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Wu S, Wu Y, Hu X, Wu F, Zhao J, Pan F, Liu X, Li Y, Ao Y, Zhuang P, Jiao J, Zheng W, Zhang Y. Fruit but not vegetable consumption is beneficial for low prevalence of colorectal polyps in a high-risk population: findings from a Chinese Lanxi Pre-colorectal Cancer Cohort study. Eur J Nutr 2024; 63:1759-1769. [PMID: 38622294 DOI: 10.1007/s00394-024-03377-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 03/15/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE The available evidence regarding the role of fruit and vegetable consumption in the development of colorectal polyps remains inconclusive, and there is a lack of data on different histopathologic features of polyps. We aimed to evaluate the associations of fruit and vegetable consumption with the prevalence of colorectal polyps and its subtypes in a high-risk population in China. METHODS We included 6783 Chinese participants aged 40-80 years who were at high risk of colorectal cancer (CRC) in the Lanxi Pre-colorectal Cancer Cohort (LP3C). Dietary information was obtained through a validated food-frequency questionnaire (FFQ), and colonoscopy screening was used to detect colorectal polyps. Dose-response associations of fruit and vegetable intake with the prevalence of polyps were calculated using multivariate-adjusted regression models, which was reported as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS 2064 cases of colorectal polyps were ascertained in the LP3C during 2018-2019. Upon multivariable adjustments, including the diet quality, fruit consumption was inversely associated with the prevalence of polyps (P trend = 0.02). Participants in the highest tertile of fruit intake had a 25% lower risk (OR: 0.75; 95% CI 0.62‒0.92) compared to non-consumers, while vegetable consumption had no significant association with polyp prevalence (P trend = 0.86). In terms of colorectal histopathology and multiplicity, higher fruit intake was correlated with 24, 23, and 33% lower prevalence of small polyps (OR: 0.76; 95% CI 0.62‒0.94; P trend = 0.05), single polyp (OR: 0.77; 95% CI 0.62‒0.96; P trend = 0.04), and distal colon polyps (OR: 0.67; 95% CI 0.51‒0.87; P trend = 0.003), respectively. CONCLUSIONS Fresh fruit is suggested as a protective factor to prevent colorectal polyps in individuals at high risk of CRC, and should be underscored in dietary recommendations, particularly for high-risk populations.
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Affiliation(s)
- Shengzhi Wu
- Lanxi Red Cross Hospital, Jinhua, 321000, Zhejiang, China
| | - Yuqi Wu
- Department of Food Science and Nutrition, Zhejiang Key Laboratory for Agro-Food Processing, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Xiaodong Hu
- Lanxi Red Cross Hospital, Jinhua, 321000, Zhejiang, China
| | - Fei Wu
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Jing Zhao
- Lanxi Red Cross Hospital, Jinhua, 321000, Zhejiang, China
| | - Fuzhen Pan
- Lanxi Hospital of Traditional Chinese Medicine, Jinhua, 321100, Zhejiang, China
| | - Xiaohui Liu
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Yin Li
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Yang Ao
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Pan Zhuang
- Department of Food Science and Nutrition, Zhejiang Key Laboratory for Agro-Food Processing, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Jingjing Jiao
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Weifang Zheng
- Lanxi Hospital of Traditional Chinese Medicine, Jinhua, 321100, Zhejiang, China.
| | - Yu Zhang
- Department of Food Science and Nutrition, Zhejiang Key Laboratory for Agro-Food Processing, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, 310058, Zhejiang, China.
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Sakboonyarat B, Rangsin R. Hospital admission and mortality rates for ischemic heart disease in Thailand: 2012-2021. BMC Res Notes 2024; 17:142. [PMID: 38764092 PMCID: PMC11102613 DOI: 10.1186/s13104-024-06803-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 05/13/2024] [Indexed: 05/21/2024] Open
Abstract
OBJECTIVE To provide an update on the epidemiology of ischemic heart disease (IHD), including the age-standardized rates of hospital admission and mortality for IHD in Thailand from 2012 to 2021, using the Ministry of Public Health National database. RESULTS The overall age-standardized hospital admission rate for IHD decreased from 427.5 per 100,000 people in 2012 to 390.5 per 100,000 in 2021. In men, the age-standardized hospital admission rate was 462.7 per 100,000 people in 2012, reaching 485.8 per 100,000 in 2021, p for trend = 0.141. In women, the age-standardization hospital admission rate for IHD dropped by 24.1% over the decade (p for trend = 0.008). The overall age-standardized IHD mortality rate in 2012 was 23.4 per 100,000 people, peaked at 28.6 per 100,000 in 2016, and reached 26.9 per 100,000 in 2021, p for trend = 0.181. In men, the age-standardized IHD mortality rate rose by 26.6% over a decade, p for trend = 0.004. The age-standardized IHD mortality rate among women was consistent from 2012 to 2021, p for trend = 0.130. However, for people aged < 60, rising trends in IHD mortality rates over a decade were observed; it rose by 59.6% in men and 36.1% in women.
