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I-Min Lee

Publications and source records attributed to I-Min Lee.

47 records · Page 3Linked to original sources
PubMed2003

Relative intensity of physical activity and risk of coronary heart disease.

BACKGROUND: Current recommendations prescribe at least moderate-intensity physical activity, requiring >or=3 METs (metabolic equivalents) for >or=30 minutes almost daily, generating approximately 1000 kcal/wk. Defining intensity using an absolute scale in METs may be limited because it neglects variations in physical fitness: an activity requiring a particular MET value commands greater physical effort among less fit than more fit persons. It is unknown whether moderate-intensity exercise, relative to an individual's capacity, is associated with reduced coronary heart disease (CHD) rates. METHODS AND RESULTS: We followed 7337 men (mean age, 66 years) from 1988 to 1995. At baseline, men reported their actual activities and, using the Borg Scale, the perceived level of exertion when exercising (relative intensity). During follow-up, 551 men developed CHD. After multivariate adjustment, the relative risks of CHD among men who perceived their exercise exertion as "moderate," "somewhat strong," and "strong" or more intense were 0.86 (95% confidence interval, 0.66 to 1.13), 0.69 (0.51 to 0.94), and 0.72 (0.52 to 1.00), respectively (P(trend)=0.02), compared with "weak" or less intense. This inverse association extended to men not fulfilling current recommendations, ie, expending <1000 kcal/wk in physical activity or not engaging in activities of >or=3 METs (P(trend)=0.03 and 0.007, respectively). CONCLUSIONS: There is an inverse association between relative intensity of physical activity (an individual's perceived level of exertion) and risk of CHD, even among men not satisfying current activity recommendations. Recommendations for "moderate"-intensity physical activity may need to consider individual fitness levels instead of globally prescribing activities of >or=3 METs.

Aged↗
PubMed2003

Lack of association between tea and cardiovascular disease in college alumni.

BACKGROUND: Epidemiological studies suggest that tea intake, a major dietary source of flavonoids, may be associated with a decreased risk of cardiovascular disease (CVD). METHODS: We prospectively followed 17 228 subjects (mean age, 59.5 years) initially free of CVD and cancer from the College Alumni Health Study. Participants provided baseline self-reports of tea consumption (cups/day) and coronary risk factors. During a median follow-up of 15 years, there were 3372, 2615, and 757 cases of CVD, coronary heart disease (CHD), and stroke, respectively, ascertained from either self-reports or death certificates. RESULTS: Overall, the median level of tea consumption was 1 cup/day. Compared with participants consuming no tea, the multivariate relative risks (RR) of CVD for those drinking <1, 1, 2, 3, and >/=4 cups/day were 0.99, 0.96, 0.95, 0.91, and 0.95, respectively (P, trend = 0.19). The multivariate RR were 0.97, 0.98, 0.93, 0.85, and 0.98 for CHD (P, trend = 0.25), and 1.05, 0.89, 1.00, 1.09, and 0.83 for stroke (P, trend = 0.53). There was no evidence of effect modification. Changes in tea intake were assessed in a subgroup of 7730 men, with those continuing to drink tea having a non-significant 33% reduction in the risk of stroke. CONCLUSIONS: Tea intake, likely consumed as black tea, was not strongly associated with a reduced risk of CVD in this population of US college alumni.

Cardiovascular Diseases↗
PubMed2003

Cardiorespiratory fitness and cancer mortality in Japanese men: a prospective study.

PURPOSE: Limited data are available on the relationship between cardiorespiratory fitness and cancer mortality. We evaluated the cardiorespiratory fitness and risk of cancer mortality in Japanese men. METHODS: A total of 9039 men (19-59 yr) who were given a submaximal exercise test and a health examination between 1982 and 1988 and were followed for mortality up to 1999. Cardiorespiratory fitness was measured using a cycle ergometer test, and maximal oxygen uptake was estimated. RESULTS: The mean follow-up period was slightly more than 16 yr, producing a total of 148,491 person-years of observation. There were 231 deaths, with 123 deaths due to cancer. Relative risk (RR) and 95% confidence interval (95%CI) for cancer mortality were obtained using the Cox proportional hazards model. Taking into consideration age, systolic blood pressure, body mass index, smoking habit, and alcohol habit and using the lowest physical fitness group as the reference, the RR (95% CI) for increasing quartiles of fitness were 0.75(0.48-1.16), 0.43(0.25-0.74) and 0.41(0.23-0.74); P < 0.001 for trend. CONCLUSION: Low cardiorespiratory fitness is associated with cancer mortality in Japanese men.

Adult↗
PubMed2003

Physical activity and cancer prevention--data from epidemiologic studies.

