Functional and evolutionary implications of natural variation in clock genes

Stomach cancer remains the second leading cancer in incidence in Shanghai, China, despite its decline over the past 2 decades. To clarify risk factors for this common malignancy, we conducted a population-based case-control study in Shanghai, China. Included in the study were 1,124 stomach cancer patients (age 20-69) newly diagnosed in 1988-1989 and 1,451 controls randomly selected among Shanghai residents. Usual adult dietary intake was assessed using a comprehensive food frequency questionnaire. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models. Risks of stomach cancer were inversely associated with high consumption of several food groups, including fresh vegetables and fruits, poultry, eggs, plant oil, and some nutrients, such as protein, fat, fiber and antioxidant vitamins. By contrast, risks increased with increasing consumption of dietary carbohydrates, with odds ratios (ORs) of 1.5 (95% confidence interval [CI] 1.1-2.1) and 1.9 (95% CI 1.3-2.9) in the highest quartile of intake among men (p for trend=0.02) and women (p=0.0007), respectively. Similar increases in risk were associated with frequent intake of noodles and bread in both men (p=0.07) and women (p=0.05) after further adjustment for fiber consumption. In addition, elevated risks were associated with frequent consumption of preserved, salty or fried foods, and hot soup/porridge, and with irregular meals, speed eating and binge eating. No major differences in risk were seen according to subsite (cardia vs. non-cardia). Our findings add to the evidence that diet plays a major role in stomach cancer risk and suggest the need for further evaluation of risks associated with carbohydrates and starchy foods as well as the mechanisms involved.     

Adenocarcinoma of the gastric cardia

Although adenocarcinoma of the stomach has decreased in incidence over the past several decades, cancer of the gastric cardia has increased rapidly over this time frame. There are several differences between adenocarcinoma of the cardia and distal stomach with respect to epidemiology, risk factors, and prognosis. In addition, recent data raise questions with regard to possible associations of cardia cancer with Barrett's esophagus, intestinal metaplasia of the cardia, and Helicobacter pylori. This article will review the current literature with regard to this important tumor and explore these potential disease associations.     

Smoking-specific weight gain concerns and smoking cessation in a working population.

Smoking cessation rates, progression in stage of change for smoking cessation, and serious quit attempts were examined over 2 years in a cohort of 242 men and women smokers (mean age 39.7 years, mean body mass index [BMI] 26.3) as a function of expressing concern about gaining weight because of quitting smoking. Participants were employees of 25 companies who were in a worksite health promotion program aimed at reducing risk factors for cardiovascular disease. Multivariate odds ratios (controlled for age, education, job class, sex, and BMI) for quitting smoking, attempting to quit smoking, and progressing in stage of change for smoking cessation as a function of weight concern were not significant. Interactions between sex and weight concern, and BMI and weight concern were also not significant. These findings, in a working, predominantly blue-collar population, and those of other studies, suggest that concern about gaining weight is, at best, a weak predictor of change in smoking behavior among most smokers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Association between duration of obesity and risk of non-insulin-dependent diabetes mellitus. The Sotetsu Study

The authors investigated the association between duration of obesity (ordinary obesity as body mass index (BMI) (kg/m2) > or = 25.0 and extreme obesity as BMI > or = 27.8) and the risk of diabetes mellitus. Male employees of a railway company, aged 30 years or older, observed for 10 years or more, free from serious disease conditions, with initial BMI <25.0, aged 30 years or more at the time diabetes was diagnosed, and with complete data, were examined by univariate and multivariate analyses (n = 1,598). Age-adjusted odds ratios for diabetes were significantly increased among males who were obese for 10-19.9 years and >20 years (odds ratios = 2.10 and 2.84 for ordinary obesity and 6.14 and 4.15 for extreme obesity, respectively). Additional adjustment for current obesity, physical activity, smoking, drinking, family history, and observation period did not change the findings remarkably. In conclusion, > or = 10 years duration of ordinary obesity or > or = 1 year of extreme obesity was an important predictor for diabetes independent of age, current obesity, physical activity, smoking, drinking, family history, and observation period.     

