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G Maskarinec

Publications and source records attributed to G Maskarinec.

At least 37 records · Page 2Linked to original sources
PubMed1999

Lifestyle factors and chronic diseases: application of a composite risk index.

BACKGROUND: Assessing a combination of modifiable lifestyle practices may be a practical tool to modify patients' health behavior in counseling. Therefore, we developed a chronic disease risk index (CDRI) and investigated its relation with chronic disease in a multiethnic cohort. METHODS: A total of 15,693 men and 16,007 women in Hawaii who reported their diet and other lifestyle behaviors between 1975 and 1980 were followed until 1994. A semi-quantitative composite CDRI with scores ranging from 1 to 10 included the rankings for smoking, alcohol use, body mass index, fat intake, and fruit and vegetable consumption. Cox's proportional hazards regression was used to estimate the relative risk for chronic diseases. RESULTS: When comparing the highest to the lowest CDRI category, the respective relative risks (RRs) for total mortality were 2.9 (95% CI 2.3-3.8) and 3.8 (95% CI 2.9-5.0) for men and women. With higher CDRIs, the RRs for cancer incidence, mortality from cancer, coronary heart disease, and stroke increased significantly. Among the five components of the CDRI, smoking had the greatest influence on chronic disease risk, followed by body mass index. CONCLUSIONS: Positive health behavior reflected by the CDRI is associated with a lower risk of cancer and with greater longevity.

Adult↗
PubMed1999

Isoflavone levels in soy foods consumed by multiethnic populations in Singapore and Hawaii.

Concentrations and glucosidic conjugation patterns of isoflavones were determined in soy foods consumed by multiethnic populations in Singapore and Hawaii. Six raw and 11 cooked food groups traditionally consumed in Singapore and 8 food groups consumed in Hawaii were analyzed by reversed-phase high-pressure liquid chromatography with diode array detection. Mean total isoflavone levels varied between 35 and 7500 ppm, with the lowest values found in soy milk and burgers and the highest levels observed in soybean and its seeds and in supplements. Total isoflavone levels and conjugation patterns varied as a function of soybean variety, storage conditions, and food processing. A large contribution to the differences in total isoflavone content between food groups was due to the water content in foods and to leaching of polar analytes into the water phase during boiling. Soy protein drinks and traditional soy foods were found to possess very similar isoflavone amounts considering usual serving sizes.

Beverages↗
PubMed1999

A pilot study of mammographic density patterns among Japanese women.

Mammographic density patterns, which refer to the distribution of fat, connective, and epithelial tissue in the healthy female breast, have been shown to be related to breast cancer risk. We used a quantitative method to assess mammographic densities in 41 mammograms from women in Japan without a diagnosis of breast cancer. Information about reproductive behavior and family history for breast cancer was available from a questionnaire. The statistical analysis applied Spearman correlation coefficients and multiple linear regression. The breast size as measured on the cranio-caudal view of the mammogram was approximately 12% larger, the size of the dense areas was 20% smaller, and the mean percent mammographic densities were 30% greater among premenopausal than among postmenopausal women. We found a strong relation between age at menarche and mammographic densities in premenopausal women and significant associations for age, family history of breast cancer, and age at menopause with mammographic densities in postmenopausal women. These preliminary data will be used to plan a future study that will compare mammographic density patterns and the relative importance of dietary, reproductive, and anthropometric factors between women in Japan and in the United States.

Adult↗
PubMed1999

Use of complementary and alternative medicine in Hawaii cancer patients.

This research investigated complementary and alternative medicine (CAM) use by Hawaii cancer patients. Thirty-six percent of patients used CAM, most commonly religious/spiritual therapy and herbal treatments. CAM use was linked with younger age, female gender, Catholic religion, and more education. More research is needed to inform decision-making.

Aged↗
PubMed1999

Exploring the feasibility and effects of a high-fruit and -vegetable diet in healthy women.

