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Biomedical subjects

E B Rimm

Publications and source records attributed to E B Rimm.

At least 73 records · Page 4Linked to original sources

Relation of consumption of vitamin E, vitamin C, and carotenoids to risk for stroke among men in the United States.

BACKGROUND: Antioxidants increase the resistance of low-density lipoprotein to oxidation and may thereby reduce risk for atherosclerosis. OBJECTIVE: To determine whether intake of vitamin E, vitamin C, or carotenoids predict risk for total or ischemic stroke. DESIGN: Prospective observational study. SETTING: The Health Professionals Follow-up Study. PARTICIPANTS: 43,738 men 40 to 75 years of age who did not have cardiovascular disease or diabetes. MEASUREMENTS: Repeated and validated dietary assessments were done by using a self-administered 131-item food-frequency questionnaire, which included questions on dose and duration of vitamin supplement use. The follow-up period was 8 years. RESULTS: A total of 328 strokes occurred: 210 ischemic, 70 hemorrhagic, and 48 unclassified. After adjustment for age, smoking, hypertension, hypercholesterolemia, body mass index, physical activity, parental history of myocardial infarction, alcohol consumption, and total energy intake, the relative risk for ischemic stroke in the top quintile of vitamin E intake (median, 411 IU/d) compared with the bottom quintile (5.4 IU/d) was 1.18 (95% CI, 0.77 to 1.82). The relative risk for ischemic stroke in the top quintile of vitamin C intake (1167 mg/d) compared with the bottom quintile (95 mg/d) was 1.03 (CI, 0.66 to 1.59). Results for total stroke were similar. Associations of vitamin intake with hemorrhagic stroke were also nonsignificant, but the CIs were wide. Neither dose nor duration of vitamin E or vitamin C supplement use was related to risk for total or ischemic stroke. The relative risk for ischemic stroke was 1.16 (CI, 0.81 to 1.67) in men using 250 IU or more of vitamin E supplementation per day compared with men who used no vitamin E supplements and was 0.93 (CI, 0.60 to 1.45) in men using 700 mg or more of vitamin C supplementation per day compared with men who used no vitamin C supplements. A significant inverse relation between lutein intake and risk for ischemic stroke was seen but was not independent of other dietary factors. CONCLUSIONS: Vitamin E and vitamin C supplements and specific carotenoids did not seem to substantially reduce risk for stroke in this cohort. Modest effects, however, cannot be excluded.

Adult↗

A prospective study of coffee consumption and the risk of symptomatic gallstone disease in men.

CONTEXT: Coffee has several metabolic effects that could reduce the risk of gallstone formation. OBJECTIVE: To examine the association between coffee consumption and the risk of symptomatic gallstone disease in men. DESIGN AND SETTING: The Health Professionals Follow-up Study, a prospective cohort study, in which the consumption of coffee and other caffeinated drinks was assessed starting in 1986 as part of the 131-item food frequency questionnaire given to US male health professionals with follow-up through 1996. PARTICIPANTS: A total of 46008 men, aged 40 to 75 years in 1986, without history of gallstone disease. MAIN OUTCOME MEASURES: Newly symptomatic gallstone disease (diagnosed by ultrasonography or x-ray) or a cholecystectomy. RESULTS: During 404 166 person-years of follow-up, 1081 subjects reported symptomatic gallstone disease, of whom 885 required cholecystectomy. After adjusting for other known or suspected risk factors, compared with men who did not consume regular coffee in 1986 and 1990, the adjusted relative risk (RR) for those who consistently drank 2 to 3 cups of regular coffee per day was 0.60 (95% confidence interval [CI], 0.42-0.86) and for those who drank 4 or more cups per day the RR was 0.55 (95% CI, 0.33-0.92). All coffee brewing methods showed a decreased risk. The risk of symptomatic gallstone disease also declined with increasing caffeine intake (P for trend = .005). After controlling for known or suspected risk factors, the RR for men in the highest category of caffeine intake (>800 mg/d) compared with men in the lowest category (< or =25 mg/d) was 0.55 (95% CI, 0.35-0.87). In contrast, decaffeinated coffee was not associated with a decreased risk. CONCLUSIONS: In this cohort of US men, coffee consumption may have helped to prevent symptomatic gallstone disease.