Evaluation of the automatic quantification of left ventricular function using ECG gated 99mTc-MIBI myocardial SPECT

OBJECTIVE: To compare temporal changes in body mass index (BMI) (kg/m2) and prevalence of obesity (BMI > 25 and > 30 kg/m2) among adult Kuwaitis between two periods 14 y apart. DESIGN: Comparison of two independent cross-sectional samples of Kuwaitis studied in 1980-1981 and 1993-1994. SUBJECTS: 2067 (896 men and 1171 women) and 3435 (1730 men and 1705 women) adult Kuwaitis (aged > or = 18 y), drawn from primary health care (PHC) clinics and studied for nutritional assessment and for prevalence of obesity in 1980-1981 and 1993-1994, respectively. MEASUREMENTS: BMI, which is the weight in kilograms divided by the height in meters squared (kg/m2), was based on measured weight and height. Obesity was defined as BMI > 25 kg/m2 (grade 1) and BMI > 30 kg/m2) (grade 2). RESULTS: Mean BMI increased significantly (P < 0.001) by 10.0% and 6.2% (2.5 and 1.7 kg/m2) among men and women, respectively. Prevalence of obesity (BMI > 25 and > 30 kg/m2) increased by 20.6% and 15.4% and by 13.7% and 8.4% among men and women, respectively. After controlling for sociodemographic differences between the two study periods, BMI was 2.0 and 1.6 kg/m2 higher in 1993-1994 than in 1980-1981 among men and women respectively. The risk of obesity (BMI > 25 and > 30 kg/m2) also increased among both genders between the two periods (OR = 2.1, 95% CI 1.7-2.7 and OR = 1.9, 95% CI 1.5-2.4, for men and OR = 2.2, 95% CI 1.6-3.0 and OR = 1.4, 95% CI 2.2 CI-1.0-1.9, for women). CONCLUSION: BMI and prevalence of obesity increased among Kuwaitis between 1980-1981 and 1993 and 1994 probably due to the effects of modernization, affluence, increased food consumption and the concomitant changes to sedentary lifestyles. The rate of temporal changes in BMI and obesity were higher, by comparison, in Kuwait than in selected other countries.     

Treatment of aggression and irritability after head injury

Epidemiological characteristics of colorectal cancer may differ by particular anatomical subsite, suggesting that the subsite-specific colorectal cancers may represent different disease entities. This study explored the time trends over a 23-year period in colorectal cancer incidence at various subsites by sex and age group. Data on the incidence of colorectal cancer were obtained from a population-based cancer registry in Shanghai, People's Republic of China. Between 1972 and 1994, 30,693 patients with colorectal cancer were registered at the Shanghai Cancer Registry. The overall age-adjusted colorectal cancer incidence rates increased > 50%, or 2% per year from 1972-1977 to 1990-1994, from 14 to 22 per 100,000 among men and from 12 to 19 per 100,000 among women. The increases in rates were considerably more rapid for colon cancer, with rates approximately doubling, than they were for rectal cancer. Proximal colon cancer was more common than distal colon cancer over the whole study period, whereas rates for both cancers rose with similar annual percentage changes (> 5% per year) and across virtually all age groups. The estimated annual increases rose from 2% at ages 35-44 years to 7% at ages 75-84 years for proximal colon cancer, but they were more uniform for distal colon cancer (5-6% per year). Age-adjusted and age-specific rectal cancer rates changed little. The male:female age-adjusted rate ratio for colorectal cancer was 1.19 in 1990-1994. The ratios increased over time and varied by subsites, with ratios increasing from the proximal colon to the distal colon and to the rectum. Furthermore, men had higher rates than women for distal colon and rectal cancers at ages 55 and older, whereas women had higher rates than men at younger ages for these two cancers. Male:female rate ratios for proximal colon cancer did not vary substantially with age. The findings from this study indicate that subsite-specific incidence rates of colorectal cancer differ by sex and age and in their time trends. Cancers arising in the proximal colon, distal colon, and rectum may have somewhat different disease etiologies.     

