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PubMed2002

Urodynamic patterns of normal male micturition: influence of water consumption on urine production and detrusor function.

PURPOSE: Urodynamic characterization of normal male micturition can be a useful standard in the analysis of data on patients complaining of voiding dysfunction. The validity of such a standard is based on the need to obtain baseline parameters of pressure flow values, an important consideration when evaluating prostatic obstruction and its treatment. While current numerical pressure flow values provide a useful summary of the voiding sequence, a more complete analysis of the pattern of normal voiding may reveal more functionally useful information concerning micturition. We establish basic experimental conditions that simulate normal voiding of physiologically produced urine by the kidneys measured at intervals representing real stages of bladder filling. We report the results of an investigation designed to study consecutive micturitions at bladder volumes determined by water consumption and endogenous circadian rhythm. Our particular focus is to examine critically the urodynamic pattern of pressure flow and obtain evidence to support the hypothesis that fluid consumption has an important role in detrusor function. MATERIALS AND METHODS: Urodynamic studies were conducted on 39 asymptomatic male volunteers with a mean age of 25.8 years (range 21 to 31) and mean weight of 75.5 kg. (range 63 to 95). Volunteers were divided into 2 groups according to water consumption regimen of 30 ml./kg. daily (17 patients, group 1) and 60 ml./kg. daily (12, group 2). Bladder pressure was monitored via a suprapubic catheter and abdominal pressure was measured via a rectal balloon using an ambulatory system. Average duration of each monitoring period was 20.5 hours. Detrusor pressure and flow rate records from each subject were identified, and consecutive filling and voiding phases were averaged during the entire monitoring period using the onset of micturition as a time marker. The average pattern of pressure, flow rate, cumulative volume and contractility curves for each subject, as well each for group, was computed and graphically presented. For each group the average parameters of urethral opening pressure, maximum detrusor pressure, detrusor pressure at maximum flow rate, bladder capacity and bladder contraction strength were calculated and compared statistically. Numerical values are mean +/- SE. RESULTS: Water consumption and urine production rate influenced the pattern and many of the urodynamic parameters of micturition. In both groups there was a detrusor pressure increase before voiding and numerically maximum detrusor pressure consistently occurred before micturition started. Micturition pattern showed an asymptotic relationship between pressure and flow. Doubling of water consumption increased urethral opening pressure from 51.2 +/- 3.2 to 61.5 +/- 5.1 (p <0.05), maximum detrusor pressure from 58.9 +/- 4.5 to 70.0 +/- 6.2 cm. H(2)O (p <0.01) and contractility from 15.4 +/- 1.4 to 17.7 +/- 1.4 w/m(2). There were no significant differences due to water consumption in maximum flow rate (24.4 +/- 1.4 to 25.2 +/- 1.8 ml. per second) or bladder capacity (286 +/- 20 to 329 +/- 15 ml.) but a significant increase in the number of micturitions from 5.8 +/- 0.5 to 9.8 +/- 0.5 per day (p <0.001) proportional to water consumption. CONCLUSIONS: The configuration of the observed pressure flow characteristics of the normal male is suggestive of the "Starlings law" relationship and the pattern of the urodynamic parameters were markedly different from those reported in the current standardization literature, suggesting the need to revise the current concept of normal male micturition. Voiding pressure and contractility increased in accordance with water consumption and urine production.

Adult↗
PubMed1995

Ethnic group and alcohol consumption: the case of 15-16-year-olds in Leicestershire.