Adult↗

Fluid intake and the risk of bladder cancer in men.

BACKGROUND: Studies in animals have shown that the frequency of urination is inversely associated with the level of potential carcinogens in the urothelium. In humans, an increase in total fluid intake may reduce contact time between carcinogens and urothelium by diluting urinary metabolites and increasing the frequency of voiding. The data on fluid intake in relation to the risk of bladder cancer are inconclusive. METHODS: We examined the relation between total fluid intake and the risk of bladder cancer over a period of 10 years among 47,909 participants in the prospective Health Professionals Follow-up Study. There were 252 newly diagnosed cases of bladder cancer during the follow-up period. Information on total fluid intake was derived from the reported frequency of consumption of the 22 types of beverages on the food-frequency questionnaire, which was completed by each of the 47,909 participants who were free of cancer in 1986. Logistic-regression analyses were performed to adjust for known and suspected risk factors for bladder cancer. RESULTS: Total daily fluid intake was inversely associated with the risk of bladder cancer; the multivariate relative risk was 0.51 (95 percent confidence interval, 0.32 to 0.80) for the highest quintile of total daily fluid intake (>2531 ml per day) as compared with the lowest quintile (<1290 ml per day). The consumption of water contributed to a lower risk (relative risk, 0.49 [95 percent confidence interval, 0.28 to 0.86] for > or =1440 ml [6 cups] per day vs. <240 ml [1 cup] per day), as did the consumption of other fluids (relative risk, 0.63 [95 percent confidence interval, 0.39 to 0.99] for >1831 ml per day vs. <735 ml per day). CONCLUSIONS: A high fluid intake is associated with a decreased risk of bladder cancer in men.

Adult↗

A prospective study of egg consumption and risk of cardiovascular disease in men and women.

CONTEXT: Reduction in egg consumption has been widely recommended to lower blood cholesterol levels and prevent coronary heart disease (CHD). Epidemiologic studies on egg consumption and risk of CHD are sparse. OBJECTIVE: To examine the association between egg consumption and risk of CHD and stroke in men and women. DESIGN AND SETTING: Two prospective cohort studies, the Health Professionals Follow-up Study (1986-1994) and the Nurses' Health Study (1980-1994). PARTICIPANTS: A total of 37851 men aged 40 to 75 years at study outset and 80082 women aged 34 to 59 years at study outset, free of cardiovascular disease, diabetes, hypercholesterolemia, or cancer. MAIN OUTCOME MEASURES: Incident nonfatal myocardial infarction, fatal CHD, and stroke corresponding to daily egg consumption as determined by a food-frequency questionnaire. RESULTS: We documented 866 incident cases of CHD and 258 incident cases of stroke in men during 8 years of follow-up and 939 incident cases of CHD and 563 incident cases of stroke in women during 14 years of follow-up. After adjustment for age, smoking, and other potential CHD risk factors, we found no evidence of an overall significant association between egg consumption and risk of CHD or stroke in either men or women. The relative risks (RRs) of CHD across categories of intake were less than 1 per week (1.0), 1 per week (1.06), 2 to 4 per week (1.12), 5 to 6 per week (0.90), and > or =1 per day (1.08) (P for trend = .75) for men; and less than 1 per week (1.0), 1 per week (0.82), 2 to 4 per week (0.99), 5 to 6 per week (0.95), and > or =1 per day (0.82) (P for trend = .95) for women. In subgroup analyses, higher egg consumption appeared to be associated with increased risk of CHD only among diabetic subjects (RR of CHD comparing more than 1 egg per day with less than 1 egg per week among diabetic men, 2.02 [95% confidence interval, 1.05-3.87; P for trend = .04], and among diabetic women, 1.49 [0.88-2.52; P for trend = .008]). CONCLUSIONS: These findings suggest that consumption of up to 1 egg per day is unlikely to have substantial overall impact on the risk of CHD or stroke among healthy men and women. The apparent increased risk of CHD associated with higher egg consumption among diabetic participants warrants further research.

Adult↗

Fruit and vegetable intake and incidence of bladder cancer in a male prospective cohort.

