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PubMed2000

A multiethnic cohort in Hawaii and Los Angeles: baseline characteristics.

The authors describe the design and implementation of a large multiethnic cohort established to study diet and cancer in the United States. They detail the source of the subjects, sample size, questionnaire development, pilot work, and approaches to future analyses. The cohort consists of 215,251 adult men and women (age 45-75 years at baseline) living in Hawaii and in California (primarily Los Angeles County) with the following ethnic distribution: African-American (16.3%), Latino (22.0%), Japanese-American (26.4%), Native Hawaiian (6.5%), White (22.9%), and other ancestry (5.8%). From 1993 to 1996, participants entered the cohort by completing a 26-page, self-administered mail questionnaire that elicited a quantitative food frequency history, along with demographic and other information. Response rates ranged from 20% in Latinos to 49% in Japanese-Americans. As expected, both within and among ethnic groups, the questionnaire data show substantial variations in dietary intakes (nutrients as well as foods) and in the distributions of non-dietary risk factors (including smoking, alcohol consumption, obesity, and physical activity). When compared with corresponding ethnic-specific cancer incidence rates, the findings provide tentative support for several current dietary hypotheses. As sufficient numbers of cancer cases are identified through surveillance of the cohort, dietary and other hypotheses will be tested in prospective analyses.

Black or African American↗
PubMed2000

Calibration of the dietary questionnaire for a multiethnic cohort in Hawaii and Los Angeles.

The performance of the dietary questionnaire used in a multiethnic cohort study in Hawaii and Los Angeles was assessed in a calibration substudy that compared diet reported from the questionnaire with three 24-hour dietary recalls. For the calibration substudy, subjects from each of eight subgroups defined by sex and ethnic group (African-American, Japanese-American, Latino, and White) were chosen randomly from among the cohort members, and each participant's previous day's diet was assessed by telephone recall on three occasions over approximately 2 months. After completing the three 24-hour recalls, each calibration subject was sent a second questionnaire; 1,606 persons completed three recalls and a second questionnaire (127 to 267 per ethnic-sex group). This report describes correlation coefficients and calibration slopes for the relation between the 24-hour recalls and second questionnaire values for a selected set of macro- and micronutrients, as absolute intakes, nutrient densities, and calorie-adjusted nutrients. In all subgroups, estimates of the correlation between the questionnaire and 24-hour recalls were greater after energy adjustment (average correlations ranged from 0.57-0.74 for nutrient densities and from 0.55-0.74 for calorie-adjusted nutrients) than when absolute nutrient values were used (average range 0.26-0.57). For absolute nutrient intakes, the correlations were greatest for Whites, somewhat lower for Japanese-Americans and Latinos, and lowest for African-Americans. After energy adjustment, the difference between subgroups were diminished, and the correlations were generally highly satisfactory.

Black or African American↗
PubMed1975

Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: mortality.

Stroke, coronary heart disease (CHD) and total mortality are evaluated from death certificates in enumerated cohorts of 45-64-year old Japanese men in Hiroshima and Nagasaki (1965-1970), in Homolulu (1966-1970), and in the San Francisco area (1968-1972). Total mortality is highest in Japan with no consistent differences between Japanese Americans in Homolulu and San Francisco. Age-specific CHD death rates are markedly lower in all three Japanese groups than in American whites. The CHD rates are consistently and significantly lower in Japan that in American Japanese. Stroke death rates for American Japanese men appear equivalent to figures for US white men of the same age, but are significantly lower than in the Japan cohort for the 60-64-year-old group. The number of stroke deaths below that age are too few as yet for analysis. Validation of mortality ascertainment and of the accuracy of death certification has been carried out in Japan and in Hawaii. The international differences in mortaltiy do not appear to be due to certification or other methodologic artifact.

Age Factors↗
PubMed1979

Childhood cultural experience and the incidence of coronary heart disease in Hawaii Japanese men.