In recent years a number of research projects have reported on the level of alcohol use by young people. The research to date, however, has tended to overlook the ethnic origins of the young people as a factor associated with the level of alcohol use. Against this background, this paper reports findings on the use of alcohol by 15-16-year-olds in Leicestershire with specific reference to ethnic group. A survey of over 1000 young people revealed significant differences between ethnic groups in terms of their attitudes to alcohol consumption and the frequency of alcohol consumption. As expected, South Asians tended to hold less favourable attitudes to drinking alcohol than their White counterparts and reported a far lower frequency of alcohol consumption. The extent of the divergence between the two ethnic groups is detailed, revealing a stark contrast between the groups at age 15-16 years. Attitudes to alcohol consumption and reported frequency of alcohol consumption were also analysed in relation to the religion of the respondents. This analysis was undertaken to see if there were differences within the broader ethnic groups which would be disguised by aggregating the results under the headings of 'South Asian' and 'White'. Within the South Asian group, some differences in attitudes to the consumption of alcohol were found between Hindus, Sikhs and Muslims, with the Muslims exhibiting particular sensitivity to their religion's proscription of drinking alcohol. Despite this, the reported level of drinking by the Hindus and Sikhs was not much greater than that of the Muslims. The three groups tended to have a similar frequency of alcohol consumption which was markedly lower than that reported by the White 15-16-year-olds. The findings from the DART research have certain substantive and certain methodological implications in relation to epidemiological studies of alcohol consumption. Substantively, the findings reinforce the need to include ethnic group as a key factor and highlight the danger of aggregating the results from different ethnic groups. In the case of Leicestershire, the effect of ignoring the ethnic dimension would have been to underestimate significantly the extent of drinking among the White 15-16-year-olds. Methodologically, the findings offer some support for the continued use of 'South Asian' as an analytic category since the variations observed within the category were relatively minor, especially in comparison with results for the White 15-16-year-olds.

Adolescent↗
PubMed2002

Effects of nefazodone on voluntary ethanol consumption induced by isolation stress in young and aged rats.

Late-onset ethanol (EtOH) consumption is related to life and social stressors of aging. The stress system (hypothalamic-pituitary-adrenal, HPA, axis) coordinates the adaptive response of the organism to stressors, but age-related deficits in HPA function seem to be associated with disorders such as late-onset EtOH consumption, anxiety and depression. In the present study, we examined whether HPA dysfunction is associated with stress-related EtOH consumption in aged rats and whether the treatment with nefazodone hydrochloride, a phenylpiperazine antidepressant, partially reverses the adverse effects of isolation (ISOL) stress. The animals were offered two-bottle choice consumption of 0.2% saccharin and 10% EtOH/0.2% saccharin, and then exposed to 4 days of ISOL stress on an irregular, unpredictable schedule. ISOL stress-induced increases in corticosterone secretion and EtOH consumption both during and following the stress (recovery period) in aged rats. Nevertheless, this effect at the recovery period was not evident in young stressed rats. Nefazodone caused a significant decrease in plasma corticosterone levels and EtOH consumption. The attenuation of stress-induced corticosterone by nefazodone was correlated with reduced EtOH consumption. These findings link the effect of ISOL stress to the induction of voluntary EtOH consumption following the end of the stressor and the limitation of aged HPA to down-regulated corticosterone.

Aging↗
PubMed2003

Blood manganese and alcohol consumption interact on mood states among manganese alloy production workers.

Long-term exposure to manganese (Mn) can induce neurotoxic effects including neuromotor, neurocognitive and neuropsychiatric effects, but there is a great interpersonal variability in the occurrence of these effects. It has recently been suggested that blood Mn (MnB) may interact with alcohol use disorders, accentuating neuropsychiatric symptoms. The objective of the present study was to explore a possible interaction between alcohol consumption and MnB on mood states, using an existing data set on Mn exposed workers. Respirable Mn exposure in the plant averaged 0.23mg/m(3) and was correlated with MnB. All participants for whom all data on MnB concentration and mood (assessed with the Profile of Mood States (POMS)) were available and who reported currently drinking alcohol were included in the analyses (n=74). Workers were grouped according to their MnB concentration (<10 and > or =10 microg/l) and alcohol consumption (<400 and > or =400g per week). Two-way ANOVAs were performed on each POMS scale and Mann-Whitney tests were used to assess group differences. Workers in the higher alcohol consumption group had higher scores on three POMS scales: tension, anger and fatigue. There was no difference for POMS scale scores between MnB subgroups. Dividing the group with respect to alcohol consumption and MnB showed that the group with high alcohol consumption and high MnB displayed the highest scores. In the lower MnB category, those in the higher alcohol consumption group did not have higher scores than the others. The interaction term for alcohol consumption and MnB concentration was statistically significant (P<0.05) for the depression, anger, fatigue and confusion POMS scales. There was a tendency for tension (P<0.06), and it was not significant for vigor. This study shows the first evidence of an interaction between MnB and alcohol consumption on mood states among Mn exposed workers and supports the results from a previous population-based study.