BACKGROUND: Previous epidemiologic studies of fruit and vegetable intake and bladder cancer risk have yielded inconsistent results, especially with regard to the types of fruits and vegetables consumed. We examined total fruit and vegetable intake, as well as intakes of subtypes of fruits and vegetables, in relation to bladder cancer risk in a large male prospective cohort study. METHODS: Two hundred fifty-two cases of incident bladder cancer were diagnosed from 1986 through January 31, 1996, among 47,909 men enrolled in the Health Professionals Follow-up Study. Each participant in this cohort completed a 131-item food-frequency questionnaire in 1986 and subsequently in 1990 and 1994. We used logistic regression analyses to examine fruit and vegetable intake in relation to bladder cancer risk, after adjusting for age, history of cigarette smoking, current smoking status, geographic region, total fluid intake, and caloric intake. RESULTS: We observed a weak, inverse association that was not statistically significant between total fruit and vegetable intake and bladder cancer risk. Intake of cruciferous vegetables was inversely associated with risk (relative risk = 0.49; 95% confidence interval = 0.32-0.75, for the highest category of cruciferous vegetable intake compared with the lowest), but intakes of yellow or green leafy vegetables or carotenoid-rich vegetables were not associated with risk. Individual cruciferous vegetables, except for coleslaw, were all inversely related to bladder cancer risk, but only the associations for broccoli and cabbage were statistically significant. CONCLUSIONS: Data from this study indicate that high cruciferous vegetable consumption may reduce bladder cancer risk, but other vegetables and fruits may not confer appreciable benefits against this cancer.

Adult↗

Alcohol consumption, cigarette smoking, and risk of benign prostatic hyperplasia.

Alcohol consumption and cigarette smoking were evaluated in relation to development of benign prostatic hyperplasia (BPH) among 29,386 members of the Health Professionals Follow-up Study. Men who were 40-75 years old in 1986 and free of prior BPH surgery, diagnosed cancer at baseline, and prostate cancer at baseline and during follow-up were followed for incidence of BPH surgery from 1986 to 1994. Cases were men who reported BPH surgery between 1986 and 1994 (n = 1,813) or who scored > or = 15 points of 35 on seven lower urinary tract symptom questions modified from the American Urological Association symptom index in 1992 and 1994 (n = 1,786); noncases were men who scored < or = 7 points (n = 20,840). After controlling for age, race/ethnicity, body mass index, physical activity, and mutually for alcohol intake and smoking, moderate alcohol consumption was inversely related with total BPH (30.1-50 g/day vs. 0: odds ratio (OR) = 0.59, 95% confidence interval (CI) 0.51-0.70; p trend < 0.0001), although the relation was attenuated at high intake (> or = 50.1 g/day vs. 0: OR = 0.72, 95% CI 0.57-0.90). Current cigarette smoking was positively related to total BPH only among those who smoked 35 or more cigarettes/day (compared with never smokers: OR = 1.45, 95% CI 1.07-1.97). These findings suggest that moderate alcohol consumption and avoidance of smoking may benefit BPH.

Adult↗

Plasma steroid hormones, surgery for benign prostatic hyperplasia, and severe lower urinary tract symptoms.

Because benign prostatic hyperplasia (BPH) may be influenced by plasma steroid hormones, we examined their relation in the Health Professionals Follow-up Study. In 1993-1995, 18,000 cohort members provided blood. We selected as cases men who had had surgery for BPH (n=174) or who scored 20-35 points (n=126) on the American Urological Association index of severity of lower urinary tract symptoms. Cases were matched by age to men who scored</=3 points and without an enlarged prostate or elevated prostate-specific antigen. We estimated the odds ratio (OR) of BPH surgery and severe lower urinary tract symptoms for plasma testosterone (T), dihydrotestosterone (DHT), androstanediol glucuronide (AAG), estradiol (E2), and sex hormone binding globulin (SHBG) in multivariable conditional logistic regression models. Compared to the lowest tertiles, men in the middle (OR=1.42) and top (OR=1.78) tertiles of AAG were at increased risk for having either BPH surgery or severe lower urinary tract symptoms (P-trend=0.02). Men in the middle (OR=0.58) and top (OR=0.60) tertiles of E2 were at lower risk. T level was unrelated to surgery and symptoms. Our findings support opposing roles for DHT, reflected by its metabolite AAG, and E2 in the etiology of BPH.

Journal Article↗

Dietary intake of alpha-linolenic acid and risk of fatal ischemic heart disease among women.