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Affiliation(s)
- Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand.
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Wu J, Feng Y, Zhao Y, Guo Z, Liu R, Zeng X, Yang F, Liu B, Gu J, Tarimo CS, Shao W, Guo X, Li Q, Zhao L, Ma M, Shen Z, Zhao Q, Miao Y. Lifestyle behaviors and risk of cardiovascular disease and prognosis among individuals with cardiovascular disease: a systematic review and meta-analysis of 71 prospective cohort studies. Int J Behav Nutr Phys Act 2024; 21:42. [PMID: 38650004 PMCID: PMC11036700 DOI: 10.1186/s12966-024-01586-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/20/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Healthy lifestyle behaviors (LBs) have been widely recommended for the prevention and management of cardiovascular disease (CVD). Despite a large number of studies exploring the association between combined LBs and CVD, a notable gap exists in integration of relevant literatures. We conducted a systematic review and meta-analysis of prospective cohort studies to analyze the correlation between combined LBs and the occurrence of CVD, as well as to estimate the risk of various health complications in individuals already diagnosed with CVD. METHODS Articles published up to February 10, 2023 were sourced through PubMed, EMBASE and Web of Science. Eligible prospective cohort studies that reported the relations of combined LBs with pre-determined outcomes were included. Summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated using either a fixed or random-effects model. Subgroup analysis, meta-regression, publication bias, and sensitivity analysis were as well performed. RESULTS In the general population, individuals with the healthiest combination of LBs exhibited a significant risk reduction of 58% for CVD and 55% for CVD mortality. For individuals diagnosed with CVD, adherence to the healthiest combination of LBs corresponded to a significant risk reduction of 62% for CVD recurrence and 67% for all-cause mortality, when compared to those with the least-healthy combination of LBs. In the analysis of dose-response relationship, for each increment of 1 healthy LB, there was a corresponding decrease in risk of 17% for CVD and 19% for CVD mortality within the general population. Similarly, among individuals diagnosed with CVD, each additional healthy LB was associated with a risk reduction of 27% for CVD recurrence and 27% for all-cause mortality. CONCLUSIONS Adopting healthy LBs is associated with substantial risk reduction in CVD, CVD mortality, and adverse outcomes among individuals diagnosed with CVD. Rather than focusing solely on individual healthy LB, it is advisable to advocate for the adoption of multiple LBs for the prevention and management of CVD. TRIAL REGISTRATION PROSPERO: CRD42023431731.
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Affiliation(s)
- Jian Wu
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yifei Feng
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yuanyuan Zhao
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Zhiping Guo
- Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Rongmei Liu
- Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xin Zeng
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Fan Yang
- School of Public Health, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, People's Republic of China
| | - Bei Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Jianqing Gu
- Healthy Lifestyle Medicine Research Center, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, People's Republic of China
| | - Clifford Silver Tarimo
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Department of Science and Laboratory Technology, Dar es Salaam Institute of Technology, P.O. Box 2958, Dar es Salaam, Tanzania
| | - Weihao Shao
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xinghong Guo
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Quanman Li
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Lipei Zhao
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Mingze Ma
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Zhanlei Shen
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Qiuping Zhao
- Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Yudong Miao
- Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
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Zhang M, Wei J, Sun Y, He C, Ma S, Pan X, Zhu X. The efferocytosis process in aging: Supporting evidence, mechanisms, and therapeutic prospects for age-related diseases. J Adv Res 2024:S2090-1232(24)00109-7. [PMID: 38499245 DOI: 10.1016/j.jare.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Aging is characterized by an ongoing struggle between the buildup of damage caused by a combination of external and internal factors. Aging has different effects on phagocytes, including impaired efferocytosis. A deficiency in efferocytosis can cause chronic inflammation, aging, and several other clinical disorders. AIM OF REVIEW Our review underscores the possible feasibility and extensive scope of employing dual targets in various age-related diseases to reduce the occurrence and progression of age-related diseases, ultimately fostering healthy aging and increasing lifespan. Key scientific concepts of review Hence, the concurrent implementation of strategies aimed at augmenting efferocytic mechanisms and anti-aging treatments has the potential to serve as a potent intervention for extending the duration of a healthy lifespan. In this review, we comprehensively discuss the concept and physiological effects of efferocytosis. Subsequently, we investigated the association between efferocytosis and the hallmarks of aging. Finally, we discuss growing evidence regarding therapeutic interventions for age-related disorders, focusing on the physiological processes of aging and efferocytosis.