Adult↗
PubMed2001

[Alcohol consumption among primary care doctors].

OBJECTIVE: To find the personal alcohol consumption of primary care (PC) doctors. DESIGN: Observational, descriptive and cross-sectional study. SETTING: All the PC doctors in our region. PARTICIPANTS: 486 doctors, excluding paediatricians. MATERIAL: Closed, anonymous and self-administered survey, divided into two sections: a) social and demographic and work variables (7 items); b) Questionnaire on personal alcohol consumption (4 questions). MEASUREMENTS AND INTERVENTIONS: Descriptive analysis and simple correlations. RESULTS: 227 valid surveys were obtained (47.7% participation rate). A) Social and demographic and work variables: 67.6% were male, with 63.9% between 36 and 45 years old. 55.3% worked in a mixed health centre, 54.4% with tenure. > 40 patients/day (46.6%) demanded care. 82.1% were married. Two-child family units predominated (44.4%). B) Questionnaire on personal consumption of alcohol: 75.7% of the professionals who answered the questionnaire said they were consumers, with "occasionally" the most common pattern of consumption (32.33%). In 63.3% the starting age was between 16 and 20. Beer was the most common kind of drink. In general, consumption predominated in male professionals (78%). However, excess/risk consumption was proportionally higher in women (27.7%). CONCLUSIONS: a) Alcohol consumption among the doctors surveyed is similar to that found in the general population. b) Risk consumption is higher among women doctors.

Adult↗
PubMedDate not supplied

[Anti-tuberculosis drug consumption as an indicator of the epidemiological situation of tuberculosis in Spain].

OBJECTIVES: To describe anti-tuberculosis drug consumption in Spain for the period, 1985-1995, compare the associated time trend and geographical pattern against case reports of tuberculosis (TB), and estimate the number of persons undergoing anti-tuberculosis therapy in 1995. METHODS: The official Drug Database was used to ascertain consumption of anti-tuberculosis drugs (isoniazid, rifampicin, pyrazinamide and ethambutol) in Spain during the period, 1985-1995. The technical units of measurement used for comparison purposes were daily defined dose (DDD) and DDD rate per day per 100,000 population. Annual trends and geographical patterns of consumption were plotted. The respective numbers of persons treated in 1995 with each of the four drugs were first estimated and then compared against TB case reports. RESULTS: There was an overall decline in the consumption of isoniazid, rifampicin and ethambutol over the period, 1985-1995, though the former two registered rises in 1991 and 1992. Pyrazinamide consumption showed growth throughout the study period. The highest 1995 consumption rates were registered by Galicia, Cantabria, Asturias, the Basque Country, Ceuta and Melilla, and the lowest by the Canary Islands and Navarre. Comparisons run against TB case reports revealed a greater degree of underreporting in certain provinces. In 1995, approximately 18,858 persons (48 per 100,000 population) must be assumed to have undergone pyrazinamide therapy in Spain, indicating that the reported TB rate of 22 per 100,000 population could well represent underreporting in excess of 100%. CONCLUSIONS: The trend in anti-tuberculosis drug consumption reflects shifts in treatment guidelines and is compatible with a rise in TB incidence in recent years. Major underreporting of TB marked by wide inter-regional and -provincial differences was in evidence. Pyrazinamide consumption is probably the best indicator for estimating minimum TB incidence.