BACKGROUND: Experimental studies in laboratory animals and humans suggest that alpha-linolenic acid (18:3n-3) may reduce the risk of arrhythmia. OBJECTIVE: The objective was to examine the association between dietary intake of alpha-linolenic acid and risk of fatal ischemic heart disease (IHD). DESIGN: This was a prospective cohort study. The intake of alpha-linolenic acid was derived from a 116-item food-frequency questionnaire completed in 1984 by 76283 women without previously diagnosed cancer or cardiovascular disease. RESULTS: During 10 y of follow-up, we documented 232 cases of fatal IHD and 597 cases of nonfatal myocardial infarction. After adjustment for age, standard coronary risk factors, and dietary intake of linoleic acid and other nutrients, a higher intake of alpha-linolenic acid was associated with a lower relative risk (RR) of fatal IHD; the RRs from the lowest to highest quintiles were 1.0, 0.99, 0.90, 0.67, and 0.55 (95% CI: 0.32, 0.94; P for trend = 0.01). For nonfatal myocardial infarction there was only a modest, nonsignificant trend toward a reduced risk when extreme quintiles were compared (RR: 0.85; 95% CI: 0.61, 1.19; P for trend = 0.50). A higher intake of oil and vinegar salad dressing, an important source of alpha-linolenic acid, was associated with reduced risk of fatal IHD when women who consumed this food > or =5-6 times/wk were compared with those who rarely consumed this food (RR: 0.46; 95% CI: 0.27, 0.76; P for trend = 0.001). CONCLUSIONS: This study supports the hypothesis that a higher intake of alpha-linolenic acid is protective against fatal IHD. Higher consumption of foods such as oil-based salad dressing that provide polyunsaturated fats, including alpha-linolenic acid, may reduce the risk of fatal IHD.

Adult↗

A prospective study of carotenoid intake and risk of cataract extraction in US men.

BACKGROUND: Dietary antioxidants, including carotenoids, are hypothesized to decrease the risk of age-related cataracts by preventing oxidation of proteins or lipids within the lens. However, prospective epidemiologic data concerning this phenomenon are limited. OBJECTIVE: Our objective was to examine prospectively the association between carotenoid and vitamin A intakes and cataract extraction in men. DESIGN: US male health professionals (n = 36644) who were 45-75 y of age in 1986 were included in this prospective cohort study. Others were subsequently included as they became 45 y of age. A detailed dietary questionnaire was used to assess intake of carotenoids and other nutrients. During 8 y of follow-up, 840 cases of senile cataract extraction were documented. RESULTS: We observed a modestly lower risk of cataract extraction in men with higher intakes of lutein and zeaxanthin but not of other carotenoids (alpha-carotene, beta-carotene, lycopene, and beta-cryptoxanthin) or vitamin A after other potential risk factors, including age and smoking, were controlled for. Men in the highest fifth of lutein and zeaxanthin intake had a 19% lower risk of cataract relative to men in the lowest fifth (relative risk: 0.81; 95% CI: 0.65, 1.01; P for trend = 0.03). Among specific foods high in carotenoids, broccoli and spinach were most consistently associated with a lower risk of cataract. CONCLUSIONS: Lutein and zeaxanthin may decrease the risk of cataracts severe enough to require extraction, although this relation appears modest in magnitude. The present findings add support for recommendations to consume vegetables and fruit high in carotenoids daily.

Adult↗

Smoking and risk of total and fatal prostate cancer in United States health professionals.

Studies that have examined the relationship between cigarette use and prostate cancer incidence have yielded inconsistent results, although most studies have suggested that smoking is related to the occurrence of fatal prostate cancer. We evaluated prospectively the relationship between cigarette smoking and total, distant metastatic, and fatal prostate cancer in 47,781 male health professionals throughout the United States followed with questionnaires. From 1986 to 1994, we documented 1369 men with prostate cancer (excluding stage A1). One hundred fifty-two of the men had distant metastatic disease at diagnosis, and 103 fatal cases occurred from 1986 to 1994. Early (before age 30), late (within recent 10 years), and lifetime cumulative smoking history were unrelated to risk of total prostate cancer. However, men who had smoked 15 or more pack-years of cigarettes within the preceding 10 years were at higher risk of distant metastatic prostate cancer [multivariate relative risk (RR), 1.81; 95% confidence interval (CI), 1.05-3.11; P (trend), 0.03] and fatal prostate cancer [RR, 2.06; CI, 1.08-3.90; P (trend), 0.02] relative to nonsmokers. Within 10 years after quitting, the excess risk among smokers is eliminated. The higher rate of fatal prostate cancer among smokers did not appear to result from confounding by diet or other lifestyle factors, different screening behavior between smokers and nonsmokers, or from other smoking-related comorbidities. Our results indicate that although smoking was unrelated to prostate cancer incidence, recent tobacco use had a substantial impact on the occurrence of fatal prostate cancer.