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Affiliation(s)
- Meng Zhang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Jin Wei
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Yu Sun
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Chang He
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Shiyin Ma
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Xudong Pan
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
| | - Xiaoyan Zhu
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
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Peng W, Bai X, Yang Y, Cui J, Xu W, Song L, Yang H, He W, Zhang Y, Zhang X, Li X, Lu J. Healthy lifestyle, statin, and mortality in people with high CVD risk: A nationwide population-based cohort study. Am J Prev Cardiol 2024; 17:100635. [PMID: 38327628 PMCID: PMC10847055 DOI: 10.1016/j.ajpc.2024.100635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 12/09/2023] [Accepted: 01/21/2024] [Indexed: 02/09/2024] Open
Abstract
Objective To examine the joint association of healthy lifestyles and statin use with all-cause and cardiovascular mortality in high-risk individuals, and evaluate the survival benefits by life expectancy. Methods During 2015-2021, participants aged 35-75 years were recruited by the China Health Evaluation And risk Reduction through nationwide Teamwork. Based on number of healthy lifestyles related to smoking, alcohol drinking, physical activity, and diet, we categorized them into: very healthy (3-4), healthy (2), and unhealthy (0-1). Statin use was determined by self-report taking statin in last two weeks. Results Among the 265,209 included participants at high risk, 6979 deaths were observed, including 3236 CVD deaths during a median 3.6 years of follow-up. Individuals taking statin and with a very healthy lifestyle had the lowest risk of all-cause (HR: 0.70; 95 %CI: 0.57-0.87) and cardiovascular mortality (0.56; 0.40-0.79), compared with statin non-users with an unhealthy lifestyle. High-risk participants taking statin and with a very healthy lifestyle had the highest years of life gained (5.90 years at 35-year-old [4.14-7.67; P < 0.001]) compared with statin non-users with an unhealthy lifestyle among high-risk people. And their life expectancy was comparable with those without high risk but with a very healthy lifestyle (4.49 vs. 4.68 years). Conclusion The combination of preventive medication and multiple healthy lifestyles was associated with lower risk of all-cause and cardiovascular mortality and largest survival benefits. Integrated strategy to improve long-term health for high-risk people was urgently needed.
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Affiliation(s)
- Wenyao Peng
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Xueke Bai
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Yang Yang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Jianlan Cui
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Wei Xu
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Lijuan Song
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Hao Yang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Wenyan He
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Yan Zhang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Xingyi Zhang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Xi Li
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, PR China
- Central China Sub-center of the National Center for Cardiovascular Diseases, Zhengzhou, PR China
| | - Jiapeng Lu
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
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John U, Rumpf HJ, Hanke M, Meyer C. Behavior-related health risk factors, mental disorders and mortality after 20 years in a working aged general population sample. Sci Rep 2023; 13:16764. [PMID: 37798350 PMCID: PMC10556137 DOI: 10.1038/s41598-023-43669-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 09/27/2023] [Indexed: 10/07/2023] Open
Abstract
Mortality is predicted by the sum of behavior-related health risk factors (BRFs: tobacco smoking, alcohol drinking, body overweight, and physical inactivity). We analyzed degrees and combinations of BRFs in their relation to mortality and adjusted for mental disorders. In a random sample of the general population in northern Germany aged 18-64, BRFs and mental disorders had been assessed in 1996-1997 by the Munich Composite International Diagnostic Interview. A sum score including eight ranks of the behavior-related health risk factors was built. Death and its causes were ascertained 2017-2018 using residents' registration files and death certificates. Relations of the sum score and combinations of the BRFs at baseline with all-cause, cancer, and cardiovascular mortality 20 years later were analyzed. The sum score and combinations predicted all-cause, cardiovascular and cancer mortality. The odds ratio of the sum score was 1.38 (95% confidence interval 1.31-1.46) after adjustment for age, gender, and mental disorder. In addition to the BRFs, mood, anxiety or somatoform disorders were not related to mortality. We concluded that the sum score and combinations of behavior-related health risk factors predicted mortality, even after adjustment for mental disorders.
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Affiliation(s)
- Ulrich John
- Institute of Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, W.-Rathenau-Str. 48, 17475, Greifswald, Germany.
- German Center for Cardiovascular Research, partner site Greifswald, Greifswald, Germany.
| | - Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, Research Group S:TEP, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Monika Hanke
- Institute of Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, W.-Rathenau-Str. 48, 17475, Greifswald, Germany
| | - Christian Meyer
- Institute of Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, W.-Rathenau-Str. 48, 17475, Greifswald, Germany
- German Center for Cardiovascular Research, partner site Greifswald, Greifswald, Germany
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Shen J, Li Y, Xu M, Wu F, Jiang Y, Liu X, Ao Y, Lin Q, Zhuang P, Jiao J, Zheng W, Zhang Y. Association of egg consumption with colorectal polyp prevalence: findings from the Lanxi Pre-Colorectal Cancer Cohort (LP3C) in China. Food Funct 2023; 14:2597-2606. [PMID: 36847183 DOI: 10.1039/d2fo03061f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Eggs contain high-quality protein, lavish vitamins and other bioactive nutrients but are rich in cholesterol. Our study is designed to assess the association of egg intake with polyp prevalence. A total of 7068 participants at a high risk of CRC from the Lanxi Pre-Colorectal Cancer Cohort Study (LP3C) were recruited. A food frequency questionnaire (FFQ) was utilized to obtain dietary data through a face-to-face interview. Cases of colorectal polyps were identified by electronic colonoscopy. The logistic regression model was exploited to achieve odds ratios (ORs) and 95% confidence intervals (CIs). Overall 2064 cases of colorectal polyps were identified in the 2018-2019 survey of LP3C. A positive association of egg consumption with colorectal polyp prevalence was found after the multivariable adjustment [ORQ4 vs. Q1 (95% CI): 1.23 (1.05-1.44); Ptrend = 0.01]. However, a positive relationship disappeared after further adjustment for dietary cholesterol (Ptrend = 0.37), which explained that the harmful role of eggs could be ascribed to the high content of dietary cholesterol. Besides, a positive trend was found between dietary cholesterol and polyp prevalence [OR (95% CI): 1.21 (0.99-1.47); Ptrend = 0.04]. Furthermore, replacing 1 egg (50 g d-1) with an equal amount of total dairy products was related to 11% lower colorectal polyp prevalence [OR (95% CI): 0.89 (0.80-0.99); P = 0.03]. In summary, higher egg consumption was correlated with a higher polyp prevalence among the Chinese population at a high risk of CRC, which was ascribed to the high content of dietary cholesterol in eggs. Besides, individuals with the highest dietary cholesterol tended to have a higher polyp prevalence. Reducing the consumption of eggs and replacing eggs with total dairy products as alternative protein sources may prevent the occurrence of polyps in China.
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Affiliation(s)
- Jia Shen
- Lanxi Red Cross Hospital, Jinhua 321000, Zhejiang, China
| | - Yin Li
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Meihui Xu
- Lanxi Hospital of Traditional Chinese Medicine, Jinhua 321100, Zhejiang, China.
| | - Fei Wu
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Yanjie Jiang
- Lanxi Red Cross Hospital, Jinhua 321000, Zhejiang, China
| | - Xiaohui Liu
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Yang Ao
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Qianru Lin
- Lanxi Red Cross Hospital, Jinhua 321000, Zhejiang, China
| | - Pan Zhuang
- Zhejiang Key Laboratory for Agro-Food Processing, Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, Zhejiang, China.
| | - Jingjing Jiao
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Weifang Zheng
- Lanxi Hospital of Traditional Chinese Medicine, Jinhua 321100, Zhejiang, China.
| | - Yu Zhang
- Zhejiang Key Laboratory for Agro-Food Processing, Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, Zhejiang, China.
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Meraya AM. Preventive Medication Use among Adults Aged 40 and over in the United States: National Health and Nutrition Examination Survey, 2015-2018. Healthcare (Basel) 2022; 10:1875. [PMID: 36292322 PMCID: PMC9602427 DOI: 10.3390/healthcare10101875] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/12/2022] [Accepted: 09/23/2022] [Indexed: 12/02/2023] Open
Abstract
OBJECTIVES 1. To estimate the prevalence of preventive medication use among adults in the United States (US); 2. To identify the socioeconomic, demographic and clinical factors associated with preventive prescription medication use; 3. To identify the diagnoses associated with preventive prescription medication use. METHODS Data from two cycles of the National Health and Nutrition Examination Survey, 2015-2016 and 2017-2018, are analyzed. RESULTS Among US adults aged 40 years or older (N = 7634), 31% use a preventive medication. Specifically, 27% of them use aspirin and 9% use other preventive prescription medications. Among those who use other preventive prescription medications, 27% report using one of the cardiovascular agents and 24% reported using anticoagulants and/or antiplatelet agents. High percentages of preventive prescription medication users report using medications to prevent heart attacks/myocardial infarctions (25%) or blood clots (23%). Uninsured adults are less likely to use preventive medications (OR: 0.656; p-value = 0.009) as compared with their counterparts with private insurance. On the other hand, older adults and those with diabetes, heart disease, arthritis and hypertension are more likely to use preventive medications. Furthermore, past smokers and adults who never smoked are more likely to use preventive medications as compared with those who currently smoke. CONCLUSION Policies are needed to increase access to preventive care for uninsured adults. Further research needs to review the benefits and harms of the chronic use of preventive medication among older adults in the US.