Possible effects of cultural variables on the risk of coronary heart disease (CHD) were examined in 7705 men of Japanese ancestry living in Hawaii. The six-year incidence of CHD was related to birthplace (Japan or elsewhere), number of years spent in Japan, ability to read and write Japanese, ability to speak Japanese, and to an index of preference for a traditional Japanese diet. Statistically significant inverse relationships were found between CHD incidence and all of these variables which reflect the degree of exposure to Japanese culture during childhood. In multivariate analyses where the major CHD risk factors were taken into account, years spent in Japan and ability to read and write Japanese remained significant. Hence, exposure to Japanese culture during childhood appears to protect against CHD in adulthood. This may explain, in part, the gradient of CHD frequency among Japanese in Japan, Japanese-Americans, and Caucasians that could not be entirely attributed to the established risk factors.

Acculturation↗
PubMed1982

Acculturation and coronary heart disease among Japanese men in Hawaii.

A cohort of 4653 men of Japanese ancestry living in Hawaii, with traditional Japanese social and cultural lifestyles, were studied for the association of the prevalence and incidence of coronary heart disease (Honolulu Heart Program, 1971-1979). Two of four scales of acculturation were significantly associated with coronary heart disease prevalence independently of 11 other risk factors, but none of the acculturation scales were associated with incidence appeared to be mostly due to the inclusion of fatal cases in the incidence data, although other explanations are possible. Measures of acculturation were also significantly associated wih many of the other coronary heart disease risk factors in such a way that the more traditional Japanese men had lower serum cholesterol and uric acid, were less obese, more physically active, and smoked fewer cigarettes than the more westernized men. A comparison of bivariate and multivariate analyses indicated that some of acculturation scales were indirectly associated with coronary heart disease because of the confounding association with the other risk factors.

Acculturation↗
PubMed1983

Social networks and coronary heart disease among Japanese men in Hawaii.

A group of 4653 men of Japanese ancestry living in Hawaii were studied for the association of measures of social networks with both the prevalence and incidence rates of coronary heart disease (Honolulu Heart Program, 1971-1979). Prevalence rates for myocardial infarction, angina, and total coronary heart disease were inversely associated with the social network scales in bivariate analyses with age, and in multivariate analyses including 12 other risk factors. With the incidence data, the associations were less evident. Bivariate analysis with age revealed inverse associations for nonfatal myocardial infarction and total coronary heart disease with only one of the social network scales. With multivariate analyses, there was no significant association of any subgroup of coronary heart disease with any scale, although there was a borderline association (p = 0.08) of nonfatal myocardial infarction with one scale. No individual question was significantly associated with either prevalence or incidence rates for coronary heart disease. There was also little evidence of reduced risk of incident coronary heart disease associated with the social network scale for men in high risk categories of serum cholesterol, blood pressure, and cigarette smoking.

Aged↗
PubMed1984

Dietary vitamin A, carotene, vitamin C and risk of lung cancer in Hawaii.

The authors conducted a case-control study among the multiethnic population of Hawaii to test the hypotheses that lung cancer risk is inversely associated with dietary intake of total vitamin A, carotene, and vitamin C. Detailed dietary interviews were completed between September 1979 and October 1982 for 364 primary lung cancer patients and 627 general population controls matched on age and sex. After adjusting for a number of potentially confounding variables, including ethnicity, smoking history, and occupation, evidence was found that total vitamin A intake (food sources plus supplements), vitamin A intake from food sources only, and carotene intake were each inversely associated with lung cancer risk in males, but not in females. Among males, a monotonic dose-response relationship was found only for total vitamin A intake. However, a comparison of the lowest and highest quartiles of intake gave similar results for each of the three measures of nutrient intake: total vitamin A (odds ratio (OR) = 1.8; 95% confidence limits (CL) = 1.1-3.1), vitamin A from foods (OR = 2.0; 95% CL = 1.2-3.5), and carotene (OR = 2.2; 95% CL = 1.3-3.7). Similar analyses revealed no significant association between dietary vitamin C intake and lung cancer risk.

Aged↗
PubMed1984

Causal analysis of infant deaths in Hawaii.

Infant mortality among the 34,330 births registered in Hawaii during 1978-1979 was analyzed by means of several methods. Path analysis showed the Apgar score to be the best predictor of mortality, although the effects of birth weight, gestation time and preconceptional and postconceptional factors were all highly significant. Commingling analysis attributed 41% of the deaths to high risk factors recognized from the birth certificate. The infant mortality was lowest in tracts with the highest socioeconomic and health standards, but individual variation in socioeconomic standards was a poor predictor of mortality.