Distribution and frequency of gastric cancer at the para-cardiac region and fornix

To clarify the distribution and frequency of gastric cancer in the upper third of the stomach, especially in the para-cardiac region and fornix, we reviewed 634 lesions of all gastric cancers in any location in the University Hospital of Tsukuba University from April 1985 to March 1992. The para-cardiac region was defined as a circular area of 6 cm in diameter around the cardia. We found 56 lesions (8.8%) in the para-cardiac region, almost all of which were concentrated in the distal half of the para-cardiac region, and only three of which (0.47%) were in the fornix. Cancer in the upper third of the stomach tended to occur predominantly in aged male patients, and histologically most of them were classified as having differentiated adenocarcinoma. Since the percentage of advanced cancer at the para-cardiac region was much higher than at any other location, we should be careful to obtain double-contrast images of sufficient quality during the upper gastrointestinal examinations and not to overlook subtle changes in this region during the interpretation of films.     

Two cases of gastric involvement of esophageal cancer: intramural metastasis and intramural lymph node metastasis

Cases of esophageal cancer with intramural metastasis to the stomach and esophageal cancer with metastasis to an intramural lymph node of the stomach are herein reported. The former patient was a 52 year-old male. Squamous cell carcinoma (SCC) of the lower esophagus with an intramural metastasis located at the gastric cardia and a small leiomyoma at the fornix were resected. The latter patient was a 70 year-old female. SCC of the lower esophagus and an intramural lymph node metastasis located at the anterior wall of the gastric cardia were resected. The patient died nevertheless of multiple liver metastases. These gastric involvements were detectable by endoscopy before surgery. The clinicopathological features of these esophageal cancers were characterized; the sites were the lower part of the esophagus, and extreme lymphatic and vascular invasions were shown histologically. The gastric tumors were located in the upper third of the stomach, and the findings revealed submucosal tumors. It is therefore important to discriminate other gastric tumors, and to resect them simultaneously with esophageal cancer when a gastric tube has been used for reconstruction after esophagectomy.     

Risk of esophageal and gastric adenocarcinomas in relation to use of calcium channel blockers, asthma drugs, and other medications that promote gastroesophageal reflux

Incidence of adenocarcinomas of the esophagus and gastric cardia has risen dramatically over the past 2 decades in the U. S., for reasons that are not yet clear. A number of common medications (e.g., calcium channel blockers, tricyclic antidepressants, and certain asthma medications) promote gastroesophageal reflux by relaxing the lower esophageal sphincter (LES). Reflux is thought to increase cancer risk by promoting cellular proliferation, and by exposing the esophageal epithelium to potentially genotoxic gastric and intestinal contents. Recent studies have suggested that calcium channel blockers may also increase cancer risk by inhibiting apoptosis. Using personal interview data from a multicenter, population-based case-control study conducted between 1993 and 1995 in three areas of the U. S., we evaluated whether the use of LES-relaxing drugs was associated with increased risk of adenocarcinomas of the esophagus and gastric cardia. Cases of esophageal adenocarcinoma (n = 293) and gastric cardia adenocarcinoma (n = 261) were compared with general population controls (n = 695). Information on additional case groups of esophageal squamous cell carcinoma (n = 221) and noncardia gastric cancer (n = 368) were also available for comparison. Overall, 27.4% of controls had used one or more of these drugs for at least 6 months, compared with 30.2% of esophageal adenocarcinoma and 23.8% of gastric cardia adenocarcinoma cases. The adjusted odds ratios (ORs) for ever use were 1.0 [95% confidence interval (CI) = 0.7-1.5] and 0.8 (95% CI = 0.5-1.1), respectively. There was little evidence of increasing risk with increasing duration of use of all LES-relaxing drugs together. We found an increased risk of esophageal adenocarcinoma among persons reporting use of asthma drugs containing theophylline (OR = 2.5; 95% CI = 1.1-5.6) or beta agonists (OR = 1.7; 95% CI = 0.8-3.8). Risks were higher among long-term users (>5 years) of these drugs (OR = 3.1; 95% CI = 0.9-10.3 and OR = 2.3; 95% CI = 0.8-7.0, respectively). In contrast, there was no evidence that the use of calcium channel blockers or other specific groups of drugs increased the risk of any of the cancers studied. These results provide reassuring evidence that the increases in incidence of adenocarcinomas of the esophagus and gastric cardia are not likely to be related to the use of LES-relaxing drugs as a group, or calcium channel blockers in particular, but they do suggest that persons treated for long-standing asthma may be at increased risk of esophageal adenocarcinoma.     