PURPOSE: The aim of this paper is to examine whether physical activity plays any role in the prevention of cancer. METHODS: To accomplish this, data from published epidemiologic studies on the relation between physical activity and the risk of developing cancer were reviewed. RESULTS: The data are clear in showing that physically active men and women have about a 30-40% reduction in the risk of developing colon cancer, compared with inactive persons. Although the data are sparse, it appears that 30-60 min.d(-1) of moderate- to vigorous-intensity physical activity is needed to decrease risk. There is a dose-response relation, with risk declining further at higher levels of physical activity. It is also clear that physical activity is not associated with the risk of developing rectal cancer. With regard to breast cancer, there is reasonably clear evidence that physically active women have about a 20-30% reduction in risk, compared with inactive women. It also appears that 30-60 min.d(-1) of moderate- to vigorous-intensity physical activity is needed to decrease the risk of breast cancer, and that there is likely a dose-response relation. For prostate cancer, the data are inconsistent regarding whether physical activity plays any role in the prevention of this cancer. There are relatively few studies on physical activity and lung cancer prevention. The available data suggest that physically active individuals have a lower risk of lung cancer; however, it is difficult to completely account for cigarette smoking. There is little information on the role of physical activity in preventing other cancers. CONCLUSION: Physical activity is associated with lower risk of developing certain site-specific cancers, in particular colon and breast cancers.

Breast Neoplasms↗
PubMed2003

Cardiorespiratory fitness and the incidence of type 2 diabetes: prospective study of Japanese men.

OBJECTIVE: To investigate the association between cardiorespiratory fitness and the incidence of type 2 diabetes among Japanese men. RESEARCH DESIGN AND METHODS: This prospective cohort study was conducted in 4747 nondiabetic Japanese men, aged 20-40 years at baseline, enrolled in 1985 with follow-up to June 1999. Cardiorespiratory fitness was measured using a cycle ergometer test, and Vo(2max) was estimated. During a 14-year follow-up, 280 men developed type 2 diabetes. RESULTS: The age-adjusted relative risks of developing type 2 diabetes across quartiles of cardiorespiratory fitness (lowest to highest) were 1.0 (referent), 0.56 (95% CI 0.42-0.75), 0.35 (0.25-0.50), and 0.25 (0.17-0.37) (for trend, P < 0.001). After further adjustment for BMI, systolic blood pressure, family history of diabetes, smoking status, and alcohol intake, the association between type 2 diabetes risk and cardiorespiratory fitness was attenuated but remained significant (1.0, 0.78, 0.63, and 0.56, respectively; for trend, P = 0.001). CONCLUSIONS: These results indicate that a low cardiorespiratory fitness level is an important risk factor for incidence of type 2 diabetes among Japanese men.

Adult↗
PubMed2002

Is C-reactive protein specific for vascular disease in women?

BACKGROUND: C-reactive protein (CRP) predicts risk for future cardiovascular events in asymptomatic individuals. However, because CRP also predicts total mortality, its specificity for vascular disease is uncertain. OBJECTIVE: To compare the predictive value of CRP for cancer and cardiovascular disease, the major determinants of mortality. DESIGN: Prospective, nested case-control study. SETTING: The Women's Health Study, an ongoing prospective cohort study involving 28345 U.S. women 45 years of age and older who were healthy at the time of enrollment. PARTICIPANTS: 643 women who subsequently developed cancer or had cardiovascular events; 643 age- and smoking-matched women who remained free of either disease during 58-month follow-up. MEASUREMENTS: Baseline CRP levels. RESULTS: Little evidence showed that increasing quartiles of baseline CRP predicted incident cancer (adjusted relative risks, 1.0, 1.2, 1.1, and 1.3; P for trend > 0.2). In contrast, increasing quartiles of baseline CRP were a strong marker of risk for future cardiovascular disease (adjusted relative risks, 1.0, 2.9, 3.4, and 5.6; P for trend < 0.001). CONCLUSION: C-reactive protein appears to independently predict cardiovascular events but not cancer.

Biomarkers↗
PubMed2002

The relationship of physical activity and body weight with all-cause mortality: results from the Puerto Rico Heart Health Program.

PURPOSE: To study the relationship of physical activity and obesity with all-cause mortality in Puerto Rican Men. METHODS: The Puerto Rico Heart Health Program collected physical activity and anthropometric measurements in 9,824 men between 1962 and 1965. After excluding those with known coronary heart disease at baseline, and those who died within the first three years of the study we analyzed the data for the relationship between physical activity and overweight status to all-cause mortality in 9,136 men. We stratified our participants by quartiles of physical activity. Participants were classified into four categories of body weight: underweight (BMI < 18.5), healthy weight (BMI =18.5-24.9), overweight (BMI = 25-29.9), and obese (BMI = 30+). RESULTS: After adjusting for age, education, smoking status, hypertension status, hypercholesterolemic status, urban/rural residence, and overweight status, physical activity was independently related to all-cause mortality. All-cause mortality was lower in those in quartile 2 (OR = 0.68, CI = 0.58-0.79) than quartile 1 (reference, sedentary group). Mortality among those in quartile 3 and 4 (0.63, CI = 0.54-0.75; and 0.55, CI = 0.46-0.65, respectively) were also significantly lower than those observed in quartile 1, but not significantly lower than those observed in quartile 2. Furthermore, within every category of body weight, those who were most active had significantly lower odds ratio of all-cause mortality. CONCLUSION: Our findings support the current recommendation that some physical activity is better than none, in protecting against all-cause mortality. The benefits of an active lifestyle are independent of body weight and that overweight and obese Puerto Rican men who are physically active experienced significant reductions in all-cause mortality compared with their sedentary counterparts.