Apgar Score↗
PubMed1985

Psychosocial processes and cancer incidence among Japanese men in Hawaii.

As part of the Honolulu Heart Program studies, 4,581 men of Japanese ancestry living in Hawaii completed a psychosocial questionnaire in 1971. By 1980, 280 new cancer cases had been recorded. Among 12 items related to stressful life situations, there were no consistent associations with total or site-specific cancer incidence. Most of the associations which were found were in the direction opposite to that predicted by the stress hypothesis. Among eight items related to social networks, two were significantly associated with total cancer incidence in multivariate analysis, but one of these associations was in the direction opposite to that of the social support hypothesis. Among the different measures of acculturation, there was a general pattern indicating that ties to traditional Japanese culture and diet were associated with an increased risk of cancer. Cancer incidence was associated with low levels of socioeconomic status. In general, there was little evidence to support the idea that either stressful or supportive life situations were associated with cancer incidence.

Aged↗
PubMed1986

Coffee, caffeine, and serum cholesterol in Japanese men in Hawaii.

The relationship between coffee consumption and serum cholesterol was investigated in a cohort of 5,858 Japanese males born in 1900-1919 and living in Hawaii in 1965 who are currently followed by the Honolulu Heart Program. Data on coffee consumption, other dietary variables from a 24-hour dietary recall, and other potentially confounding variables collected in 1965 were correlated with serum cholesterol at that examination and at examination six years later. The mean coffee and tea consumption was 3.4 and 1.8 cups/day, respectively. Those consuming no coffee had a mean serum cholesterol of 210 mg/dl, while that of those drinking 9+ cups/day was 220 mg/dl (no such relationship was apparent with tea or cola). The relationship of coffee consumption and serum cholesterol with potentially confounding variables including body mass index, cigarette smoking, diastolic blood pressure, alcohol consumption, physical activity index, serum glucose, serum uric acid, education, age, and fat consumption was examined. When these variables were entered into a multiple regression equation with coffee consumption, a significant relationship between coffee consumption and serum cholesterol (p less than 0.001) persisted, as did that between baseline coffee consumption and serum cholesterol six years later (p less than 0.001). There was no significant relationship between tea or cola, the other major caffeine contributors to the diet, and baseline serum cholesterol. Thus, this analysis indicates a significant positive relationship between coffee consumption and serum cholesterol which is not present with other sources of caffeine.

Aged↗
PubMed1988

Diet and prostatic cancer: a case-control study in Hawaii.

A total of 452 cases of prostatic cancer identified through the population-based Hawaii Tumor Registry during the period 1977-1983 and 899 age-matched population controls were interviewed on the island of Oahu from 1981 to 1983. All interviews of the subjects, who comprised five different ethnic groups, were conducted in the home by use of a quantitative dietary history method. Usual weekly intake of fat, zinc, and vitamins A and C, including supplements, was determined for each subject. Among men 70 years or older, but not among younger men, and mean weekly consumption of saturated fat, carotenes, and zinc, adjusted for age and ethnicity, was greater for cases than for controls. In a multiple logistic regression analysis, the odds ratio for the highest quartile of fat intake among the older men was 1.7 (95% confidence interval (CI) 1.0-2.8). The corresponding odds ratios were 1.6 (95% CI 1.0-2.5) for carotenes, 1.4 (95% CI 0.9-2.3) for total vitamin C, and 1.7 (95% CI 1.1-2.7) for total zinc. There were significant linear trends in the odds ratios for saturated fat and zinc, but no synergistic interactions among the nutrients. The findings suggest that several different components of the diet may contribute independently to the risk of prostatic cancer in elderly men.

Aged↗
PubMed1988

The effect of dietary cholesterol and fat on the risk of lung cancer in Hawaii.