Body weight and risk of nonfatal acute myocardial infarction among women: a case-control study from northern Italy

BACKGROUND: The relationship between nonfatal acute myocardial infarction (AMI) and self-reported body weight and body mass index (BMI; Quetelet index, kg/m2) has been investigated. METHODS: A case-control study was conducted between 1983 and 1992 in northern Italy on 432 women with nonfatal AMI and 867 controls in hospital for acute, noncardiovascular, nonneoplastic, nondigestive, non-hormone-related conditions. Odds ratios (OR), with their 95% confidence intervals (CI), were computed by unconditional multiple logistic regression analysis, including terms for age, education, and smoking, plus history of selected diseases. RESULTS: Women with body weight and BMI in the highest quartile had an increased risk of AMI after allowance for age, education, and smoking status (OR 1.5, 95% CI 1.0 to 2.2, and OR 1.7, 95% CI 1.2 to 2.4, respectively). Compared with leaner women, the risk was higher among women with BMI above the median, in association with a history of diabetes (OR 5.2) or hyperlipidemia (OR 6.0). Hypertensive women had similar OR in the two strata of BMI (OR 5.1 and 4.8). The association of BMI with risk of AMI was apparently stronger among women younger than 50 years and among less educated women, but was similar among smokers and never smokers. CONCLUSIONS: The results of this study confirm that AMI among women is related to excess BMI, with a population attributable risk of 17%. The excess risk was substantial among overweight women with history of diabetes or hyperlipidemia, stressing the importance of controlling body weight among these women.     

Body mass index and mortality in a general population sample of men and women. The Buffalo Health Study

The objective of this research was to investigate the long-term relation between body mass index (BMI) and mortality from all causes and from specific causes in the general population. A 29-year follow-up study was conducted in a random sample of white men (n = 611) and women (n = 697) aged 20-96 years who were residents of Buffalo, New York, in 1960. At baseline, height and weight were determined by self-report. BMI was calculated as weight (kg)/height (m2). During the follow-up period, 295 (48.3 percent) men and 281 (40.3 percent) women died. With the Cox proportional hazards model and adjustment for age, education, and cigarette smoking, a significant linear association was found between BMI and all-cause mortality in men less than age 65 years at baseline (relative risk (RR) = 1.06, 95 percent confidence interval 1.02-1.09), but not in women (RR = 1.02, 95 percent confidence interval 0.99-1.05). In men age 65 years and older, the relation was quadratic in form (p = 0.02), with the lowest risks appearing in the BMI range of 23-27. BMI was most strongly related to cardiovascular disease (CVD) and coronary heart disease mortality in women and younger men. No such associations were observed in older men. BMI was not related to an increased risk of death from non-CVD or cancer in either sex. These findings illustrate the importance of BMI as a risk factor for CVD and coronary heart disease mortality in certain gender-age groups and indicate that the majority of the impact of BMI on overall mortality is due to the strong relation between relative weight and these specific causes of death.     

