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M J Stampfer

Publications and source records attributed to M J Stampfer.

At least 217 records · Page 12Linked to original sources
PubMed1997

Prospective study of diet and the risk of duodenal ulcer in men.

The authors examined the associations between dietary factors and the risk of duodenal ulcer in a prospective cohort of 47,806 men, aged 40-75 years, who were free of diagnosed gastric or duodenal ulcer or cancer. During 6 years of follow-up, they documented 138 newly diagnosed cases of duodenal ulcer. They found little evidence for an important effect of fat, type of fat, or protein intake. Higher consumption of fruits and vegetables was associated with lower risk of duodenal ulcer (relative risk (RR) = 0.67, 95% confidence interval (CI) 0.39-1.15 for > or = 7 servings per day vs. < 3 servings per day) after adjustment for age, body mass index, smoking, and use of aspirin or other nonsteroidal anti-inflammatory drugs. Total dietary fiber intake was inversely associated with the risk of duodenal ulcer (RR = 0.55, 95% CI 0.31-0.96 for men in the highest vs. the lowest quintile of dietary fiber). The soluble component of fiber was strongly associated with a decreased risk of duodenal ulcer (RR = 0.40, 95% CI 0.22-0.74 for the highest quintile). Several age- and energy-adjusted nutrients correlated with dietary fiber were also inversely related to the risk of duodenal ulcer, but vitamin A from all sources combined (including supplements and multivitamins) was the only nutrient that was statistically significant after adjustment for other risk factors (RR = 0.46, 95% CI 0.23-0.91 for men in the highest vs. the lowest quintile of vitamin A intake). These findings provide evidence that vitamin A from all sources, as well as diets high in fruits and vegetables, may reduce the development of duodenal ulcer, possibly due to their fiber content. Although the associations appeared stronger for dietary fiber and vitamin A, the authors can not exclude the possibility that other closely correlated dietary factors may be the true protective factors.

Adult↗
PubMed1997

A prospective study of thiazide use and fractures in women.

Thiazide diuretics reduce urinary calcium and may inhibit bone resorption, and hence may help to attenuate age-related bone loss and to lower the risk of osteoporotic fracture. We followed 83728 women, who were 36-61 years of age at baseline in 1982, for 10 years with biennial mailed questionnaires on which they reported incident fractures, use of thiazide diuretics, and other medical behavioral information. From descriptions of fracture sites and circumstances, 251 hip (proximal femur) and 1594 forearm (distal radius) fractures were identified as low or moderate trauma events. After controlling for age, body mass index, menopausal status, postmenopausal hormone use, cigarette smoking and dietary factors, we observed a statistically significant 22% reduction in the risk of forearm fractures among current thiazide users compared with women who reported no thiazide use. Risk appeared to decline with longer duration of use, reaching a 37% reduction in risk among women who had been using thiazides for 8 or more years. For hip fractures, thiazide use was protective among the postmenopausal women (relative risk = 0.69, 95% confidence interval 0.48-0.99). We conclude that the potential benefit of thiazide diuretics for osteoporosis should be considered when prescribing antihypertensive treatment.

Adult↗
PubMed1997

Reproducibility of oral contraceptive histories and validity of hormone composition reported in a cohort of US women.

Histories of oral contraceptive (OC) use were reported by 116,686 women aged 25 to 42 years in the Nurses' Health Study II on a self-administered questionnaire accompanied by a color photo booklet of all OC preparations ever marketed in the US. To evaluate the quality of this information, we compared the responses of a randomly selected sample of 215 participants with their data from a subsequent, detailed telephone interview using a structured life events calendar. Agreement for a history of ever having used OC was high between the two methods (exact agreement 99%). Reported durations of use were equivalent (mean duration 42.7 months by telephone interview and 44.6 months by questionnaire). The Spearman correlation for duration of use calculated from the two methods was 0.94 (p < 0.0001). For a subset of women for whom we were able to obtain OC prescription records, the medical record confirmed the use of an identical or equivalent brand in 75% of intervals of reported use. Acceptably valid OC histories were obtained with a self-administered questionnaire.

Adult↗
PubMed1997

Parity and other reproductive factors and risk of adenomatous polyps of the distal colorectum (United States).