Body Mass Index↗
PubMed2002

Estrogen-progestin replacement therapy and breast cancer risk: the Women's Health Study (United States).

OBJECTIVE: While there is substantial evidence that unopposed estrogen use increases the risk of breast cancer, there are limited data from epidemiologic studies on the impact of estrogen-progestin combinations. We therefore examined estrogen-progestin replacement therapy and breast cancer risk in the Women's Health Study. METHODS: We investigated postmenopausal hormone (PMH) use among 17,835 apparently healthy postmenopausal women aged > or =45 years, and followed them prospectively for an average of 5.9 years. Breast cancer occurred in 411 women. RESULTS: The multivariate relative risks of all breast cancer associated with never use of PMH, use of estrogen replacement therapy (ERT), and use of estrogen-progestin replacement therapy (HRT) were 1.00 (referent), 0.96 (95% CI 0.65-1.42), and 1.37 (95% CI 1.05-1.78). The increase in risk among users of HRT was largely limited to those women who had used estrogen-progestin replacement therapy for five years or more, and to those women who were on continuous rather than cyclic progestin combinations. Higher doses of estrogen, but not progestin, were associated with increased breast cancer risk, compared with lower doses. CONCLUSIONS: These prospective data suggest that use of estrogen-progestin replacement therapy imparts an increased risk of breast cancer in comparison with never use of PMH.

Breast Neoplasms↗
PubMed2002

Migraine and coronary heart disease in women and men.

OBJECTIVE: We evaluated migraine as an independent risk factor for subsequent coronary heart disease (CHD) events among women in the Women's Health Study (WHS) and men in the Physicians' Health Study (PHS). BACKGROUND: Although several studies have suggested that migraine is associated with increased risk of stroke, there are few and conflicting data on whether migraine predicts risk of future CHD events. METHODS: The WHS is an ongoing randomized, double-blind, placebo-controlled trial of low-dose aspirin and vitamin E in the primary prevention of cardiovascular disease and cancer in 39876 women health professionals aged > or =45 years in 1993, and the PHS is a completed randomized, double-blind, placebo-controlled trial of aspirin and beta-carotene in the primary prevention of cardiovascular disease and cancer in 22071 men physicians aged 40 to 84 years in 1982. Primary endpoints were defined as major CHD (nonfatal myocardial infarction [MI] or fatal CHD) and total CHD (major CHD plus angina and coronary revascularization). RESULTS: After adjusting for other CHD risk factors, female health professionals and male physicians reporting migraine were not at increased risk for subsequent major CHD (women: relative risk [RR], 0.83; 95% confidence interval [CI], 0.53 to 1.29; men: RR, 1.02; 95% Cl, 0.79 to 1.31) or total CHD (women: RR, 1.01; 95% Cl, 0.76 to 1.34; men: RR, 0.98; 95% Cl, 0.82 to 1.18). When considered separately, there was also no increase in risk of MI or angina. CONCLUSION: These prospective data suggest that migraine is not associated with increased risk of subsequent CHD events in women or men.

Adult↗
PubMedDate not supplied

C-reactive protein in the prediction of rheumatoid arthritis in women.

BACKGROUND: The purpose of this study was to examine whether levels of C-reactive protein (CRP), a sensitive marker of disease activity in rheumatoid arthritis (RA), are associated with increased risk of subsequent RA. METHODS: Eligible subjects were 39 876 healthy women from the Women's Health Study, a completed randomized trial of aspirin and vitamin E in cardiovascular disease and cancer prevention, begun in 1992. We included 27 939 women who provided blood samples at baseline that could be assayed for CRP. RESULTS: During 9.9 years of follow-up, 398 women reported a new diagnosis of RA. Of these, 90 cases were confirmed on medical chart review using American College of Rheumatology criteria. In age-adjusted analysis, the relative risks for developing confirmed, incident RA associated with increasing tertiles of CRP (first, second, and third) were 1.00 (reference value), 0.94 (0.54-1.61), and 1.29 (0.78-2.12) (P = .30 for trend). Further adjustment for randomized treatment, age, body mass index, and smoking demonstrated corresponding relative risks of 1.00 (reference value), 0.95 (0.55-1.65), and 1.33 (0.77-2.30) (P = .48 for trend). When we examined whether CRP levels predicted incident RA within 4 years, between 5 to 8 years, and 9 or more years after CRP measurement, we found no significant associations for any time period. CONCLUSIONS: In this prospective study of healthy women, a single CRP level did not predict increased risk of RA. Furthermore, CRP measurement closer to the time of diagnosis was not predictive. The consistency of this effect throughout different time periods from diagnosis suggests that CRP does not have a large effect in predicting incident RA.

Arthritis, Rheumatoid↗