Gastroesophageal reflux disease versus Helicobacter pylori infection as the cause of gastric carditis

To explore the potential contributions of gastroesophageal reflux disease, as opposed to Helicobacter pylori infection, to the development of gastric carditis, we evaluated gastric carditis (using the criteria of the updated Sydney system for the classification of gastritis), clinical and morphologic features of esophagitis, and H. pylori infection (evaluation of Steiner stains) in biopsy specimens from the gastroesophageal squamocolumnar junction. We correlated clinical, endoscopic, and histologic features in an unselected group of 116 patients. Some degree of carditis was found in 107 (92%) of the patients. The mean age of the patients increased with increasing severity of carditis (P < .05). The various groups of patients with different degrees of carditis did not differ significantly in sex ratio, ethnic background, presence of obesity, percentage having symptoms of gastroesophageal reflux disease (such as heartburn, regurgitation, dysphagia, or odynophagia), endoscopic evidence of esophagitis and columnar epithelium in the distal esophagus, or histologic evidence of active esophagitis. The presence, however, of active gastritis and H. pylori infection in the distal stomach and/or in the cardia was significantly associated with carditis. In patients without carditis, H. pylori was not detected in any cardiac or distal gastric biopsy specimen. In contrast, H. pylori was demonstrated in gastric tissue samples (either from the cardia or distally) of patients with carditis, with the prevalence rate increasing with greater degrees of cardiac inflammation. The H. pylori prevalence rate was 12% in the group with mild carditis, 40% in those with moderate carditis, and 57% in patients with marked carditis (P = .0001). In summary, carditis is commonly found in patients with symptoms related to upper gastrointestinal diseases. From analysis of our study cohort, we concluded that carditis was significantly associated with H. pylori infection and active gastritis but not with symptoms or signs of gastroesophageal reflux disease. These findings suggest that carditis with histologic features similar to those of gastritis in the distal stomach was a sequel of H. pylori infection and represented a part of an H. pylori--associated gastric inflammation.     

The influence of cigarette smoking on the association between body weight and mortality. The Framingham Heart Study revisited

PURPOSE: To calculate for two measures of obesity, the Metropolitan Relative Weight (MRW) and body mass index (BMI), the value at which minimum mortality occurs. This was done to retest the hypothesis, in the Framingham Heart Study data, that the association between obesity and mortality can be obscured by an interaction between the measure of obesity and smoking. In the original analysis of the Framingham data it was suggested that there was a U- or J-shaped relationship between MRW and death in smokers but a linear relationship in nonsmokers. The design and setting were those of the NHLBI Framingham Heart Study. METHODS: The 5209 members of the Framingham Heart Study underwent a baseline examination in 1948-1952 (Exam 1) and they were reexamined at approximately two-year intervals over a 30-year period. The study included both men (n = 2336) and women (n = 2873) in the age range of 28 to 62 years. After excluding persons with missing baseline data, the analytic sample size was 5163. Additional analyses were conducted by deleting persons with cardiovascular disease (CVD) at baseline (n = 135), the sample used by the original paper by Garrison and colleagues, and persons who died within the first four years of follow-up (n = 62). The main outcome measures consisted of thirty-year survival through Exam 16, approximately in 1980, as influenced by MRW or BMI, age, and smoking status at baseline (Exam 1). RESULTS: We were able to show that the sample sizes of male nonsmokers were too small to test the hypothesis within age groups < 40 and 40-49 years. In men ages 50-62 there was a significant age-adjusted quadratic relationship between BMI or MRW, and risk of death. The estimated BMI at the minimum risk of death for smokers (24.5) and nonsmokers (23.8) were not statistically different. Identical results were found for MRW (minimum: smokers = 112.5, nonsmokers = 111.4). In men and women ages 28-62 there appeared to be a u- or j-shaped relationship between the 30-year crude mortality rate and MRW. After excluding persons with missing data, CVD at baseline, and persons who died within the first four years of follow-up, the age adjusted estimated BMI value at the minimum risk of death was nearly identical for men and women and for smokers and nonsmokers (Men: smokers = 22.8, nonsmokers = 22.8; Women: smokers = 22.9, nonsmokers = 23.3). Additionally, the estimates of the minimum were always below the mean. Identical results were found without deleting persons with CVD at baseline and deaths in the first four years of follow-up. Identical results were found for MRW. CONCLUSIONS: Reanalysis of the Framingham Heart Study data does not support the hypothesis that there is an interaction between smoking and measures of obesity. Moreover, the estimated BMI or MRW at the minimum risk of death was similar for men and women smokers and nonsmokers alike even after deleting prevalent cases of CVD and deaths within the first four years of follow-up.     