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Affiliation(s)
- Abdulkarim M Meraya
- Department of Pharmacy Practice, Faculty of Pharmacy, Jazan University, Jazan P.O. Box 114-45124, Saudi Arabia
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Combined lifestyle, mental health, and mortality in US cancer survivors: a national cohort study. J Transl Med 2022; 20:376. [PMID: 35986290 PMCID: PMC9389483 DOI: 10.1186/s12967-022-03584-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 08/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background Adopting healthy lifestyles and staying mentally health are two cost-effective modifiable strategies that cancer survivors can implement in self-management. We aimed to evaluate the independent, mediation, interaction, and joint associations of combined lifestyle and mental health with mortality in cancer survivors. Methods We performed a cohort study including 3145 cancer survivors from National Health and Nutrition Examination Survey (2005–2018). A healthy lifestyle score was constructed based on post-diagnosis body mass index, physical activity, diet, smoking, and drinking. Post-diagnosis mental health was assessed by Patient Health Questionnaire (PHQ-9). Hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cancer, and non-cancer mortality were computed using Cox proportional hazards regression models. Results After 20,900 person-years of follow-up (median, 6.3 years), cancer survivors with higher lifestyle score had decreased mortality, independent of mental health. Compared to participants with lower lifestyle score (0–1), HRs (95% CIs) for all-cause and non-cancer mortality among those with higher lifestyle score (3–5) were 0.68 (0.52–0.89) and 0.69 (0.56–0.85), respectively. 6.2–10.3% of the associations were mediated by mental health. Similar trends were observed among participants categorized by mental health, those with better mental health had lower mortality, independent of lifestyle. Participants with better mental health benefited more from adopting healthy lifestyles, and vice versa. Combinations of higher healthy lifestyle score and better mental health were associated with significant decreased mortality, the lowest mortality was seen in participants with highest healthy lifestyle score and concurrently with best mental health. Conclusions For the first time, in this cohort study with a nationally representative sample of US cancer survivors, we comprehensively explored the complex associations of lifestyle, mental health, and mortality. Evidence derived from this study may give much confidence to cancer survivors and healthcare providers that, changing one’s lifestyle and/or staying mentally healthy after cancer diagnosis can improve survival. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-022-03584-4.
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Chai X, Li Y, Yin Z, Wu F, Hu P, Liu X, Tong S, Zhuang P, Zhang Y, Zheng W, Jiao J. Association of Meat Subtypes With Colorectal Polyp Prevalence: Finding From the Lanxi Pre-colorectal Cancer Cohort in China. Front Nutr 2022; 9:833571. [PMID: 35369045 PMCID: PMC8971953 DOI: 10.3389/fnut.2022.833571] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 02/18/2022] [Indexed: 01/10/2023] Open
Abstract
Background Although the detrimental effect of red meat on colorectal cancer (CRC) incidence has been extensively reported, no previous studies have comprehensively linked different meat subtypes with colorectal polyp occurrence. The aim was to assess the association of meat and subtypes with colorectal polyp prevalence for the high-risk CRC Chinese population. Besides, we also focused on the association according to sizes, subsites, and multiplicity of polyps. Methods High-risk CRC patients aged 40–80 years were enrolled into the Lanxi Pre-colorectal Cancer Cohort (LP3C) between March 2018 and December 2019. Cross-sectional analyses were conducted by using the baseline data from LP3C. A validated food frequency questionnaire (FFQ) was employed to collect dietary information. Odds ratios (ORs) and 95% confidence intervals (95% CIs) of colorectal polyp prevalence were estimated by multivariate logistic regression. Results 2,064 colorectal polyp cases were identified among 6,783 eligible participants in the survey of LP3C (March 2018 and December 2019). Total meat intake was positively related to rectum polyp prevalence (Pfor trend = 0.01) but was not linked to total colorectal polyps after multivariable adjustment. For meat subtypes, higher poultry consumption was significantly related to a higher polyp prevalence [ORQ4vs.Q1 (95% CI): 1.20 (1.02–1.42); Pfor trend = 0.03]. Processed red meat intake was linked to an increased small polyp prevalence (Pfor trend = 0.03) while unprocessed red meat had a relation with a higher rectum polyp prevalence (Pfor trend = 0.04). Furthermore, seafood intake had a significant association with a higher multiple polyp prevalence [ORQ4vs.Q1 (95% CI): 1.70 (1.31–2.21); Pfor trend < 0.001]. Conclusion The finding was that poultry meat consumption was related to a higher polyp prevalence. Besides, total meat consumption, processed and unprocessed red meat consumption, seafood consumption had a positive relation with certain polyp subtypes prevalence. Generally recommending reducing total meat consumption, including poultry, processed and unprocessed red meat, and seafood intake, may prevent colorectal polyps.