A population-based case-control study of the association between dietary lipids and lung cancer was carried out in Hawaii between March 1983 and October 1985. The sample included 226 men and 100 women with lung cancer and 597 male and 268 female controls, frequency-matched to the cases on sex and five-year age group. Personal interviews were conducted in the home by trained interviewers using a quantitative diet history method. The items in the questionnaire were chosen to provide an estimate of 85% or more of the intakes of dietary cholesterol and fat for individuals in each of the five ethnic groups included in the study. The results showed a significant positive association of dietary cholesterol and the risk of lung cancer in men, but not in women. The odds ratio for the risk of lung cancer among men in the highest compared with the lowest quartile of cholesterol intake was 2.2 (95% confidence interval 1.3-3.8). Although there was a significant trend (p less than 0.05), the effect of cholesterol suggested a threshold rather than a continuous gradient. The association of cholesterol and lung cancer was consistent for three of four ethnic groups analyzed separately. These results confirmed earlier findings by these investigators. The effect of cholesterol on the development of lung cancer was restricted to current cigarette smokers who smoked tobacco heavily and to squamous and small cell histologic types of lung cancer. Similar results were found for total, saturated, and, to some extent, unsaturated dietary fat, but because of the high correlation between fat and cholesterol (r = 0.76 for total fat and cholesterol), it was not possible to separate the effects of these nutrients.

Adult↗
PubMed1991

Vegetable and fruit consumption in relation to prostate cancer risk in Hawaii: a reevaluation of the effect of dietary beta-carotene.

This is a further analysis of a case-control study of 452 prostate cancer cases and 899 population controls that was conducted in 1970-1983 among the multiethnic population of Hawaii. Because a previous analysis had shown a positive association with intake of beta-carotene, a nutrient presently being tested for chemoprevention, the authors reexamined the data for consistency among the main food sources of beta-carotene. Vegetables and fruits containing other phytochemicals suspected to be cancer inhibitors were also examined. With the exception of papaya, which was positively associated with risk among men aged 70 years and older, consumption of other yellow-orange fruits and vegetables, tomatoes, dark green vegetables, and cruciferous vegetables was not associated with prostate cancer risk. These results suggest that: 1) the positive association with beta-carotene intake among older men that the authors previously reported was essentially due to the greater papaya consumption of cases compared with controls; and 2) intake of beta-carotene, lycopene, lutein, indoles, phenols, or other phytochemicals is not associated with prostate cancer risk.

Aged↗
PubMedDate not supplied

A statewide hepatitis B vaccination program for school children in Hawaii: vaccination series completion and participation rates over consecutive school years.

OBJECTIVE: The authors assessed a statewide school-based Hepatitis B (HepB) vaccination program for preadolescents in Hawaii over three consecutive school years. Factors assessed included number of schools and students participating and number of students receiving three doses of hepatitis B vaccine. METHODS: Records of the program, which targeted 4th and/or 5th graders in public and private schools, were reviewed for the period from 1996 to 1999. RESULTS: The proportion of participating schools increased from 76% of all schools in the state in School Year 1 to 94% in School Year 3. The proportion of children with completed consent forms who received three doses of HepB vaccine at school exceeded 80% throughout the project. In School Year 1, 10,003 (70%) of 14,333 children enrolled at participating schools received three vaccine doses in school; however, this proportion declined over subsequent school years to 51% (7,722/15,013) in School Year 2 and 24% (7,344/30,429) in School Year 3. A survey of 477 parents not consenting to school vaccination indicated that 84% of their children completed the vaccine series at a private provider office. CONCLUSION: Statewide school-based HepB vaccination campaigns for at-risk populations can result in a majority of children in targeted age groups receiving three doses of hepatitis B vaccine, though declining participation may be observed as uptake in the private sector increases.

Child↗
PubMed2001

Morphological and physiological adjustment to N and P fertilization in nutrient-limited Metrosideros polymorpha canopy trees in Hawaii.

