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D Trichopoulos

Publications and source records attributed to D Trichopoulos.

At least 253 records · Page 14Linked to original sources
PubMed1995

Mediterranean diet pyramid: a cultural model for healthy eating.

We present a food pyramid that reflects Mediterranean dietary traditions, which historically have been associated with good health. This Mediterranean diet pyramid is based on food patterns typical of Crete, much of the rest of Greece, and southern Italy in the early 1960s, where adult life expectancy was among the highest in the world and rates of coronary heart disease, certain cancers, and other diet-related chronic diseases were among the lowest. Work in the field or kitchen resulted in a lifestyle that included regular physical activity and was associated with low rates of obesity. The diet is characterized by abundant plant foods (fruit, vegetables, breads, other forms of cereals, potatoes, beans, nuts, and seeds), fresh fruit as the typical daily dessert, olive oil as the principal source of fat, dairy products (principally cheese and yogurt), and fish and poultry consumed in low to moderate amounts, zero to four eggs consumed weekly, red meat consumed in low amounts, and wine consumed in low to moderate amounts, normally with meals. This diet is low in saturated fat (< or = 7-8% of energy), with total fat ranging from < 25% to > 35% of energy throughout the region. The pyramid describes a dietary pattern that is attractive for its famous palatability as well as for its health benefits.

Animals↗
PubMed1995

Reproducibility and validity of an extensive semiquantitative food frequency questionnaire among Greek school teachers.

We evaluated the reproducibility and validity of a 190-item semiquantitative food frequency questionnaire (FFQ) to be used in a large prospective study in the Athens area of Greece. Eighty persons, 42 men and 38 women, ages 25-67 years, completed a self-administered FFQ, followed by monthly 24-hour diet recalls and then a second FFQ 1 year after the first. Correlation coefficients measuring the reproducibility and validity of the FFQ indicate that the questionnaire is reproducible and provides a reasonably reliable measure of intake for many nutrients over a period of 1 year.

Adult↗
PubMed1995

Coffee intake and other factors in relation to multiple deliveries: a study in Greece.

We conducted a case-control study of factors that may be related to the prevalence of multiple births with at least one liveborn. Over a period of 15 months during 1991-1992 in Athens, Greece, we identified 380 women who had a multiple birth that was delivered in one of the six larger maternity hospitals in the area. We selected as controls 380 livebirth singleton pregnancies delivered at the same hospitals immediately following a multiple pregnancy. All mothers were interviewed in the maternity wards or at home, and zygosity was ascertained through the similarity method. The odds ratio for ovulation-inducing drugs was not elevated for monozygotic twins, but it was 9-fold for dizygotic twins and 90-fold for triplets or quadruplets. We excluded drug-induced pregnancies, twins of indeterminable zygosity, and all triplets from further analyses. We found no remarkable association between any of the study variables and the occurrence of monozygotic twins, with the exception of an increasing trend with age. For dizygotic twins, we found weak associations in the expected directions with maternal age (positive) and height (positive) as well as with parity and number of induced abortions (positive). A history of oral contraceptive use was inversely, but weakly, associated with dizygotic twinning. Each cup of coffee per day was associated with an increment in the odds ratio of 1.23-fold. (95% confidence interval = 1.05-1.43). Restriction of the analysis to dizygotic twins of different gender increased the point estimate of the odds ratio to 1.31 for each cup of coffee consumed daily.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Man-made vitreous fibers and risk of respiratory system cancer: a review of the epidemiologic evidence.

Because asbestos has been demonstrated to cause lung cancer, the issue regarding safety of other fibers, including man-made vitreous fibers (MMVF), has been raised. We reviewed the available evidence, in particular the epidemiologic data, on MMVF and the risk of respiratory system cancer. Glass fibers (especially glass wool) have been studied most extensively. Taken together, the data indicate that among those occupationally exposed, glass fibers do not appear to increase risk of respiratory system cancer. Of six studies that specifically examined rock and slag wool workers, three reported excesses in respiratory system cancer among such workers. Two of these three studies, however, did not control for cigarette smoking, a powerful predictor of such cancers. There are no published studies, in humans, of refractory ceramic fibers. Future studies evaluating the potential of MMVF to increase risk of respiratory system cancer will not add to existing knowledge if investigators do not address potential confounding by cigarette smoking and other workplace carcinogens.