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Affiliation(s)
| | - Yin Li
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Zihan Yin
- Lanxi Red Cross Hospital, Jinhua, China
| | - Fei Wu
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | | | - Xiaohui Liu
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | | | - Pan Zhuang
- Zhejiang Key Laboratory for Agro-Food Processing, Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Fuli Institute of Food Science, Zhejiang University, Hangzhou, China
| | - Yu Zhang
- Zhejiang Key Laboratory for Agro-Food Processing, Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Fuli Institute of Food Science, Zhejiang University, Hangzhou, China
| | - Weifang Zheng
- Lanxi Hospital of Traditional Chinese Medicine, Jinhua, China
- *Correspondence: Weifang Zheng,
| | - Jingjing Jiao
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
- Jingjing Jiao,
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11
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Kelly NA, Soroka O, Onyebeke C, Pinheiro LC, Banerjee S, Safford MM, Goyal P. Association of healthy lifestyle and all-cause mortality according to medication burden. J Am Geriatr Soc 2022; 70:415-428. [PMID: 34695226 PMCID: PMC9036408 DOI: 10.1111/jgs.17521] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/12/2021] [Accepted: 09/18/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Healthy lifestyle is associated with reduced all-cause mortality, but it is not known whether this association persists for individuals with high medication burden. We examined the association between healthy lifestyle behaviors and all-cause mortality across different degrees of polypharmacy. METHODS This was a secondary analysis of 20,417 adults aged ≥45 years from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study. The primary exposure was healthy lifestyle (adherence to Mediterranean diet, physical activity, smoking abstinence, sedentary behavior avoidance, and composite healthy behavior score [HBS]). The primary outcome was all-cause mortality. Strata of medication burden were based on the number of medications taken (no polypharmacy: 0-4, polypharmacy: 5-9, hyperpolypharmacy: ≥10). We used Cox proportional hazards regression models to examine the association between healthy lifestyle behaviors and mortality within each medication burden stratum and examined for interactions with age. RESULTS The healthiest category of each lifestyle behavior, except sedentary behavior avoidance among the hyperpolypharmacy group, was associated with lower all-cause mortality (hazard ratio [HR]) regardless of medication burden: Mediterranean diet (no polypharmacy: HR 0.77, polypharmacy: HR 0.78, hyperpolypharmacy: HR 0.85), physical activity (no polypharmacy: HR 0.87, polypharmacy: HR 0.82, hyperpolypharmacy: HR 0.79), smoking abstinence (no polypharmacy: HR 0.40, polypharmacy: HR 0.45, hyperpolypharmacy: HR 0.52), and sedentary behavior avoidance (no polypharmacy: HR 0.88, polypharmacy: HR 0.86, hyperpolypharmacy: HR 0.95). Higher HBS was inversely associated with all-cause mortality within each medication burden stratum (no polypharmacy: HR 0.52, polypharmacy: HR 0.55, hyperpolypharmacy: HR 0.69). Although there was an interaction with age among those with no polypharmacy and those with polypharmacy, point estimates for HBS followed a graded pattern whereby higher HBS was incrementally associated with improved mortality across all age strata. CONCLUSION Greater adherence to a healthy lifestyle was associated with lower all-cause mortality irrespective of medication burden and age.
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Affiliation(s)
| | - Orysya Soroka
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine (New York, NY)
| | | | - Laura C. Pinheiro
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine (New York, NY)
| | - Samprit Banerjee
- Department of Healthcare Policy and Research, Weill Cornell Medicine (New York, NY)
| | - Monika M. Safford
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine (New York, NY)
| | - Parag Goyal
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine (New York, NY),Division of Cardiology, Department of Medicine, Weill Cornell Medicine (New York, NY)
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12
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Xi Y, Tian Q, Na B, Han K, Duan M, Zhang X, Wang W, Wang Y. Protocol of the Inner Mongolian Healthy Aging Study (IMAGINS): a longitudinal cohort study. BMC Public Health 2022; 22:115. [PMID: 35039022 PMCID: PMC8762848 DOI: 10.1186/s12889-022-12542-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) remain the leading cause of premature mortality and burden of diseases in the world. The Inner Mongolia Autonomous Region is located in northern China, constitute 17.66% individuals with Mongolian, which have unique diet and lifestyles. Therefore, the Inner Mongolian Healthy Aging Study (IMAGINS) was designed to explore risk factors for chronic diseases and evaluate the effectiveness of health management on CVDs in population at high-risk. METHODS The IMAGINS is an ongoing and prospective cohort study of men and women aged ≥35 years from Inner Mongolian Autonomous Region, northern China. This study performed in investigating risk factors for CVDs, screening and providing health management strategy for high-risk population of CVDs. The IMAGINS began in September 2015 and scheduled to recruiting and follow-up outcome until 2030. For general population, a long-term follow-up will be conducted every 5 years to collect the information above and data on clinical outcomes. For high-risk population, comprehensive health managements were performed and scheduled to follow-up annually. All IMAGINS participants are followed for incident CVDs and death. DISCUSSION The IMAGINS is designed to increase understanding how cardiovascular-related risk factors contribute to the development of CVDs and the positive effect of health management strategy for high-risk CVD participants. Key features of this study include (i) a carefully characterized cohort between high risk of CVDs and non-high risk population; (ii) detailed measurement of CVDs risk factors and health management strategies for high risk population; (iii) long-term follow-up of CVDs and death. The IMAGINS represents a good research opportunity to investigate clinical and genetic factors in high-risk population, might providing basis for the prevention and control of non-communicable diseases.
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Affiliation(s)
- Yunfeng Xi
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, Hohhot, 010000, China
| | - Qiuyue Tian
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 YouanmenXitoutiao, Beijing, 100069, China
| | - Buqi Na
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, Hohhot, 010000, China
| | - Ke Han
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, Hohhot, 010000, China
| | - Mingrui Duan
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 YouanmenXitoutiao, Beijing, 100069, China
| | - Xingguang Zhang
- School of Public Health, Inner Mongolia Medical University, Hohhot, 010000, China
| | - Wenrui Wang
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, Hohhot, 010000, China
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 YouanmenXitoutiao, Beijing, 100069, China.