Based on reports that fruits and vegetables may protect against breast cancer, this randomized intervention study tested the feasibility of increasing fruit and vegetable intake among healthy women to 9 daily servings through individual dietary counseling and group activities. Adherence to the dietary recommendations was monitored by 24-h food recalls, log sheets, and plasma carotenoid assessments. To explore possible cancer protective mechanisms of fruits and vegetables, we investigated the treatment effect on plasma phenol levels and on thiobarbituric acid-reactive substances measured as malondialdehyde equivalents, a possible marker of oxidative damage. At baseline, women in the intervention (n = 13) and control (n = 16) group reported an average daily consumption of 3.3 and 3.2 fruit and vegetable servings, respectively. After 3 and 6 months of intervention, intake in the intervention group had increased to 8.3 and 7.4 servings, whereas the control group reported an average of 4.2 and 4.1 daily servings. An increase of plasma carotenoid levels from 1249 microg/liter at baseline to 1854 and 1827 microg/liter after 3 and 6 months confirmed compliance with the dietary recommendations in the intervention group. Plasma carotenoid levels among controls changed slightly from 1165 to 1231 and 1291 microg/liter Whereas total phenol levels did not respond according to our hypothesis, malondialdehyde levels decreased slightly in the intervention group. These results suggest that motivated women can substantially increase their fruit and vegetable intake, which leads to a notable increase in plasma carotenoid levels.

Adult↗
PubMed1998

Dietary soy intake and urinary isoflavone excretion among women from a multiethnic population.

Isoflavones are present in soybeans and its products in concentrations up to 300 mg/100 g, have estrogenic and antiestrogenic properties, and may be protective against hormone-related cancers. The purpose of this cross-sectional study was to investigate the association between urinary isoflavone excretion and self-reported soy intake. A total of 102 women of Caucasian, Native Hawaiian, Chinese, Japanese, and Filipino ancestry completed a dietary questionnaire for soy products consumed during the last year and during the 24-h period before urine collection. Overnight urine samples were analyzed for coumestrol and the soy isoflavones genistein, daidzein, and glycitein and their main human metabolites by reverse-phase high-pressure liquid chromatography. Soy protein and isoflavone intake (predominantly from tofu) were estimated using published nutritional databases. Wilcoxon's rank-sum test scores and Spearman rank correlation coefficients were computed. Japanese women excreted more daidzein, genistein, and glycitein than did Caucasian women, whereas Caucasian women excreted slightly more coumestrol. Soy intake differed significantly among ethnic groups. Dietary soy protein and isoflavone intakes during the previous 24 h were positively related to urinary isoflavone excretion [rs = 0.61 (P < 0.0001) and 0.62 (P < 0.0001), respectively]. Urinary excretion of isoflavones was also related to annual dietary soy protein and isoflavone intake [rs = 0.32 (P < 0.0012) and 0.31 (P < 0.0016), respectively]. The strong correlation between urinary isoflavone excretion and self-reported soy intake validates the dietary history questionnaire that is now used in a study exploring dietary risk factors for breast cancer.

Adult↗
PubMed1998

Alcohol intake, body weight, and mortality in a multiethnic prospective cohort.

The purpose of this analysis was to investigate the effects of alcohol intake and body weight on mortality from all causes, cancer, and cerebrovascular and coronary heart disease. A cohort of more than 40,000 persons with Caucasian, Chinese, Filipino, Japanese, and native Hawaiian ethnicity was followed for close to 20 years. We calculated mortality rates using the person-years at risk for each gender and ethnic group as denominators. We used proportional hazards regression models to adjust for confounding variables and to estimate relative risks. Men and women with low alcohol intake (1-7 drinks per week) experienced a 20% reduction in total mortality. At higher levels of alcohol intake, women and Asian men experienced no mortality benefit. The protective effect of alcohol consumption was limited to coronary heart disease mortality. The relation between body mass index and total mortality was J-shaped for all groups. In agreement with previous reports, this study found that persons with moderate alcohol intake appear to have a lower risk of dying than nondrinkers, but the possible protective levels of alcohol for women and Asian men appear to be lower than for Caucasian men.

Adult↗
PubMed1997

Ethnicity and conditional breast cancer survival in Hawaii.

The conditional survival experience of 4502 female breast cancer cases diagnosed in Hawaii between 1960 and 1983 was studied. The calculation of conditional survival is based on patients who have already survived for a specified time period. Cox proportional hazards models were used to examine the effect of ethnicity, stage at diagnosis, and menopausal, marital, and socioeconomic statuses on conditional survival prognosis. Native Hawaiian and Filipino women showed a significantly higher risk of dying from breast cancer than any other ethnic group, followed by Chinese and Caucasian women, while Japanese women had the lowest risk. The ethnic pattern of breast cancer survival changed and ethnic survival differences decreased from 17 to 4% as time progressed. Conditional survival varied greatly with stage at first diagnosis. For localized, regional, and distant disease, the conditional survival rate increased from 92, 71, and 24% after diagnosis to 95, 85, and 65% 5 years after diagnosis, respectively, indicating that stage at diagnosis becomes less important in determining survival as time progresses. Being married and of a high socioeconomic status increased survival probability. These results suggest that considering time effect, the conditional survival rate is an informative tool to assess clinical outcome of breast cancer among ethnic groups over a long follow-up period.