Animals↗
PubMed1995

Factors influencing serum immunoglobulin E levels in Greek children.

Serum levels of immunoglobulin E (IgE) were determined by enzyme immunoassay in 414 Greek infants and children of both sexes, 1 month to 14 years old. The children were admitted to the "Aghia Sophia" Teaching Hospital for Children (Athens, Greece) for surgical corrections of minor anatomic abnormalities, but they were otherwise healthy. Statistical analysis was performed through multiple regression after logarithmic transformation of the immunoglobulin values. IgE levels increased significantly by about 80% per year up to the age of 5 years, without noticeable impact of age on these levels thereafter. History of allergic disease showed a significant positive association with serum levels of IgE in both younger (less than 5 years) and older children. History of frequent infections was positively associated with IgE levels, although the relation was statistically significant only in the older age group, IgE levels in Greek children appear to be higher than the corresponding levels of children living in northern Europe, but much lower than those of children in Southeast Asia, a fact that may reflect different exposure level during childhood to infections known to influence IgE levels.

Adolescent↗
PubMed1995

Age patterns of immunoglobulins G, A & M in healthy children and the influence of breast feeding and vaccination status.

Serum levels of immunoglobulins G, A and M were determined by nephelometry in 414 infants and children aged 1 month to 14 years. The children were admitted to "Aghia Sophia" Teaching Hospital for Children for surgical corrections of minor anatomical abnormalities, but they were otherwise healthy. Statistical analysis was performed through multiple regression after logarithmic transformation of the immunoglobulin values. Immunoglobulin G (IgG) levels increased significantly by 18% per year until the age of 5 years and by 2% per year thereafter. Among children less than 5 years old, IgG levels tended to increase significantly with the number of doses of either DTP or Sabin vaccine. Immunoglobulin A (IgA) levels increased significantly by 27% until the age of 7 years and by 4% thereafter. Among children less than 7 years old, history of breast feeding was significantly associated with higher levels of IgA. Vaccination with either DTP or Sabin was associated with elevation of IgA levels among younger and, to a lesser extent, older children, but the elevations did not reach statistical significance. Immunoglobulin M (IgM) levels increased rapidly during the first 12 months of life and very slowly thereafter and they were significantly higher among girls. Among children less than one year old, there was evidence that vaccination with either DTP or Sabin was associated with elevated IgM levels, although the differences were not statistically significant possibly because of small numbers of infants in the study sample.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Biosocial variables and auditory acuity as risk factors for non-fatal childhood injuries in Greece.

OBJECTIVES: To examine whether biosocial variables and auditory acuity are risk factors for injuries among children. SETTING: Children with injuries who presented at the emergency clinics of one of the two university hospitals for children in Athens, Greece between December 1993 and April 1994. METHODS: 144 children aged 5-14 years, residents of Athens, were brought to the emergency clinics for a moderate to severe injury. For each of these children one hospital control, matched for age and sex, and one classmate control similarly matched were identified. A standard interview form was completed for all 432 children and acouometric and tympanometric examinations were performed in each of them. Analysis was done through conditional logistic regression. RESULTS: The likelihood of an accident was higher in children of younger fathers (odds ratio (OR) = 0.7, p = 0.04), children of mothers with non-professional jobs (OR = 1.9, p = 0.03) as well as in children of higher birth order (OR = 1.7, p = 0.01), in those with predominantly other than parental daily supervision (OR = 2.6, p = 0.001), and those with a history of previous accident (OR = 1.3, p = 0.002). Somatometric factors, school performance, use of corrective eyeglasses and subnormal auditory acuity were not found to be risk factors, but auditory imbalance and abnormal tympanograms were positively related to the risk of childhood injury (OR = 2.6, p = 0.02; and OR = 2.3, p = 0.08 respectively). CONCLUSIONS: the findings of this study underline the importance of attentive supervision and safety training of children living in modern cities; they also suggest that children with auditory imbalance and history of an accident are at higher injury risk and they should be targeted with specific intervention programs.

Accidents, Home↗
PubMed1995

A prospective study of diet and adult-onset asthma.