Antitubercular Agents↗
PubMedDate not supplied

Low dose of morphine and the consumption of a sweetened ethanol solution: differential effects on acquisition and maintenance.

The influence of a low dose of morphine was investigated on the acquisition and maintenance of consumption of a sweetened ethanol solution with water as the alternative in a two-bottle choice procedure. During acquisition in Experiment 1, morphine failed to significantly increase the consumption of a sweetened ethanol solution compared to either a postinjection period in the same animals or a no-treatment control group. Although morphine significantly increased sweetened ethanol consumption when compared to a saline control group, this appears to be due to a stress response to the injections, which suppressed ethanol consumption in the saline animals. During maintenance in Experiment 2, morphine significantly increased consumption of sweetened ethanol in all groups compared to consumption following saline control injections. There was no difference in this effect among the three groups, suggesting that prior history with morphine was not a factor. In addition, rats that were exposed to morphine during both experiments drank significantly more sweetened ethanol following injections in Experiment 2 than in Experiment 1. This suggests that morphine's potentiation of ethanol consumption is due to its interaction with endogenous opioid receptors that modulate the reward value of ethanol rather than more general mechanisms affecting satiety or taste. The results of these experiments provide support for both the Deficit and Surfeit Hypotheses of ethanol consumption, both of which suggest that endogenous opioid receptors are responsible, in part, for ethanol's reinforcing properties.

Alcohol Drinking↗
PubMed2000

Fruit and vegetable consumption in relation to risk factors for cancer: a report from the Malmö Diet and Cancer Study.

OBJECTIVE: To examine the associations between the consumption of fruit and vegetables and other markers of cancer risk. DESIGN: A cross-sectional survey within the population-based prospective Malmö Diet and Cancer (MDC) Study. Information on food habits was collected through the modified diet history method designed and validated for the MDC Study. Data on smoking and alcohol habits, leisure time physical activity, birth country, education, socioeconomic status and cohabitation status were collected through a questionnaire. SETTING: Malmö, the third largest city in Sweden. SUBJECTS: All subjects who entered the MDC Study during winter 1991 to summer 1994 (men and women living in Malmö, aged between 46 and 68 years), with a total of 15 173. RESULTS: Women consumed more fruit and vegetables than men. Low consumption of both fruits and vegetables was associated with unfavourable nutrient profiles: higher percentage of energy from fat and lower intakes of antioxidant nutrients and dietary fibre. Low consumption was also associated with smoking, low leisure time physical activity, low education and being born in Sweden. High age was associated with low vegetable consumption in both genders. CONCLUSION: This study indicates that several established risk markers and risk factors of cancer may be independently associated with low fruit and vegetable consumption. The findings suggest that the adverse effects of factors such as smoking, low physical activity and a high-fat diet could partly be explained by low consumption of fruit or vegetables. The implied health benefits of a low or moderate alcohol consumption may be similarly confounded by high consumption of fruit or vegetables.

Aged↗
PubMed1997

Consumption of anti-infective drugs in Bulgaria for the period from 1979 to 1994.

The use of systemic antibacterial drugs in Bulgaria for the period from 1979 to 1994 had been studied using the Defined Daily Doses (DDD) methodology. The total consumption of antibacterials, the consumption by therapeutic groups and preparations were presented. The usage of anti-infectives in Bulgaria was growing during the period under discussion. Most of the groups followed the general tendency of the total consumption showing their own variations throughout the years. The role of the different preparations was defined. Bulgarians' way of using antibacterials showed the following characteristics: permanent increase in the total consumption; high consumption of tetracyclines and extended spectrum penicillins; low consumption of narrow spectrum antibiotics; and relatively high consumption of aminoglycosides and chloramphenicol. In this study an attempt was made to relate the data with several factors influencing the consumption. For comparison we studied available statistical data of some other countries.