Breast Neoplasms↗
PubMed1997

Ethnic differences and factors related to breast cancer survival in Hawaii.

BACKGROUND: Previous studies have described differences in breast cancer survival among women from various ethnic backgrounds even after adjustment for stage at diagnosis. The aim of this study is to identify factors that could explain this disparity in prognosis and to update breast cancer survival patterns in Hawaii. METHODS: The Hawaii Tumor Registry identified 3345 breast cancer cases diagnosed between 1980 and 1988. The following covariates were studied: ethnicity, stage at diagnosis, geographical residence, and menopausal, marital and socioeconomic statuses. The Kaplan-Meier method and proportional hazards regression were used to estimate survival by group. RESULTS: Native Hawaiian and Filipino women had a higher risk of dying within 5 years than women of other ethnic groups. Japanese had the highest survival probability, followed by Chinese and Caucasians. Stage was the most important prognostic factor. Married women had better survival than widowed and divorced women. Filipinos had a much greater chance of dying from localized cancer than other women with localized disease. Geographical residence, menopausal and socioeconomic statuses were not associated with survival. CONCLUSIONS: Despite an overall improvement in breast cancer survival, ethnic disparity in prognosis still exists. Other possible explanations for the differential prognosis, such as treatment, diet, genetics, obesity, oestrogen receptor and hormonal statuses need to be explored in future studies.

Adult↗
PubMed1997

Diabetes in Hawaii: estimating prevalence from insurance claims data.

OBJECTIVES: The purpose of this study was to determine the prevalence of diabetes mellitus in Hawaii from insurance claims data. METHODS: Information from two major health plans covering approximately 66% of the state's population was used to estimate prevalence rates by sex, age group, and geographic area. Weighted multiple linear regression was applied to identify predictors of diabetes prevalence. RESULTS: The statewide diabetes prevalence was estimated at 43.8 per 1000 persons. The ethnic composition of the population and rural residence partially explained the geographic variation in diabetes prevalence. CONCLUSIONS: Insurance claims data may be a useful tool for population-based diabetes surveillance.

Adult↗
PubMed1997

Mammography screening and the increase in breast cancer incidence in Hawaii.

This ecological study investigated the association between mammography utilization and breast cancer incidence in Hawaii with the hypothesis that geographic areas with high mammography use have higher breast cancer incidence than geographic areas with low mammography use. Insurance claims for mammograms received during 1992 and 1993 were combined with breast cancer incidence data from the Hawaii Tumor Registry and data from the 1990 Census ZIP File. The claims data were obtained from four private and three public health plans and covered approximately 85% of women 40 years of age and older. Age-specific breast cancer incidence rates for the 79 ZIP code areas were regressed on mammography rates and selected aggregate demographic variables using multiple linear regression. An estimated 42% of women 40 years of age and older had received at least 1 mammogram during 1992 and 1993, with the highest rate (45%) in women ages 50-64 years old. Overall, 23% of the variation in age-specific breast cancer incidence could be predicted by mammography utilization, 23% by increasing age, and 4% by higher education. The relationship between mammography use and breast cancer incidence was strongest for women 50-64 years old and for localized disease. The magnitude of the association between breast cancer incidence and mammography utilization was comparable to the increase in breast cancer rates observed in Hawaii during the mid-1980s, supporting the hypothesis that the sharp increase in breast cancer incidence was attributable to screening and early detection. However, the long-term 1% increase in breast cancer incidence requires alternate explanations.

Adult↗
PubMed1995

Prevalence of systemic lupus erythematosus in Hawaii: is there a difference between ethnic groups?

This population-based study in Hawaii collected cases of systemic lupus erythematosus from medical facilities and a patient support group. A total of 454 cases was found and the prevalence was estimated at 41.8 per 100,000 population for 1989. The prevalence odds ratio for all non-Caucasians compared to Caucasians was 1.2 (0.9-1.5), for Japanese 1.3 (1.0-1.7), for Filipinos 1.5 (1.1-2.0), for Chinese 2.4 (1.7-3.4), and for Hawaiians 0.8 (0.6-1.1). Mortality rates were 3 times higher for non-Caucasians than for Caucasians in 1985 to 1989. Despite the observed differences, it remains unclear whether individuals with Asian or Pacific Islander ancestry are at higher risk for systemic lupus erythematosus. The variation in prevalence rates may be a result of differences in access to medical care and in survival.

