16S - genetics
Saliva - drug effects - microbiology
Time Factors
Abstract
The human microbiota contributes to health and well-being. Antimicrobials (AM) have an immediate effect on microbial diversity and composition in the gut, but next to nothing is known about their long-term contribution to saliva microbiota. Our objectives were to investigate the long-term impact of AM use on saliva microbiota diversity and composition in preadolescents. We compared the lifetime effects by gender and AMs. We used data from 808 randomly selected children in the Finnish Health In Teens (Fin-HIT) cohort with register-based data on AM purchases from the Social Insurance Institution of Finland. Saliva microbiota was assessed with 16S rRNA (V3-V4) sequencing. The sequences were aligned to the SILVA ribosomal RNA database and classified and counted using the mothur pipeline. Associations between AM use and alpha-diversity (Shannon index) were identified with linear regression, while associations between beta-diversity (Bray-Curtis dissimilarity) and low, medium or high AM use were identified with PERMANOVA.
Of the children, 53.6% were girls and their mean age was 11.7 (0.4) years. On average, the children had 7.4 (ranging from 0 to 41) AM prescriptions during their lifespan. The four most commonly used AMs were amoxicillin (n = 2622, 43.7%), azithromycin (n = 1495, 24.9%), amoxicillin-clavulanate (n = 1123, 18.7%) and phenoxymethylpenicillin (n = 408, 6.8%). A linear inverse association was observed between the use of azithromycin and Shannon index (b -?0.015, p value = 0.002) in all children, the effect was driven by girls (b -?0.032, p value = 0.001), while not present in boys. Dissimilarities were marked between high, medium and low users of all AMs combined, in azithromycin users specifically, and in boys with amoxicillin use. Amoxicillin and amoxicillin-clavulanate use was associated with the largest decrease in abundance of Rikenellaceae. AM use in general and phenoxymethylpenicillin specifically were associated with a decrease of Paludibacter and pathways related to amino acid degradations differed in proportion between high and low AM users.
A systematic approach utilising reliable registry data on lifetime use of AMs demonstrated long-term effects on saliva microbiota diversity and composition. These effects are gender- and AM-dependent. We found that frequent lifelong use of AMs shifts bacterial profiles years later, which might have unforeseen health impacts in the future. Our findings emphasise a concern for high azithromycin use, which substantially decreases bacterial diversity and affects composition as well. Further studies are needed to determine the clinical implications of our findings. Video Abstract.
PubMed ID
32825849 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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