Adult↗

Prospective study of alcohol consumption patterns in relation to symptomatic gallstone disease in men.

Although the association between alcohol intake and gallstone disease has been characterized previously, the relation between alcohol consumption patterns, specific types of alcoholic beverages, and risk for cholelithiasis has not been addressed systematically. These issues were examined prospectively in a cohort of men who were free from symptomatic gallstone disease in 1986 and were followed to 1996. During follow-up, 2.4% of the men reported newly symptomatic gallstones that were diagnosed by ultrasonography or x-ray, or a cholecystectomy. After adjusting for other known or suspected risk factors, an increase in the amount of alcohol consumed was associated with a decreased risk of symptomatic gallstone disease. An increase in frequency of alcohol consumption also was related to decreased risk. Combining the reports of quantity and frequency of alcohol intake, a consumption pattern that reflected frequent intake (5-7 days/week) of any given amount of alcohol was associated with a decreased risk, as compared with nondrinkers. In contrast, infrequent alcohol intake (1-2 days/week) showed no significant association with risk. All alcoholic beverage types were inversely associated with risk of symptomatic gallstone disease, independent of patterns of consumption. These results suggest that frequent, moderate intake of alcohol decreases the risk for symptomatic gallstone disease, in contrast to infrequent or episodic alcohol intake. Recommendations regarding the benefit of moderate quantities of alcohol for gallstone discase should be weighed against the potential health hazards of alcohol consumption.

Adult↗

Incidence rates and risk factors for acute urinary retention: the health professionals followup study.

PURPOSE: We define incidence rates and risk factors for acute urinary retention. MATERIALS AND METHODS: In 1992, 41,276 United States male health professionals 45 to 83 years old self-reported baseline health data and American Urological Association symptom index scores. In 1995 a subset reported the year of any episode of acute urinary retention requiring catheterization. Of 8,418 respondents 6,100 without a history of prostate cancer, prostatectomy or acute urinary retention before 1992 provided data. Incidence rates from 1992 to 1995 were calculated and risk factors were assessed using logistic regression. RESULTS: During 15,851 person-years of followup 82 men reported an episode of acute urinary retention (sampling weighted incidence 4.5/1,000 person-years, 95% confidence intervals 3.1 to 6.2). Rates increased with age and baseline symptom severity. In men with symptom score 0 to 7 (none or mild lower urinary tract symptoms) the incidence of acute urinary retention increased from 0.4/1,000 person-years for those 45 to 49 years old to 7.9/1,000 person-years for those 70 to 83 years old. In men with symptom score 8 to 35 (moderate or severe lower urinary tract symptoms) rates increased from 3.3/1,000 person-years for those 45 to 49 years old to 11.3/1,000 person-years for those 70 to 83 years old. Men with a clinical diagnosis of benign prostatic hyperplasia and a symptom score 8 or greater had the highest rates (age adjusted incidence 13.7/1,000 person-years). All 7 lower urinary tract symptoms comprising the American Urological Association symptom index individually predicted acute urinary retention (age adjusted odds ratio 1.8 to 2.9 for symptoms occurring more than 25% of the time during the last month). The sensation of incomplete bladder emptying, having to void again after less than 2 hours and a weak urinary stream were the best independent symptom predictors. Use of medications with adrenergic or anticholinergic side effects also predicted acute urinary retention. CONCLUSIONS: Acute urinary retention occurred relatively infrequently but older age, moderate or severe lower urinary tract symptoms, a diagnosis of benign prostatic hyperplasia and specific drug therapies significantly increased the risk of occurrence.

Acute Disease↗

Supplemental vitamin E intake and prostate cancer risk in a large cohort of men in the United States.