Evidence for an effect of reproductive factors on colorectal carcinogenesis is inconsistent and little is known about their role in development of precursor adenomatous polyps. We evaluated the relation between reproductive factors and distal colorectal adenomas (n = 982) during 14 years of follow up of 26,983 participants in the Nurses' Health Study (United States). The women were free of diagnosed cancer or polyps in 1980, underwent endoscopy 1980-94, and had reported on their parity, oral contraceptive (OC) use, and ages at menarche, first term-pregnancy, and menopause. We calculated relative risks (RR) and 95 percent confidence intervals (CI) using multiple logistic regression. Women with higher parity had an increased risk of adenomas of the distal colorectum (P trend = 0.004; 6+ cf 0 parity: RR = 1.3, CI = 0.9-1.8) or distal colon (P trend = 0.002, RR = 1.7, CI = 1.2-2.6). This association was significantly stronger among women with a family history of colorectal cancer (P interaction = 0.03); comparing 6+ term-pregnancies with nulliparity, among those with a family history, the RR for distal colon adenoma was 3.2 (CI = 1.4-7.2), while among those without a family history, the RR was 1.3 (CI = 0.8-2.2). We observed no association for distal colorectal adenoma and age at menarche, age at first term-pregnancy, ever use of OCs, or menopausal status. Further work is needed to clarify the relation of parity with colon adenoma risk.

Adenoma↗
PubMed1997

A prospective study of oral contraceptive use and risk of breast cancer (Nurses' Health Study, United States).

Results of previous epidemiologic studies have provided reassurance that there is little, if any, increase in risk of breast cancer with oral contraceptive (OC) use in general. However, in several studies, an increased risk of breast cancer has been observed in two subgroups, young women who used OCs for extended durations and in women who used OCs prior to a first-term pregnancy. We evaluated these relationships using data from the ongoing Nurses' Health Study cohort (United States). We documented 3,383 cases of breast cancer from 1976 to 1992 among 1.6 million person-years of follow-up. We observed no overall relationship between duration of OC use and breast cancer risk, even among women who reported using OCs for 10 or more years (multivariate relative risk [RR] = 1.11, 95 percent confidence interval [CI] = 0.94-1.32). Among women less than 45 years of age, the multivariate RR for using OCs for 10 or more years was 1.07 (CI = 0.70-1.65) compared with never-users. The risk associated with five or more years of OC use prior to a first full-term pregnancy compared with never-use was 0.96 (CI = 0.65-1.43). Among women less than 45 years of age, we observed no evidence of an increased risk with OC use before a first full-term pregnancy (use for five or more years: RR = 0.57, CI = 0.24-1.31). Because of the age distribution of our cohort, we were unable to evaluate these relationships among women less than 40 years of age. Our study provides considerable evidence that long-term past OC use, either overall or prior to a first full-term pregnancy, does not result in any appreciable increase in breast cancer risk in women over 40 years of age.

Adult↗
PubMed1997

Measurement of retinoids and carotenoids in breast adipose tissue and a comparison of concentrations in breast cancer cases and control subjects.

A case-control study of the associations of retinoids and specific carotenoids with breast cancer using concentrations of these nutrients in breast adipose tissue was conducted among women attending a breast clinic in the Boston area in 1989-1992. Breast adipose tissue was collected during breast biopsy. Cases (n = 46) were women whose biopsies revealed invasive or in situ breast cancer; control subjects (n = 63) were women whose biopsies revealed benign disease. We observed inverse associations between breast adipose concentrations of retinoids and carotenoids and risk of breast cancer, although not all were statistically significant. The multivariate-adjusted odds ratio comparing women above the median value of the control group for retinol with those below or equal to the median was 0.71 (95% CI: 0.26, 1.93; NS); corresponding odds ratios were 0.61 (95% CI: 0.23, 1.64; NS) for retinyl palmitate, 0.30 (95% CI: 0.11, 0.85) for beta-carotene, 0.32 (95% CI: 0.11, 0.94) for lycopene, and 0.68 (95% CI: 0.27, 1.73; NS) for lutein/zeaxanthin. There was a nonsignificant positive correlation (r = 0.23, P = 0.15) between breast adipose tissue concentrations of retinol and dietary intake of preformed vitamin A, including supplements measured by using a food-frequency questionnaire. No correlation was found between breast adipose concentrations of carotenoids and intake of dietary carotenoids. These data suggest that higher breast adipose concentrations of retinoids and some carotenoids may be associated with decreased risk of breast cancer and that further examination of these relations is warranted.