Leaf-level studies of Metrosideros polymorpha Gaud. (Myrtaceae) canopy trees at both ends of a substrate age gradient in the Hawaiian Islands pointed to differential patterns of adjustment to both nutrient limitation and removal of this limitation by long-term (8-14 years) nitrogen (N), phosphorus (P) and N + P fertilizations. The two study sites were located at the same elevation, had similar annual precipitation, and supported forests dominated by M. polymorpha, but differed in the age of the underlying volcanic substrate, and in soil nutrient availability, with relatively low N at the young site (300 years, Thurston, Hawaii) and relatively low P at the oldest site (4,100,000 years, Kokee, Kauai). Within each site, responses to N and P fertilization were similar, regardless of the difference in soil N and P availability between sites. At the young substrate site, nutrient addition led to a larger mean leaf size (about 7.4 versus 4.8 cm2), resulting in a larger canopy leaf surface area. Differences in foliar N and P content, chlorophyll concentrations and carboxylation capacity between the fertilized and control plots were small. At the old substrate site, nutrient addition led to an increase in photosynthetic rate per unit leaf surface area from 4.5 to 7.6 micromol m(-2) s(-1), without a concomitant change in leaf size. At this site, leaves had substantially greater nutrient concentrations, chlorophyll content and carboxylation capacity in the fertilized plots than in the control plots. These contrasting acclimation responses to fertilization at the young and old sites led to significant increases in total carbon gain of M. polymorpha canopy trees at both sites. At the young substrate site, acclimation to fertilization was morphological, resulting in larger leaves, whereas at the old substrate site, physiological acclimation resulted in higher leaf carboxylation capacity and chlorophyll content.

Hawaii↗
PubMed1986

HTLV-I-associated T-cell leukemia in Hawaii.

Adult T-cell leukemia (ATL) is a disease found endemic in Southern Japan and the Caribbean basin. The human T-cell leukemia virus I (HTLV-I) has been implicated epidemiologically as the causative agent in this disease. This paper describes the identification of this disease in Hawaii in a second generation immigrant from Southern Japan. The disease was initially indolent, then clinically explosive, characterized by cutaneous lesions, leukemic lymphocytes with convoluted nuclei of T-cell phenotype, hypercalcemia, and a terminal infection.

Asian↗
PubMed1994

Animal fat consumption and prostate cancer: a prospective study in Hawaii.

Whereas case-control studies have been very consistent in suggesting a positive association between intake of dietary fat, especially animal fat, and prostate cancer, the results from past cohort studies have been mostly inconclusive. In this study, we evaluated consumption of high-fat animal products, raw vegetables, and fresh fruits, as well as obesity, smoking, and drinking, in relation to subsequent occurrence of prostate cancer. We studied a cohort of 20,316 men of various ethnicities interviewed between 1975 and 1980 in Hawaii. As of December 1989, 198 incident cases with invasive prostate cancer were identified by computer-assisted linkage of this cohort to the statewide Surveillance, Epidemiology, and End Results registry. Relative risks (RRs) for prostate cancer computed by proportional hazards regression were elevated for intake of beef [RR for highest to lowest tertile of intake = 1.6; 95% confidence interval (CI) = 1.1-2.4] and milk (RR = 1.4; 95% CI = 1.0-2.1), and for a summary variable for intake of high-fat animal products (RR = 1.6; 95% CI = 1.0-2.4). Weight was not consistently associated with prostate cancer, but there was an association with height (> 167 cm) (RR = 1.8; 95% CI = 1.0-3.2 for the third and fourth quartiles relative to the lowest quartile in height). These associations were stronger in men diagnosed before age 72.5 years. The risk estimates for raw vegetable and fresh fruit intakes were close to 1.0. Smoking and alcohol drinking appeared to be unrelated to risk.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

A case-control study of mesothelioma and employment in the Hawaii sugarcane industry.

We conducted a case-control study of 93 mesothelioma cases and 281 cancer controls to determine whether sugarcane workers exposed to biogenic silica fibers were at increased risk of mesothelioma. We found no important excess risk of mesothelioma in sugarcane workers [odds ratio (OR) = 1.3; 95% confidence interval (CI) = 0.4-3.8] when we excluded all control subjects with cancer of sites suspected of being associated with asbestos exposure. We could not identify any sugarcane workers who developed mesothelioma and worked in jobs where high exposure levels of biogenic silica fibers have been measured. We did confirm that mesothelioma risk in Hawaii is associated with probable occupational asbestos exposure. Work at the Pearl Harbor Naval Shipyard was associated with a 10-fold increase in mesothelioma when we excluded controls with cancer of sites related to asbestos exposure (OR = 10.1; 95% CI = 2.6-56.6). Work in the medical industry was also associated with an unexpected increased risk for mesothelioma (OR = 4.2; 95% CI = 1.2-15.5).

Agricultural Workers' Diseases↗