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13
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Wu F, Wang B, Zhuang P, Lu Z, Li Y, Wang H, Liu X, Zhao X, Yang W, Jiao J, Zheng W, Zhang Y. Association of preserved vegetable consumption and prevalence of colorectal polyps: results from the Lanxi Pre-colorectal Cancer Cohort (LP3C). Eur J Nutr 2021; 61:1273-1284. [PMID: 34750639 DOI: 10.1007/s00394-021-02719-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 10/18/2021] [Indexed: 01/06/2023]
Abstract
PURPOSE Although fresh vegetable consumption has been linked with a lower risk of colorectal polyps, a precursor lesion for colorectal cancer (CRC), the association between preserved vegetable consumption and colorectal polyps is unknown. We aimed to assess the association of preserved vegetable intake with the prevalence of colorectal polyps with the consideration of subsites, sizes and multiplicity of polyps. METHODS We analyzed the cross-sectional data from 40-80 years Chinese at a high risk of CRC from the Lanxi Pre-colorectal Cancer Cohort (LP3C) baseline survey, which was conducted between March 2018 and December 2019. Dietary information was obtained via a validated food frequency questionnaire. Multivariate logistic regression was employed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of preserved vegetable consumption and the prevalence of colorectal polyps. RESULTS Of 6783 eligible participants in 2018-2019 survey of LP3C, 2064 prevalent colorectal polyp cases were identified. In the multivariable-adjusted model, preserved vegetable consumption was positively associated with the prevalence of colorectal polyps (OR for fourth vs. first quartile: 1.18; 95% CI 1.01-1.36; P trend = 0.02). The similar association was also detected for small polyps [ORQ4 vs Q1 (95% CI): 1.17 (1.00-1.37); P trend = 0.03]. The similar trend was detected for multiple polyps [OR Q4 vs Q1 (95% CI):1.27 (0.98-1.64); P trend = 0.04], proximal colon polyps [ORQ4 vs Q1 (95% CI): 1.12 (0.90-1.38); P trend = 0.07], and single polyp [ORQ4 vs Q1 (95% CI) for 1.15 (0.98-1.35); P trend = 0.06]. No significant association was observed for distal colon [ORQ4 vs Q1 (95% CI) 1.19 (0.98-1.45); P trend = 0.09]. Replacing one serving per day of preserved vegetables with fresh vegetables was related to 20%, 23%, and 37% lower prevalence of overall, small, and multiple polyps, respectively. CONCLUSIONS Preserved vegetable consumption was associated with a higher prevalence of colorectal polyps in a Chinese population at a high risk of CRC. Replacing preserved vegetables with fresh vegetables may be conducive to lower prevalent colorectal polyps.
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Affiliation(s)
- Fei Wu
- Department of Nutrition, School of Public Health, Department of Clinical Nutrition of Affiliated Second Hospital, Zhejiang University School of Medicine, HangzhouZhejiang, 310058, China
| | - Baoquan Wang
- Lanxi Red Cross Hospital, JinhuaZhejiang, 321000, China
| | - Pan Zhuang
- Zhejiang Key Laboratory for Agro-Food Processing, Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Fuli Institute of Food Science, Zhejiang University, HangzhouZhejiang, 310058, China
| | - Zhonghua Lu
- Lanxi Red Cross Hospital, JinhuaZhejiang, 321000, China
| | - Yin Li
- Department of Nutrition, School of Public Health, Department of Clinical Nutrition of Affiliated Second Hospital, Zhejiang University School of Medicine, HangzhouZhejiang, 310058, China
| | - Hongying Wang
- Lanxi Red Cross Hospital, JinhuaZhejiang, 321000, China
| | - Xiaohui Liu
- Department of Nutrition, School of Public Health, Department of Clinical Nutrition of Affiliated Second Hospital, Zhejiang University School of Medicine, HangzhouZhejiang, 310058, China
| | - Xuqiu Zhao
- Lanxi Red Cross Hospital, JinhuaZhejiang, 321000, China
| | - Wanshui Yang
- Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Jingjing Jiao
- Department of Nutrition, School of Public Health, Department of Clinical Nutrition of Affiliated Second Hospital, Zhejiang University School of Medicine, HangzhouZhejiang, 310058, China
| | - Weifang Zheng
- Lanxi Red Cross Hospital, JinhuaZhejiang, 321000, China.
| | - Yu Zhang
- Zhejiang Key Laboratory for Agro-Food Processing, Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Fuli Institute of Food Science, Zhejiang University, HangzhouZhejiang, 310058, China.