Adipose Tissue↗
PubMed1997

The role of antioxidants in preventive cardiology.

Vitamin C, carotenoids, and vitamin E, the three main dietary sources of antioxidants, each effect lipid peroxidation and may reduce atherogenesis and lower the risk of coronary heart disease (CHD). Crosscultural studies of antioxidants find that regions with relatively low dietary intake tend to have higher rates of CHD, but in these studies it is difficult to account for other important cardiovascular risk factors. Evidence from observational studies with more detailed information do not support a cardiovascular benefit for vitamin C, although the cardiovascular effect of vitamin C supplementation among populations with marginal vitamin C deficiency is not known. Results from recent clinical trials of beta-carotene supplementation show no cardiovascular benefit, although several observational studies have found an inverse association between carotenoid intake or plasma levels and risk of CHD. The benefit reported in the observational studies may be due to consumption in foods rich in beta-carotene rather than the beta-carotene itself. The evidence for a cardiovascular benefit of antioxidants is strongest for vitamin E. Three large prospective studies find that vitamin E supplement users have approximately 40% lower rates of CHD. Short durations and doses of less than 100 IU/d (when data were available) have no significant effect. The effect of dietary vitamin E may be more modest but still associated with lower risk of CHD in populations in which vitamin E supplementation is infrequent. In a large randomized trial, a nonsignificant reduction in CHD risk was reported for 50 IU/d, although the dose may have been insufficient. A secondary prevention trial of 400 and 800 IU/day reported a strong reduction in nonfatal myocardial infarction, further supporting the large body of evidence that suggests that high doses of vitamin E reduce risk of CHD.

Antioxidants↗
PubMed1997

A prospective study of alcohol, smoking, caffeine, and the risk of duodenal ulcer in men.

The associations between smoking, caffeine, and alcohol intake and the risk of duodenal ulcer have rarely been investigated prospectively. We examined these associations in a prospective cohort of 47,806 men, 40-75 years of age, using a mailed baseline questionnaire in 1986, with follow-up every 2 years through 1992. During 6 years of follow-up, we documented 138 newly diagnosed cases of duodenal ulcer. After adjustment for age, energy-adjusted dietary fiber, body mass index, and use of aspirin or other nonsteroidal antiinflammatory drugs, current smoking was not associated with a substantial risk of duodenal ulcer [relative risk (RR) = 1.07; 95% confidence interval (CI) = 0.61-1.89]. Overall, past smokers were not at increased risk compared with never-smokers (RR = 0.99; 95% CI = 0.69-1.42). Adjusting for other risk factors, alcohol intake (comparing those who drink > 30 gm of alcohol per day to nondrinkers) was not associated with higher risk of duodenal ulcer (RR = 0.74; 95% CI = 0.42-1.29). We observed little association between caffeine, caffeine-containing beverages, and decaffeinated coffee and the risk of duodenal ulcer. These results indicate that smoking is not associated with a substantial increase in risk of duodenal ulcer, nor is high intake of alcohol and caffeine.

Adult↗
PubMed1997

Family history and risk of kidney stones.

Kidney stones develop more frequently in individuals with a family history of kidney stones than in those without a family history; however, little information is available regarding whether the increased risk is attributable to genetic factors, environmental exposures, or some combination. In this report, the relation between family history and risk of kidney stone formation was studied in a cohort of 37,999 male participants in the Health Professionals Follow-up Study. Information on family history, kidney stone formation, and other exposures of interest, including dietary intake, was obtained by mailed questionnaires. A family history of kidney stones was much more common in men with a personal history of stones at baseline in 1986 than in those without a history of stones (age-adjusted prevalence odds ratio, 3.16; 95% confidence interval [CI], 2.90 to 3.45). During 8 yr of follow-up, 795 incident cases of stones were documented. After adjusting for a variety of risk factors, the relative risk of incident stone formation in men with a positive family history, compared with those without, was 2.57 (95% CI, 2.19 to 3.02). Family history did not modify the inverse association between dietary calcium intake and the risk of stone formation. These results suggest that a family history of kidney stones substantially increases the risk of stone formation. In addition, these data suggest that dietary calcium restriction may increase the risk of stone formation, even among individuals with a family history of kidney stones.