A role for diet in the pathophysiology of asthma may be mediated by altered immune or antioxidant activity with consequent effects on airway inflammation. We evaluated associations between several dietary factors assessed by a semiquantitative food frequency questionnaire, and incidence of asthma over a 10-yr period in 77,866 women 34 to 68 yr of age. Women in the highest quintile of vitamin E intake from diet, but not from supplements, had a risk of 0.53 (95% confidence interval [CI] = 0.33 to 0.86) compared with women in the lowest quintile. This relationship, however, was attenuated when the contribution from nuts, a major source of vitamin E in these data and a possible allergen, was removed (relative risk = 0.74 [0.50 to 1.10], p for trend = 0.007). Positive associations were found for vitamins C and E from supplements, but appeared to be explained by women at high risk of asthma initiating use of vitamin supplements prior to diagnosis. A nonsignificant inverse association with carotene intake was noted, but no clear relations with asthma were demonstrated for intake of linoleic acid or omega-3 fatty acids. These data suggest that antioxidant supplementation and intake of various fats during adulthood are not important determinants of asthma, although vitamin E from diet may have a modest protective effect.

Adult↗
PubMed1995

Menopause, postmenopausal estrogen preparations, and the risk of adult-onset asthma. A prospective cohort study.

We prospectively evaluated the association of hormone replacement therapy and asthma incidence in a cohort of pre- and postmenopausal women 34 to 68 yr of age. During 582, 135 person-years of follow-up between 1980 and 1990, 726 new cases of asthma were documented. Postmenopausal women who were never users of replacement hormones had a significantly lower age-adjusted risk of asthma than premenopausal women (relative risk = 0.65; 95% confidence interval [CI] = 0.46 to 0.92). Among naturally menopausal women, the age-adjusted relative risk of asthma for ever use of postmenopausal hormones was 1.49 (95% CI = 1.10 to 2.00); for current use of hormones (conjugated estrogens with or without progesterone), 1.50 (95% CI = 0.98 to 2.30); and for past use, 1.52 (95% CI = 1.08 to 2.13), compared with never use of hormones. Ever users of 10 or more years' duration had twice the age-adjusted risk of asthma compared with women who never used postmenopausal hormones (95% CI = 1.39 to 2.87). Among current users of conjugated estrogens, there was a positive dose-response demonstrated between daily dose and asthma risk (p for trend = 0.007). While confirmatory studies are warranted, these data suggest that estrogen plays a role in the pathophysiology of asthma and that long-term use and/or high doses of postmenopausal hormone therapy increase subsequent risk of asthma.

Adult↗
PubMed1995

Misclassification of smoking status among women in relation to exposure to environmental tobacco smoke.

In studies of the health effects of exposure to environmental tobacco smoke (ETS), misclassification of active smokers has the potential to bias the estimates of disease risk. Biochemical validation of exposure to ETS can provide objective evidence of current smoking status in epidemiological studies. Intrinsic to this effort is the establishment of appropriate cut-off points for the measurements of tobacco biomarkers. Within a collaborative study on ETS co-ordinated by the International Agency for Research on Cancer, questionnaire data and urine samples were collected from 1,369 women at 13 centres in 10 countries. Forty seven of these women had urine cotinine levels above 50 ng.mg-1 creatinine, a level used to discriminate smokers from nonsmokers in previous studies. The distributions of the subjects across cotinine values and self-reported exposure to ETS was consistent with the association, at one extreme, of moderate cotinine levels (50-150 ng.mg-1) with very high exposure to ETS, and, at the other extreme, of very high cotinine levels indicating actual use of nicotine-containing products in women with low ETS exposure. Using the cut-off point of 150 ng.mg-1, only 1.5% of the alleged nonsmokers were reclassified as current light smokers. Potential bias due to smoker misclassification is very unlikely to be responsible for the increased health risks observed in epidemiological studies on ETS.

Bias↗
PubMed1995

Cigarette smoking and incidence of chronic bronchitis and asthma in women.