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14
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Liu G, Xie Z, Pang Y, Huang T, Huang Y. Association between 4-dimension lifestyle pattern and 10-year mortality risk in Chinese individuals older than 65: a population-based cohort study. Aging (Albany NY) 2021; 13:8835-8848. [PMID: 33741751 PMCID: PMC8034959 DOI: 10.18632/aging.202695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/09/2021] [Indexed: 06/12/2023]
Abstract
While the impact of a 4-dimension lifestyle pattern (4DL) on older people's mortality (aged ≥65 years) has been reported in high-income countries, few studies investigated the association between lifestyle pattern and disease-accompanied mortality, or examined the difference among different age or gender groups in low- and middle-income countries. We followed up 16,954 Chinese older participants from 2008 to 2018 and adopted the Cox proportional hazard model to evaluate the protective effect of 4DL. After adjustment for confounders, individuals with 3-4 4DL scores had a 38% reduction in all-cause mortality risk, and up to 36%, 42% and 41% reduced risk of mortality accompanied by hypertension, respiratory disease and dementia, respectively in contrast with those scored 0. Compared with octogenarians, nonagenarians, and centenarians, adhering to 3-4 4DL could further reduce the mortality risks in the younger elderly (aged 65-79 years). This study shows that among the elderly population in China, participants who adhered to 4DL had a lower all-cause mortality risk than those who did not. Additionally, hypertension, respiratory disease, or dementia accompanied mortality risk was also reduced significantly. The findings indicated that the positive effects of 4DL on longevity should be acknowledged in China's older population, especially for the younger elderly.
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Affiliation(s)
- Guangqi Liu
- Department of Global Health, Peking University School of Public Health, Haidian 100191, Beijing, China
- Institute for Global Health, Peking University, Haidian 100191, Beijing, China
| | - Zheng Xie
- Department of Global Health, Peking University School of Public Health, Haidian 100191, Beijing, China
- Institute for Global Health, Peking University, Haidian 100191, Beijing, China
| | - Yuanjie Pang
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Haidian 100191, Beijing, China
| | - Tao Huang
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Haidian 100191, Beijing, China
| | - Yangmu Huang
- Department of Global Health, Peking University School of Public Health, Haidian 100191, Beijing, China
- Institute for Global Health, Peking University, Haidian 100191, Beijing, China
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15
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Wang K, Li Y, Liu G, Rimm E, Chan AT, Giovannucci EL, Song M. Healthy Lifestyle for Prevention of Premature Death Among Users and Nonusers of Common Preventive Medications: A Prospective Study in 2 US Cohorts. J Am Heart Assoc 2020; 9:e016692. [PMID: 32578485 PMCID: PMC7670542 DOI: 10.1161/jaha.119.016692] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background It remains unknown whether individuals who regularly use preventive medications receive the same benefit from healthy lifestyle as those who do not use medications. We aimed to examine the associations of healthy lifestyle with mortality according to use of major preventive medications, including aspirin, antihypertensives, and lipid‐lowering medications. Methods and Results Among 79 043 women in the Nurses' Health Study (1988–2014) and 39 544 men in the Health Professionals Follow‐up Study (1986–2014), we defined a healthy lifestyle score based on body mass index, smoking, physical activity, diet, and alcohol intake. We estimated multivariable hazard ratios (HRs) and population‐attributable risks of death from any cause, cardiovascular disease, cancer, and other causes in relation to healthy lifestyle according to medication use. We documented 35 195 deaths. A similar association of healthy lifestyle score with lower all‐cause mortality was observed among medication users (HR, 0.82 per unit increment; 95% CI, 0.81–0.82) and nonusers (HR, 0.81; 95% CI, 0.79–0.83) (P interaction=0.54). The fraction of premature deaths that might be prevented by adherence to the 5 healthy lifestyle factors among medication users and nonusers was 38% (95% CI, 32%–42%) and 40% (95% CI, 29%–50%) for all‐cause mortality, 37% (95% CI, 27%–46%) and 45% (95% CI, 18%–66%) for cardiovascular disease mortality, and 38% (95% CI, 28%–46%) and 33% (95% CI, 14%–49%) for cancer mortality, respectively. Conclusions Adherence to a healthy lifestyle confers substantial benefit for prevention of premature death among both regular users and nonusers of preventive medications. Adherence to a healthy lifestyle remains important even among individuals regularly using preventive medications.
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Affiliation(s)
- Kai Wang
- Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA
| | - Yanping Li
- Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA
| | - Gang Liu
- Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA.,Department of Nutrition and Food Hygiene Hubei Key Laboratory of Food Nutrition and Safety Ministry of Education Key Lab of Environment and Health School of Public Health Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Eric Rimm
- Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA.,Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA.,Channing Division of Network Medicine Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA
| | - Andrew T Chan
- Channing Division of Network Medicine Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA.,Clinical and Translational Epidemiology Unit Massachusetts General Hospital and Harvard Medical School Boston MA.,Division of Gastroenterology Massachusetts General Hospital and Harvard Medical School Boston MA.,Broad Institute of MIT and Harvard Cambridge MA.,Department of Immunology and Infectious Diseases Harvard T.H. Chan School of Public Health Boston MA
| | - Edward L Giovannucci
- Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA.,Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA.,Channing Division of Network Medicine Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA
| | - Mingyang Song
- Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA.,Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA.,Clinical and Translational Epidemiology Unit Massachusetts General Hospital and Harvard Medical School Boston MA.,Division of Gastroenterology Massachusetts General Hospital and Harvard Medical School Boston MA
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