Adult↗
PubMed1997

Milk, dietary calcium, and bone fractures in women: a 12-year prospective study.

OBJECTIVES: This study examined whether higher intakes of milk and other calcium-rich foods during adult years can reduce the risk of osteoporotic fractures. METHODS: This was a 12-year prospective study among 77761 women, aged 34 through 59 years in 1980, who had never used calcium supplements. Dietary intake was assessed with a food-frequency questionnaire in 1980, 1984, and 1986. Fractures of the proximal femur (n = 133) and distal radius (n = 1046) from low or moderate trauma were self-reported on biennial questionnaires. RESULTS: We found no evidence that higher intakes of milk or calcium from food sources reduce fracture incidence. Women who drank two or more glasses of milk per day had relative risks of 1.45 for hip fracture (95% confidence interval [CI] = 0.87, 2.43) and 1.05 for forearm fracture (95% CI = 0.88, 1.25) when compared with women consuming one glass or less per week. Likewise, higher intakes of total dietary calcium or calcium from dairy foods were not associated with decreased risk of hip or forearm fracture. CONCLUSIONS: These data do not support the hypothesis that higher consumption of milk or other food sources of calcium by adult women protects against hip or forearm fractures.

Adolescent↗
PubMed1997

A prospective study of oral contraceptives and NIDDM among U.S. women.

OBJECTIVE: To examine prospectively the association between modern oral contraceptives with low doses of estrogen and progestin and subsequent incidence of NIDDM. RESEARCH DESIGN AND METHODS: In a prospective cohort study, 98,590 U.S. female nurses aged 25 to 42 and free of diagnosed diabetes, coronary heart disease, stroke, and cancer at baseline in 1989 were followed for 4 years. Endpoint was incidence of confirmed NIDDM. Oral contraceptive use was reported on mailed questionnaires. RESULTS: During 352,067 person-years follow-up, we confirmed 185 incident cases of NIDDM. After adjusting for age, BMI, cigarette smoking, family history of diabetes, parity, physical activity, alcohol intake, ethnicity, history of diagnosis of infertility, elevated cholesterol, and hypertension, women currently using oral contraceptives had a relative risk (RR) of 1.6 (95% CI, 0.9-3.1). For past users, the multivariate RR was 1.2 (95% CI, 0.8-1.8). This association was attenuated after restricting the analysis to symptomatic cases of NIDDM. For current users, RR = 1.3 (95% CI, 0.6-2.8), and for past users, RR = 0.9 (95% CI, 0.6-1.4), suggesting that increased surveillance may explain at least part of any excess risk. CONCLUSIONS: In this large prospective study, we found no appreciable increase in the 4-year risk of NIDDM among current users of oral contraceptives. There was no apparent increase in risk among past users. The small number of cases reflect the low absolute risk of NIDDM in this population of young women.

Adult↗
PubMed1997

Dietary fiber, glycemic load, and risk of NIDDM in men.

OBJECTIVE: Intake of carbohydrates that provide a large glycemic response has been hypothesized to increase the risk of NIDDM, whereas dietary fiber is suspected to reduce incidence. These hypotheses have not been evaluated prospectively. RESEARCH DESIGN AND METHODS: We examined the relationship between diet and risk of NIDDM in a cohort of 42,759 men without NIDDM or cardiovascular disease, who were 40-75 years of age in 1986. Diet was assessed at baseline by a validated semiquantitative food frequency questionnaire. During 6-years of follow-up, 523 incident cases of NIDDM were documented. RESULTS: The dietary glycemic index (an indicator of carbohydrate's ability to raise blood glucose levels) was positively associated with risk of NIDDM after adjustment for age, BMI, smoking, physical activity, family history of diabetes, alcohol consumption, cereal fiber, and total energy intake. Comparing the highest and lowest quintiles, the relative risk (RR) of NIDDM was 1.37 (95% CI, 1.02-1.83, P trend = 0.03). Cereal fiber was inversely associated with risk of NIDDM (RR = 0.70; 95% CI, 0.51-0.96, P trend = 0.007; for > 8.1 g/day vs. < 3.2 g/day). The combination of a high glycemic load and a low cereal fiber intake further increased the risk of NIDDM (RR = 2.17, 95% CI, 1.04-4.54) when compared with a low glycemic load and high cereal fiber intake. CONCLUSIONS: These findings support the hypothesis that diets with a high glycemic load and a low cereal fiber content increase risk of NIDDM in men. Further, they suggest that grains should be consumed in a minimally refined form to reduce the incidence of NIDDM.