Anti-Infective Agents↗
PubMed2001

Are coffee, tea, and total fluid consumption associated with bladder cancer risk? Results from the Netherlands Cohort Study.

OBJECTIVES: Coffee, tea, and fluid consumption have been thought to influence bladder cancer incidence. In a large prospective study, these associations were investigated. METHODS: In 1986, cohort members (55-69 years) completed a questionnaire on cancer risk factors. Follow-up was established by linkage to cancer registries until 1992. The multivariable case-cohort analysis was based on 569 bladder cancer cases and 3,123 subcohort members. RESULTS: The incidence rate ratios (RR) for men consuming <2 cups of coffee/day was 0.89 (95% CI 0.51-1.5) using the median consumption category (4-<5 cups/day) as reference. This RR increased to 1.3 (95% CI 0.94-1.9) for men consuming >7 cups/day, although no clear dose response association was found. The RRs decreased from 1.2 (95% CI 0.56-2.7) for women consuming <2 cups of coffee/day to 0.36 (95% CI 0.18-0.72) for women consuming >5 cups/day compared to the median consumption category (3-<4 cups/day). Men and women who abstained from drinking tea had a RR of 1.3 (95% Cl 0.97-1.8) compared to those consuming 2-<3 cups of tea per day (median consumption category). The RR for men and women comparing highest to lowest quintile of total fluid consumption was 0.87 (95% CI 0.63 1.2). CONCLUSION: The data suggest a possible positive association between coffee consumption and bladder cancer risk in men and a probable inverse association in women. Tea consumption was inversely associated with bladder cancer. Total fluid consumption did not appear to be associated with bladder cancer.

Aged↗
PubMed2002

Mapping of QTL influencing saccharin consumption in the selectively bred alcohol-preferring and -nonpreferring rat lines.

The inbred preferring (iP) and nonpreferring (iNP) rat strains were derived from the selectively bred alcohol-preferring (P) and alcohol-nonpreferring (NP) lines. Previously, 381 iP x iNP F2 progeny were generated to identify quantitative trait loci (QTLs) influencing alcohol consumption and preference. Saccharin consumption (ml/48 h) and saccharin intake (ml/kg/day) were also measured in the F2 sample and were significantly correlated with both alcohol consumption and preference (all r > or = .20, p < .0001), suggesting that there might be some QTLs influencing both saccharin and alcohol phenotypes. We have performed a genome screen using F2 animals with extreme saccharin or alcohol consumption to identify QTLs contributing to saccharin-related phenotypes. Lod scores greater than 2.0 were found on chromosomes 3, 16 and 18 in this sample. Additional genotyping was performed in these regions in the full sample of 381 F2 progeny to further characterize these putative QTLs. On chromosome 3, the maximum lod score in the full sample was 2.7 with saccharin consumption. This QTL appears to overlap with a QTL identified for alcohol consumption in the iP and iNP lines and has pleiotropic effects on both phenotypes. Interestingly, this region of rat chromosome 3 is syntenic with mouse chromosome 2, where a QTL influencing alcohol preference has been previously reported. The QTL on chromosome 16 has a maximum lod score of 4.0 with saccharin intake and 2.6 with saccharin consumption. The QTL on chromosome 18 has a maximum lod score of 2.7 with saccharin consumption. Taken together, these data provide the first results of a genome screen for QTLs contributing to saccharin phenotypes in the rat.

Alcohol Drinking↗
PubMed2003

Assessment of alcohol consumption by mailed questionnaire in epidemiological studies: evaluation of misclassification using a dietary history interview and biochemical markers.