STUDY OBJECTIVE: To examine the relation of smoking habits and development of asthma in a large cohort of US women. DESIGN: Prospective cohort study. PARTICIPANTS: Among 74,072 women, 34 to 68 years of age, who were free of major diseases, we documented 671 incident asthma cases and 798 incident cases of chronic bronchitis during 10 years of follow-up. METHODS: Age-adjusted relative risk estimates for smoking categories were calculated separately for chronic bronchitis and asthma. RESULTS: Risk of chronic bronchitis was significantly higher in current smokers than in never smokers (relative risk [RR] = 2.85; 95% confidence interval [CI] = 2.45 to 3.32) and increased with the number of cigarettes smoked per day (p for trend < 0.0001). Approximately 5 years after quitting, chronic bronchitis risk in past smokers approached that in never smokers. In contrast, current smokers were at significantly lower risk for asthma than women who never smoked (RR = 0.57; 95% CI = 0.46 to 0.71) and women who quit (RR = 0.50; 95% CI = 0.40 to 0.62), possibly because individuals with sensitive airways are less likely to become regular smokers, and smokers who develop respiratory symptoms of any etiology tend to quit. Asthma risk in past smokers initially increased compared with that in never smokers, possibly because of quitting prior to diagnosis in response to symptoms of any etiology, but decreased with time since quitting (p for trend = 0.007); within approximately 5 years, the risk did not differ between past and never smokers. CONCLUSION: These data suggest that smoking in adults may not be an independent cause of asthma but could exacerbate or be perceived as exacerbating asthma symptoms in susceptible individuals.

Adolescent↗
PubMed1995

Organochlorine compounds in relation to breast cancer, endometrial cancer, and endometriosis: an assessment of the biological and epidemiological evidence.

There is an increasing public and scientific concern that certain chlorinated compounds, recognized as environmental pollutants, may cause estrogen-related neoplastic disease in humans. The main hypothesis has been that certain organochlorines, through their estrogenic actions, might cause breast cancer. From experimental studies, both in vitro and in vivo, there is evidence that certain organochlorine compounds may cause estrogenic effects, whereas others may cause antiestrogenic effects. In limited studies, some of these compounds in high doses have also been shown to increase and reduce the frequency of estrogen-related tumors in animals. The epidemiological findings regarding the association between organochlorines and breast cancer are inconclusive. However, the largest and best designed study has been interpreted as negative with respect to DDT and polychlorinated biphenyls (PCB) in relation to breast cancer. Associations between organochlorine exposure and endometrial cancer or endometriosis have even more limited empirical basis. The hypothesis that human exposure to environmental levels or organochlorines would favor an estrogenic overactivity leading to an increase in estrogen-dependent formation of mammary or endometrial tumors is not supported by the existing in vitro, animal and epidemiological evidence. It can, however, not be conclusively rejected on the basis of available data.

Animals↗
PubMed1995

Do the nonsmoking daughters of smokers tend to marry smokers? Implications for epidemiological research on environmental tobacco smoke: the IARC collaborative study.

The IARC collaborative study on exposure to environmental tobacco smoke (ETS) involved collecting interview data and biochemical indicators of exposure from 1369 nonsmoking women in 13 centers in 10 countries. Information on childhood and adulthood exposure to other people's smoke and duration of this exposure from both parents and spouse was gathered at the interview. Of the 900 women whose husbands smoked (current or exsmokers), 71.3% had one or both parents who smoked (predominantly the father), whereas among the 277 women married to never-smokers, only 60.3% had at least one parent who smoked. The odds ratio for the daughter of a smoker to marry a smoker was, therefore, 1.64 (95% confidence interval = 1.24-2.17; P > 0.001), and there was an exposure-response relation between the number of years of childhood exposure to ETS from the parents and the likelihood of being married to a smoker. These results show that nonsmoking women married to smokers are more likely to have been exposed to tobacco pollution during their whole life. Because the duration of exposure is known to be important in the genesis of lung cancer, some of the excess risk of lung cancer in nonsmoking women married to smokers may be due exposure to ETS from parents during childhood.

Adolescent↗
PubMed1994

Parity, age at first childbirth, and risk of ovarian cancer.