A clinical trial of vitamin E and beta-carotene supplementation for lung cancer prevention among male smokers in Finland recently reported an unexpected, strong protective effect of vitamin E against prostate cancer incidence and mortality. Our objective was to prospectively examine supplemental vitamin E intake and prostate cancer risk in a distinct U.S. population. In 1986, we identified 47,780 U.S. male health professionals, free from diagnosed cancer, who completed a dietary and lifestyle questionnaire; supplemental vitamin E and prostate cancer incidence were updated biennially through 1996. We estimated relative risks (RRs) from multivariate pooled logistic regression models. There were 1896 total (non-stage A1), 522 extraprostatic, and 232 metastatic or fatal incident prostate cancer cases diagnosed between 1986-1996. Men consuming at least 100 IU of supplemental vitamin E daily had multivariate RRs of 1.07 (95% confidence interval [CI], 0.95-1.20) for total and 1.14 (95% CI, 0.82-1.59) for metastatic or fatal prostate cancer compared with those consuming none. Current use, dosage, and total duration of use of specific vitamin E supplements or multivitamins were not associated with risk. However, among current smokers and recent quitters, those who consumed at least 100 IU of supplemental vitamin E per day had a RR of 0.44 (95% CI, 0.18-1.07) for metastatic or fatal prostate cancer compared with nonusers. Thus, supplemental vitamin E was not associated with prostate cancer risk generally, but a suggestive inverse association between supplemental vitamin E and risk of metastatic or fatal prostate cancer among current smokers and recent quitters was consistent with the Finnish trial among smokers and warrants further investigation.

Adult↗

Racial variation in insulin-like growth factor-1 and binding protein-3 concentrations in middle-aged men.

African-American men have the highest and Asian-American men have the lowest prostate cancer incidence rates in the United States; internationally, rates for the Asian continent are among the lowest. Higher insulin-like growth factor (IGF)-1, which participates in the control of cellular growth and differentiation and is modulated by IGF-binding protein-3 (IGFBP-3), was associated with an increased prostate cancer risk in three recent studies. We, therefore, investigated whether plasma levels of IGF-1 and IGFBP-3 vary by race in United States men selected from among members of the Health Professionals Follow-up Study who were 47-78 years old in 1993-1995 when they provided blood (n = 18,000). All of the men who described their major ancestry as African American (n = 63) and a random sample of 75 Asians and 75 Caucasians were invited to provide a second blood sample in 1997, of whom 42, 52, and 55, respectively, did so. IGF-1 and IGFBP-3 concentrations were determined by ELISA. We used nonparametric methods to assess racial variation in age-adjusted levels. Caucasians had the highest median IGF-1 level (224 ng/ml), followed by Asians (208 ng/ml) and African Americans (205 ng/ml). Median IGFBP-3 concentration was similar between Caucasians and Asians but was more than 13% lower in African Americans. Median molar IGF-1:IGFBP-3 ratio was greatest in Caucasians and lowest in Asians. The lower IGF-1 blood levels relative to IGFBP-3 levels among Asian men are consistent with their lower prostate cancer incidence. Although differences in circulating IGF-1 do not seem to account for the greater prostate cancer risk among African-American men, their absolute lower levels of IGFBP-3 may be contributory.

Age Distribution↗

Physical activity and benign prostatic hyperplasia.

BACKGROUND: Benign prostatic hyperplasia (BPH) leading to prostatic enlargement and lower urinary tract symptoms is highly prevalent among older men. Sympathetic nervous system activity, which is decreased by physical activity, is associated with increased prostatic smooth-muscle tone and prostatic symptoms. Therefore, we assessed whether physical activity leads to fewer lower urinary tract symptoms in the Health Professionals Follow-up Study. METHODS: We observed men who were aged 40 to 75 years at baseline in 1986 for subsequent incidence of surgery for BPH. The men were free of diagnosed cancer, including prostate cancer at baseline and during follow-up, had not had a radical prostatectomy, and provided data on physical activity. Cases were men who under-went BPH surgery between 1986 and 1994 (n = 1890) or, among those who did not have surgery, who scored 15 or more points of 35 (n = 1853) on 7 questions about lower urinary tract symptoms modified from the American Urological Association Symptom Index. Noncases were men who scored 7 points or less (n = 21745). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated from multiple logistic regression models. RESULTS: After controlling for age, race or ethnicity, alcohol consumption, and smoking, physical activity was inversely related with total BPH (extreme quintiles: OR, 0.75; 95% CI, 0.67-0.85; P for trend, <.001), surgery for BPH (OR, 0.76; 95% CI, 0.64-0.90; P for trend, <.001), and symptomatic BPH (OR, 0.75; 95% CI, 0.64-0.87; P for trend, <.001). Walking, the most prevalent activity, was inversely related to BPH risk; men who walked 2 to 3 h/wk had a 25% lower risk of total BPH. CONCLUSION: Our results indicate that more physically active men have a lower frequency of lower urinary tract symptoms.