BACKGROUND: Self-reported information on alcohol from questionnaires is generally assumed to introduce misclassification of consumption, mainly in the direction of underestimation. The aim of this study was to evaluate self-reported information on alcohol consumption from a mailed questionnaire by comparing to a dietary history interview and biochemical markers of alcohol intake. SUBJECTS AND METHODS: For 76 male twin pairs of the Finnish Twin Cohort Study aged 40-70 years information on self-reported alcohol consumption was collected through mailed questionnaire and dietary history interview. Carbohydrate-deficient transferrin (CDT), Gamma-glutamyltransferase (Gamma-GT) and mean corpuscular volume (MCV) were determined from blood samples. RESULTS: Mean levels of CDT, gamma-GT and MCV showed a rise with increased self-reported alcohol consumption already at low levels of reported consumption (<20 g alcohol/day). There was a positive correlation between reported amount alcohol intake per day and levels of CDT (r = 0.46), gamma-GT (r = 0.32) and MCV (r = 0.36) but within the high consumption group (> or = 30 g/day) there was no such correlation. The questionnaire had sensitivity of 28-43% and specificity of 89% for identification of high consumers of alcohol using the biochemical markers as reference and sensitivity 41% and specificity 94% using the dietary history interview as reference. Sensitivity was improved when information on binge drinking (82%) or possible drinking problems (73%) was considered. CONCLUSION: Comparison to dietary history interview as well as to biochemical markers indicate that self-reported information on alcohol consumption from a mailed questionnaire may be used to distinguish between groups with different levels of alcohol consumption. The suggested misclassification of high consumers implies that only strong associations between high alcohol intake and disease are likely to be detected in studies based on questionnaire data.

Adult↗
PubMed1980

Associations between cancer incidence and alcohol/cigarette consumption among five ethnic groups in Hawaii.

The average annual age-adjusted incidence rates of cancer for 15 sites were determined for 10 ethnic-sex groups in Hawaii. Consumption rates for cigarettes, beer, wine and hard liquor were also determined for the same 10 groups based on personal interview of a sample of 9920 individuals. Covariance analysis was used to adjust each exposure variable for the other three, and the cancer incidence rates were then linearly regressed on these covariance-adjusted consumption rates. Statistically significant regression coefficients were found for cancer of the tongue/mouth, pharynx, larynx, pancreas, lung, kidney and bladder regressed on cigarette consumption. Eight cancer sites, including tongue/mouth, pharynx, larynx, oesophagus, stomach, pancreas, lung and kidney, had significant positive regression coefficients for beer consumption which could not be explained by outlying values on the scattergram. Significant associations were also suggested between wine consumption and pharyngeal cancer and between hard-liquor consumption and pharyngeal, laryngeal and possibly brain cancer. No association was found between beer consumption and colorectal cancer. Multiple regression analysis with sex, cigarettes and alcoholic beverage as independent variables consistently found sex to be least important in determining cancer risk. This study supports the hypothesis that beer consumption may play a role in cancer risk for several sites. It is suggested that future studies of alcoholic beverages and cancer should examine not only types of alcoholic beverages, but individual brands of each type in an attempt to identify cancer risk due to carcinogens in only certain brands.

Alcohol Drinking↗
PubMed2005

Water and food consumption patterns of U.S. adults from 1999 to 2001.