Adolescent↗
PubMed1994

Investigation of increased incidence in childhood leukemia near radio towers in Hawaii: preliminary observations.

Twelve children from the Waianae Coast, Hawaii, were diagnosed with acute leukemia from 1979 to 1990. The standardized incidence ratio (SIR) of 2.09 (95% confidence interval (CI) 1.08 to 3.65) indicates a significant increase. Seven cases occurred between 1982 and 1984 and were unusual in terms of sex, age, and type of leukemia. A case-control study (12 cases, 48 matched controls) explored risk factors, including parents' occupation, X-ray exposure, domestic smoking, family and medical histories, and distance of children's residence locations to low frequency radio towers. The odds ratio (OR) for having lived within 2.6 miles of the radio towers before diagnosis was 2.0 (95% CI 0.06 to 8.3). The clustering may have been a chance event, but because of its peculiar characteristics, we feel it should be noted.

Case-Control Studies↗
PubMed1993

Blood lead levels among children in Hawaii.

The objectives of this study were to estimate blood lead levels of children under 6 years of age in the State of Hawaii, to identify high-risk populations, and to decide what kind of blood lead screening program is needed in Hawaii. Children from Oahu and Maui were recruited in medical care facilities and 6 preschools. Informed consent for a blood lead test was obtained from the parents. A questionnaire was administered whenever possible; participation/response rates were quite low, varying between 15% and 50%. The mean blood lead level for the 389 study participants was 4.5 micrograms/dL. Twelve children (3% of children tested) had a level above 9 micrograms/dL. No child was found to have a level above 14 micrograms/dL. Blood lead levels varied by age, geographic area, occupational factors, laboratory that performed the analysis, and type of phlebotomy (capillary versus venous) but not by sex, ethnicity or age of home. Follow-up investigations in the 12 homes of the children with levels above 9/lg/dL were performed and in 3 homes a possible source of lead exposure was found.

Age Factors↗
PubMed1991

Environmental epidemiology: an introduction to its merits and problems.

During the course of this century the science of epidemiology has expanded its interest from only infectious diseases to include a wide variety of diseases and health events. It has become more of a systematic methodology which can be used for the description and the analysis of diverse health events. The basic assumption of epidemiologic research is that diseases do not occur randomly, but in patterns which reflect the underlying causes. By studying the patterns etiologic factors can be discovered. Recently, Environmental Epidemiology has been emerging as a new subspecialty. In 1989 the newly founded International Society for Environmental Epidemiology held its first Annual Meeting; its second meeting was held in August 1990 in Berkeley, California.

Environmental Exposure↗
PubMedDate not supplied

Investigating increased incidence of events in the islands: a Hawaii department of health perspective.

Despite the relatively clean environment on the islands of Hawaii, residents have been concerned about clusters of disease due to environmental exposures. Close to 40 inquiries related to perceived increases in health conditions have been examined during the last three years. The standardized incidence ratio approach was the preferred strategy to evaluate occurrence of disease. Three examples of cluster investigation are presented. Even though all investigations except one showed results within the expected range, cluster investigations appear to be useful in allaying fears, in particular about cancer, by providing comparative numbers and factual information on carcinogenesis.

Attitude to Health↗
PubMedDate not supplied

Perceived cancer causes: use of complementary and alternative therapy.

PURPOSE: The objectives of this report are to describe beliefs about general and personal cancer causes among patients with cancer who use and do not use complementary and alternative medicine (CAM), to compare these beliefs with current epidemiologic knowledge, and to explore associations between these beliefs and choice of CAMs. DESCRIPTION OF INTERVIEWS: The authors conducted a semistructured interview with 143 patients with cancer, who were identified via the Hawaii Tumor Registry and had participated in a survey on CAM use. By design, the majority of interviewees (85%) were CAM users. A qualitative data analysis was performed. RESULTS: Genetics, environment, and diet were among the most common perceived general causes of cancer, whereas psychosocial factors were by far the most common perceived personal causes. CAM users were more likely than nonusers to name environment, immune system, and stress as cancer causes. Compared with the epidemiologic literature, study participants were less likely to mention tobacco use and more likely to consider environmental exposures, psychosocial factors, immunologic mechanisms, and physical injury as causes of cancer. Furthermore, the interviews suggest that causal thinking may be related to the type of CAM used. CLINICAL IMPLICATIONS: Given the discrepancy between popular cancer theories and current scientific knowledge, the challenge for the healthcare provider is to listen and try to understand the patient's beliefs about cancer etiology. Understanding the patient's beliefs about their disease is important in providing the support and information they need to make effective decisions about their medical care.

Adult↗