Adult↗
PubMed1997

A prospective study of reproductive factors, oral contraceptive use, and risk of colorectal cancer.

To explore the roles of reproductive factors and oral contraceptive use in the etiology of colorectal cancer, we examined incident cases of colorectal cancer (n = 501) that occurred during 1,012,280 person-years of follow-up between 1980 and 1992 in the Nurses' Health Study. The women completed mailed, self-administered questionnaires every 2 years to update information on the risk factors and major medical events. In multivariate analysis, the relative risk (RR) of colorectal cancer among women who experienced menarche at age 14 or older was 0.83 (95% confidence interval (CI) = 0.64-1.08) compared with women who had menarche at age 13; women whose menarche occurred under age 12 were at higher risk (RR = 1.22; 95% CI = 0.96-1.55, P for trend = 0.01). Compared with women whose first pregnancy was before age 24, the risk for colorectal cancer was significantly increased among women whose first pregnancy was at age 30 or older (RR = 1.57; 95% CI = 1.15-2.14; P for trend = 0.02). No important associations were seen for parity or age at menopause. Women who used oral contraceptives for 96 months or longer had a 40% lower risk of developing colorectal cancer (RR = 0.60; 95% CI = 0.40-0.89; P for trend = 0.02) compared with women who never used oral contraceptives. These prospective data suggest that a later age of menarche and use of oral contraceptives may reduce risk of colorectal cancer, whereas women with a later age at first pregnancy may have a higher risk.

Adult↗
PubMed1997

A polymorphism of the 5 alpha-reductase gene and its association with prostate cancer: a case-control analysis.

Prostate cancer (CaP) is the most commonly diagnosed, nondermatological cancer in the United States. The development and progression of CaP is influenced by androgens. 5 alpha-Reductase, type II, converts testosterone to dihydrotestosterone and is critical to the development of the prostate. A TA dinucleotide repeat polymorphism exists in the 3' untranslated region of the 5 alpha-reductase type II gene. 5 alpha-Reductase alleles with longer TA repeats are more common in African-Americans, the group with the highest incidence of CaP. It has been hypothesized that the longer TA repeat alleles might be associated with increased risk of CaP. We studied this potential association within the Physician's Health Study, a predominantly Caucasian cohort study. Using PCR we identified the TA genotype in 590 men with CaP and 802 age-matched controls. The frequency of each allele in the controls was TA(0), 0.87, TA(9), 0.13, and TA(18), 0.01. Homozygotes for the longer TA alleles, TA(9) and TA(18), were underrepresented among cases with an odds ratio of 0.47 (confidence interval, 0.20-1.12), but this was not statistically significant (P = 0.08, two tailed). Our analysis does not support the prior hypothesis that longer TA alleles confer an increased risk of CaP in a predominantly Caucasian population; in fact, longer TA alleles are more prevalent in men without CaP.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1997

Glutathione S-transferase class mu deletion polymorphism and breast cancer: results from prevalent versus incident cases.

A common deletion polymorphism in the gene coding for the glutathione S-transferase class mu (the GSTM1 gene) results in a decreased ability to detoxify carcinogenic epoxide intermediates and has been associated with increased breast cancer risk in some small studies. We studied the GSTM1 gene deletion polymorphism (conferring the null genotype) in 243 women who had prevalent breast cancer and 245 women without breast cancer, who were among the 32,826 women in the Nurses' Health Study who gave a blood sample in 1989-1990. In the prevalent case series, the null genotype was slightly more common among cases (58%) than among controls (51%; age-adjusted odds ratio = 1.30; 95% confidence interval, 0.91-1.86). Among cases, the prevalence of the GSTM1 deletion increased with duration of survival [68% for > or = 8 years since diagnosis; 57% for 4-8 years; 51% for < 4 years; P (trend) = 0.04]. In an incident case series of 240 women who were diagnosed with breast cancer following blood collection and prior to June of 1992 and compared with age-matched controls, the GSTM1 deletion was not associated with an elevation in risk (relative risk, 1.08; 95% confidence interval, 0.74-1.57). No significant interaction with cigarette smoking was evident. Thus, there was no significant increase in risk of incident breast cancer associated with the GSTM1 null genotype; however, the gene deletion polymorphism appeared to confer improved survival. These data suggest that odds ratios based upon prevalent cases in molecular epidemiologic studies may be biased due to differential survival. Further studies are required to determine whether this polymorphism is associated with improved breast cancer prognosis.