OBJECTIVE: High water consumption has been proposed as an aid to weight control and as a means of reducing the energy density of the diet. This study examines the relationship between water consumption and other drinking and eating patterns. RESEARCH METHODS AND PROCEDURES: The National Health and Nutrition Examination Survey 1999 to 2001, with responses from 4755 individuals > or =18 years of age, provides the data for this cross-sectional analysis. A cluster analysis was performed using z-scores of specific food and beverage consumption to examine patterns. A multinomial logit analysis was used to examine sociodemographic characteristics of each dietary pattern and to examine the effects of water consumption on the likelihood of consuming a non-dairy caloric beverage. All results were weighted to be nationally representative and controlled for design effects. RESULTS: Within the sample, 87% consumed water, with an average daily consumption of 51.9 oz (1.53 liters) per consumer. Water consumers drank fewer soft/fruit drinks and consumed 194 fewer calories per day. Water consumers (potentially a self-selected sample) consumed more fruits, vegetables, and low- and medium-fat dairy products. Four distinct unhealthy dietary patterns were found that included little or no water consumption. Older and more educated persons used healthier food patterns. Mexican dietary patterns were much healthier than dietary patterns of blacks. DISCUSSION: Water consumption potentially is a dietary component to be promoted, but much more must be understood about its role in a healthy diet. Because high water consumption is linked with healthier eating patterns-patterns more likely to be followed by higher-educated, older adults-the target of water promotion and healthy diet options should focus on younger and less educated adults.

Adult↗
PubMed2002

Interaction between alcohol dehydrogenase II gene, alcohol consumption, and risk for breast cancer.

MaeIII Restriction Fragment Length Polymorphism in exon 3 of the alcohol dehydrogenase II was assessed in serum from 467 randomly selected German women and 278 women with invasive breast cancer to evaluate the interaction between a polymorphism of the alcohol dehydrogenase II gene, alcohol consumption and risk for breast cancer. In both groups, usual consumption of different alcoholic beverages was asked for using semiquantitative food frequency questionnaires. We used multivariable logistic regression to separately estimate the association between alcohol consumption and alcohol dehydrogenase II polymorphism in the population sample and women with breast cancer. The alcohol dehydrogenase II polymorphism was detected in 14 women from the population sample (3.0%) and in 27 women with invasive breast cancer (9.7%). Frequency of alcohol consumption was independent of the genotype in the population sample. In women with breast cancer, there was a significant inverse association between the alcohol dehydrogenase II polymorphism and frequency of alcohol consumption (adjusted case-only odds ratio over increasing frequency of alcohol consumption=0.5; P for interaction=0.02). We observed a gene-environment interaction between the alcohol dehydrogenase II polymorphism, alcohol consumption, and risk for breast cancer. Breast cancer risk associated with alcohol consumption may vary according to the alcohol dehydrogenase II polymorphism, probably due to differences in alcohol metabolism.

Adult↗
PubMed1998

By how much does fruit and vegetable consumption reduce the risk of ischaemic heart disease?

OBJECTIVE: To quantify the relationship between fruit and vegetable consumption and the incidence of ischaemic heart disease. DESIGN: A meta-analysis of cohort studies of the relationship between ischaemic heart disease and markers of fruit and vegetable consumption, namely dietary intake of fruit, vegetables, carotenoids, vitamin C, fruit fibre and vegetable fibre, and serum concentration of carotenoids and vitamin C, adjusted for other risk factors. MAIN OUTCOME MEASURES: Risk of ischaemic heart disease at the 90th centile of consumption relative to that at the 10th, equivalent to about a four-fold difference in fruit consumption and a doubling of vegetable consumption. RESULTS: The association with ischaemic heart disease was of similar magnitude for all six dietary markers of fruit and vegetable consumption. The median of the six estimates was that risk was 15% (range 12-19%) lower at the 90th centile of consumption than at the 10th. The estimates were generally adjusted for the possible confounding effect of other heart disease risk factors. The serum studies of vitamin C were consistent with this; those of carotenoids suggested a larger difference (43%) but were not adjusted for the important confounding effect of smoking. The substances in fruit and vegetables responsible for the protective effect on heart disease are uncertain but the effect is commensurate with the estimated protective effects of the potassium and folate in fruit and vegetables. Beta-carotene or vitamin E are not likely to be important because randomised trials of these vitamins in large doses have shown no reduction in heart disease mortality. CONCLUSIONS: The risk of ischaemic heart disease is about 15% lower at the 90th than the 1Oth centile of fruit and vegetable consumption.