Adult↗

A prospective study of physical activity and prostate cancer in male health professionals.

Because the role of exercise in prostate cancer is unclear, we examined the relationship between leisure time physical activity and risk of prostate cancer in the Health Professionals Follow-up Study, a prospective cohort study of male health professionals in the United States. In 1986, 47,542 men 40-75 years of age and free of cancer responded to a mailed questionnaire that included an assessment of physical activity. The reported average time per week spent on each of a variety of nonoccupational activities was multiplied by its typical energy expenditure requirements expressed in metabolic equivalents (METs) and summed to yield a total weekly MET-hour score. We also examined MET-hours from all vigorous activities, defined as those requiring energy expenditures of six or more METs, and nonvigorous activities. From 1986 until January 31, 1994, we identified 1362 incident cases of total prostate cancer (excluding stage A1), 419 advanced (extraprostatic) cases, and 200 metastatic cases. No relationship with total or advanced prostate cancer was evident for total, vigorous, and nonvigorous physical activity. For metastatic prostate cancer, we also found no linear trends for these activities, but did observe a significantly lower risk in the highest category of vigorous activity (multivariate relative risk = 0.46; 95% confidence interval = 0.24-0.89 for > 25 versus 0 MET-hours), controlling for age, vasectomy, history of diabetes, height, smoking, and dietary factors. This highest category included 15% of the population and reflects at least 3 h/week of participation in vigorous activities. Differences in disease surveillance according to activity level could not account for our findings. The results from this cohort indicate that physical activity is unlikely to influence the incidence of total prostate cancer appreciably; however, the suggestion of a lower risk of metastatic prostate cancer in men engaging in high levels of vigorous activities warrants further study.

Adult↗

Frequent nut consumption and risk of coronary heart disease in women: prospective cohort study.

OBJECTIVE: To examine the relation between nut consumption and risk of coronary heart disease in a cohort of women from the Nurses' Health Study. DESIGN: Prospective cohort study. SETTING: Nurses' Health Study. SUBJECTS: 86 016 women from 34 to 59 years of age without previously diagnosed coronary heart disease, stroke, or cancer at baseline in 1980. MAIN OUTCOME MEASURES: Major coronary heart disease including non-fatal myocardial infarction and fatal coronary heart disease. RESULTS: 1255 major coronary disease events (861 cases of non-fatal myocardial infarction and 394 cases of fatal coronary heart disease) occurred during 14 years of follow up. After adjusting for age, smoking, and other known risk factors for coronary heart disease, women who ate more than five units of nuts (one unit equivalent to 1 oz of nuts) a week (frequent consumption) had a significantly lower risk of total coronary heart disease (relative risk 0.65, 95% confidence interval 0.47 to 0.89, P for trend=0.0009) than women who never ate nuts or who ate less than one unit a month (rare consumption). The magnitude of risk reduction was similar for both fatal coronary heart disease (0.61, 0.35 to 1.05, P for trend=0.007) and non-fatal myocardial infarction (0.68, 0.47 to 1.00, P for trend=0.04). Further adjustment for intakes of dietary fats, fibre, vegetables, and fruits did not alter these results. The inverse association persisted in subgroups stratified by levels of smoking,use of alcohol, use of multivitamin and vitamin E supplements, body mass index, exercise, and intake of vegetables or fruits. CONCLUSIONS: Frequent nut consumption was associated with a reduced risk of both fatal coronary heart disease and non-fatal myocardial infarction. These data, and those from other epidemiological and clinical studies, support a role for nuts in reducing the risk of coronary heart disease.

Adult↗