Adult↗
PubMed1997

Height, body weight, and risk of prostate cancer.

Using data from the Health Professionals Follow-Up Study, we prospectively examined the relationships between height, body mass index, waist and hip circumferences, and risk of total and advanced (extraprostatic and metastatic) prostate cancer. In addition, we assessed adiposity during childhood, adolescence, and early, middle, and late adulthood using pictograms in relation to prostate cancer risk. Between 1986 and 1994, 1,369 cases of prostate cancer (excluding stage A1) were confirmed in 47,781 men. Adult body mass index and waist and hip circumferences were not appreciably related to risk of total prostate cancer or advanced prostate cancer. In contrast, preadult (age 10) obesity assessed in 33,336 men in 1988 was prospectively related to lower risk of advanced [relative risk (RR) = 0.72 with 95% confidence interval (CI) = 0.47-1.10, between high and low quintiles; P(trend) = 0.06] and metastatic prostate cancer (RR = 0.38 with 95% CI = 0.19-0.77; P(trend) = 0.004). For the advanced lesions, an association was observed with height (RR = 1.68 with 95% CI = 1.16-2.43 for men 74 inches or taller, relative to men 68 inches or shorter; P(trend) = 0.01). In an analysis limited to particularly aggressive forms of prostate cancer, i.e., cases found to be metastatic at time of diagnosis between 1988 and 1994 after a negative digital rectal examination in 1988, we found that obesity at ages 5 and 10 had a strong inverse association (RR = 0.16 with 95% CI = 0.05-0.54, between high and low quintiles at age 10) and that tallness had a strong direct association with risk of metastatic disease (RR = 2.29 with 95% CI = 1.04-5.05, for height > or = 74 inches versus < or = 68 inches). Our findings suggest that the preadult hormonal milieu, as reflected in attained height and childhood obesity, may have a strong influence on prostate carcinogenesis.

Adolescent↗
PubMed1997

Dietary fiber and distal colorectal adenoma in men.

We evaluated the relation of specific sources and components of fiber with diagnosis of distal colon (n = 531) or rectal (n = 159) adenomatous polyps or hyperplastic (n = 327) polyps in the Health Professionals Follow-up Study. We studied 16,448 men free of cancer or polyps in 1986, who underwent endoscopy in 1986-1994, and who provided diet and medical history. Relative risks (RRs) and 95% confidence intervals (CIs) adjusted using multiple logistic regression were calculated. We observed a modest reduced risk of distal colon adenoma with increasing intake of fiber from fruit (P-trend = 0.03) but not cereals or vegetables. The RR comparing the highest (median, 8.4 g/day) to lowest (1.3 g/day) quintile of fruit fiber intake was 0.81 (95% CI, 0.59-1.11). Soluble fiber, but not insoluble fiber, appeared to be inversely associated with distal colon adenoma (P-trend = 0.007). Comparing extreme quintiles (9.4 versus 3.4 g/day soluble fiber), the RR was 0.69 (95% CI, 0.46-1.03). Polyps detected in 1986 or later among men also with a negative endoscopy before 1986 may be considered to be "incident," with diet report corresponding more closely to time of polyp development. For "incident" cases (n = 130), the relation between soluble fiber and distal colon adenoma was strengthened (extreme quintiles RR, 0.27; 95% CI, 0.11-0.66; P-trend = 0.003), whereas for "prevalent" cases (n = 401), we found no association. No consistent relation between fiber and rectal adenomas or hyperplastic polyps was observed. These results suggest that soluble fiber may be particularly important in reducing risk of adenomatous polyps of the distal colon and support national dietary guidelines of increasing fruit consumption.

Adenoma↗