Adult↗
PubMed1999

Variation in fruit and vegetable consumption among adults in Britain. An analysis from the dietary and nutritional survey of British adults.

OBJECTIVES: Using a national representative sample to examine variation in fruit and vegetable consumption among adults in the UK, with particular reference to consumers with high and low reported intakes. DESIGN: National representative dietary survey using 7-d weighed diet records of men and women aged 16-64 y living in private households in the UK in 1986-1987. SETTING: The UK. SUBJECTS: 1087 men and 1110 women. The sample was selected by a multi-stage random probability design. The response was 70%. Subjects with low energy intake were subsequently excluded. MAIN OUTCOME MEASURES: Food group, nutrient intake, physiological measures socio-economic, demographic and behavioural characteristics. RESULTS: Consumption of fruit and vegetables was estimated. The sample was divided by sex into four quarter groups according to fruit and vegetable consumption. There were significant similarities between quarter groups in fruit and vegetable and other food intake, nutrient intake, physiological measures, and socioeconomic, demographic and behavioural variable. The lowest consumers of fruit and vegetables had a mean intake of 738 g/week (men) and 630 g/week (women), equivalent to 1.3 and 1.1 portion/d, respectively. Conversely, the mean intake of both men women with the highest consumption was 3137 g/week (5.6 portions day). There were more than twice as many adults in the age group 16-24 located in Q1 than in Q4. The Manual social class and those in receipt of benefits were negatively associated with fruit and vegetable consumption. Smokers were significantly associated with low fruit and vegetable intake. Being married was associated with increased fruit and vegetable intake and being single or divorced/separated was associated with low fruit and vegetable intake. Eating home grown produce was associated with high intake. Consumers who lived in London or the South-East were associated with higher fruit and vegetable intake. CONCLUSIONS: The analysis draws attention to the wide variation in reported fruit and vegetable consumption among British adults. High consumers merit further investigation to elucidate practical strategies for increasing fruit and vegetable consumption. Strategies to increase consumption should be targeted at groups most likely to include low consumers of fruits and vegetables. SPONSORSHIP: London School of Hygiene and Tropical Medicine.

Adolescent↗
PubMed1998

Influence of alcohol consumption and various beverages on waist girth and waist-to-hip ratio in a sample of French men and women.

OBJECTIVE: The goal of the present study was to assess the association between alcohol consumption and abdominal fat deposition in France, a country where wine is the most commonly consumed alcoholic beverage. METHODS: We analyzed the association between alcohol consumption and various markers of body weight, in a population sample recruited in three distinct geographical areas of France (MONICA centers). This sample included men (n = 1778) and women (n = 1730) aged 35- 64 y, randomly selected from electoral rolls. Alcohol consumption was assessed with a quantitative frequency questionnaire. RESULTS: Alcohol intake ranged from 0-1655 ml of alcohol per week. Wine was the main source of alcohol, representing 67% of total alcohol intake in both genders. In men, there was no association between alcohol intake and body mass index (BMI) or body weight, whereas in women, alcohol consumption was inversely correlated with BMI (P < 0.0001) and body weight (P < 0.0002). In men, total alcohol consumption was positively associated with waist-to-hip ratio (WHR, P < 0.0002) and waist girth (P < 0.004), independently of BMI. Similarly, in women, positive associations were found between alcohol intake and WHR (P < 0.0001) as well as waist girth (P < 0.0001), independently of BMI. In a linear regression model including types of beverages and usual confounders, reporting consumption of either wine, beer or spirit was poorly associated with WHR in men, whereas wine (P < 0.0008) and beer (P < 0.0001) consumptions were both positively associated with WHR in women. However, there was no evidence of a statistically significant heterogeneous effect of wine, beer and spirits on WHR in both genders. CONCLUSION: In a sample of representative French people, in whom wine is the most common alcoholic beverage, alcohol consumption is associated with greater WHR independently of BMI in both men and women.

Adult↗