Increasing parity is associated with a reduction in the risk of ovarian cancer, but it is not clear whether this association applies to different histopathological types and to borderline tumours. Moreover, the temporal relations are poorly understood, and the possible role of age at first birth remains unequivocal. We have investigated these issues in a case-control study nested in a nationwide cohort of women born between 1925 and 1960 in Sweden. During follow-up until 1984, 3486 invasive ovarian cancers (2992 epithelial, 330 stromal, 149 germ-cell, 15 not classifiable) and 510 tumours of borderline malignant potential were diagnosed. 5 individually age-matched controls (total 19,980) were selected for each case woman. After simultaneous adjustment for parity and age at first birth, increasing parity was associated with a pronounced consistent decrease in relative risk of all invasive cancers (odds ratio for each additional birth 0.81 [95% Cl 0.77-0.85]), epithelial cancer (0.81 [0.77-0.86]), stromal cancer (0.84 [0.72-0.98]), and germ-cell cancer (0.71 [0.48-1.05]), but a less consistent decrease for borderline tumours (0.92 [0.81-1.04]). The risk of ovarian cancer decreased by about 10% for each 5-year increment in age at first childbirth (odds ratios 0.89 [0.84-0.94] epithelial cancer, 0.92 [0.77-1.10] stromal cancer, 0.92 [0.65-1.32] germ-cell cancer, 0.93 [0.80-1.09] borderline tumours). Because our findings cannot be readily explained by theories involving incessant ovulation or high serum concentrations of gonadotropins, new aetiological hypotheses are needed. Pregnancy-dependent clearance from the ovaries of cells that have undergone malignant transformation could explain the reproductive risk factors for ovarian cancer.

Adolescent↗
PubMed1994

Ethanol and breast cancer: an association that may be both confounded and causal.

We have examined the association of alcohol intake during various life periods, by beverage category, with breast cancer risk in Greece. A hospital-based case-control study was performed in Athens, involving 820 women with breast cancer as well as 795 orthopedic patients and 753 healthy visitor controls. Relative risk patterns were very similar with either control series, which were therefore combined to increase precision of the estimates. Drinkers of beer were at significantly elevated risk for breast cancer [odds ratio (OR), 1.34 (95% confidence interval, 1.05-1.71)]. However, drinkers of other alcoholic beverages were not at increased risk. Among beer drinkers there was no dose-response, and drinkers of both beer and other beverages had a lower OR compared to drinkers of beer only. By contrast, drinkers of 3 or more glasses of alcohol per day, mostly of spirits, were at elevated risk for breast cancer [OR for 3 - < 4 glasses per day, 3.01 (1.14-7.95); OR for 4 or more glasses per day, 3.79 (1.05-13.71)]. Reported frequency of consumption was a stronger predictor of breast cancer risk than either duration-weighted total consumption or consumption before the age of 30 years. There were no coherent patterns for interaction with menopausal status, obesity or use of menopausal estrogens. The association of very low levels of alcohol intake with breast cancer risk may be due to confounding, whereas drinking 3 or more glasses of alcoholic beverages daily appears to genuinely increase breast cancer risk, perhaps by acting as a late-stage growth enhancing factor. However, the data also are compatible with a linear relationship that has no threshold.

Adult↗
PubMed1994

Transient increase in the risk of breast cancer after giving birth.

BACKGROUND: The effect of pregnancy on the risk of breast cancer is not clear. We tested the hypothesis that the risk of breast cancer increases transiently after pregnancy but then falls to a level below that of age-matched nulliparous women. METHODS: We conducted a case-control study of a nationwide cohort in Sweden, using a computerized record linkage between the Cancer Registry and the Fertility Registry. The study subjects were women born from 1925 through 1960 who were resident citizens of Sweden at the time of the 1960 census. A total of 12,666 patients with breast cancer were compared with 62,121 age-matched control subjects. We used conditional logistic regression to estimate odds ratios for the development of breast cancer at different ages, according to maternal age at first delivery (in uniparous as compared with nulliparous women) and age at second delivery (in biparous as compared with uniparous women). RESULTS: Uniparous women were at higher risk of breast cancer than nulliparous women for up to 15 years after childbirth and at lower risk thereafter. The excess risk was most pronounced among women who were older at the time of their first delivery (odds ratio 5 years after delivery among women 35 years old at first delivery, 1.26; 95 percent confidence interval, 1.10 to 1.44). Women who had two pregnancies had a less striking increase in risk. CONCLUSIONS: Pregnancy has a dual effect on the risk of breast cancer: it transiently increases the risk after childbirth but reduces the risk in later years. In women with two pregnancies, the short-term adverse effect is masked by the long-term protection imparted by the first pregnancy. A plausible biologic interpretation is that pregnancy increases the short-term risk of breast cancer by stimulating the growth of cells that have undergone the early stages of malignant transformation but that it confers long-term protection by inducing the differentiation of normal mammary stem cells that have the potential for neoplastic change.

Adult↗