Increasing incidence of carcinoma of the gastric cardia in Sweden from 1970 to 1985

Several American, Japanese and European centres have reported an increase in carcinoma of the gastric cardia, contrary to the general trend in the incidence of gastric cancer. The aim of this nationwide population-based study was to describe trends in the incidence of tumours of the gastric cardia in Sweden over the 16-year period from 1970 to 1985. The Swedish cancer register, which is more than 95 per cent complete, was used to identify cases. There were 1514 men and 481 women with cancer of the gastric cardia. The age-standardized rates increased in men from 1.9 per 10(5) population in 1970-1973 to 3.0 per 10(5) in 1982-1985, corresponding to a mean annual increase of 2.5 per cent (95 per cent confidence interval (c.i.) 1.6-3.4 per cent). In women, the age-standardized rates increased from 0.5 per 10(5) in 1970-1973 to 0.8 per 10(5) in 1982-1985, the mean annual increase being 0.9 per cent (95 per cent c.i. 0.0-1.8 per cent). The highest incidences were found in southern Sweden, contrary to the geographical distribution of gastric cancer in general, which shows a south-to-north gradient. The disparate epidemiological features of cancer of the cardia and gastric cancer at other sites suggest that the aetiologies may also be different. Since little is known about the aetiology of cancer of the cardia, and the incidence seems to be rising rapidly, analytical studies are urgently needed.     

Cellular and molecular regulation of eosinophil trafficking to the lung

OBJECTIVE: To examine the associations of diet and other lifestyle factors with body mass index (BMI) using data from the Oxford Vegetarian Study. SUBJECTS: 1914 male and 3378 female non-smokers aged 20-89 y at recruitment to the study. MEASUREMENTS: All subjects completed a diet/lifestyle questionnaire at recruitment giving details of their usual diet and other characteristics including height and weight, smoking and drinking habits, amount of exercise, occupation and reproductive history. Answers to the food frequency questionnaire were used to classify subjects as either meat eaters or non-meat eaters, and to estimate intakes of animal fat and dietary fibre. Subjects were further classified according to their alcohol consumption, exercise level, social class, past smoking habits and parity. RESULTS: Mean BMI was lower in non-meat eaters than in meat eaters in all age groups for both men and women. Overall age-adjusted mean BMIs in kg/m2 were 23.18 and 22.05 for male meat eaters and non-meat eaters respectively (P < 0.0001) and 22.32 and 21.32 for female meat eaters and non-meat eaters respectively (P < 0.0001). In addition to meat consumption, dietary fibre intake, animal fat intake, social class and past smoking were all independently associated with BMI in both men and women; alcohol consumption was independently associated with BMI in men, and parity was independently associated with BMI in women. After adjusting for these factors, the differences in mean BMI between meat eaters and non-meat eaters were reduced by 36% in men and 31% in women. CONCLUSIONS: Non-meat eaters are thinner than meat eaters. This may be partly due to a higher intake of dietary fibre, a lower intake of animal fat, and only in men a lower intake of alcohol.     

A severe case of acute autonomic and sensory neuropathy

This study was conducted to explore whether anthropometric indices of obesity are associated with atherogenic risk factors in young adult working women in Japan. The subjects were 492 women in an occupational setting. Predictor variables were body mass index (BMI), the sum of triceps and subscapular skinfold thickness (SFT), and the waist to hip ratio (WHR). Outcome variables were serum total cholesterol, triglyceride and blood pressures. The average age of the subjects was 26.3 (SD 3.9) years. The upper quartiles of BMI and SFT were significantly associated with all atherogenic risk factors, while the upper quartiles of WHR were not. Multiple comparisons revealed the 4th quartiles of BMI (> 22.25) and SFT (> 39 mm) to have significantly higher values for all atherogenic risk factors. We found that BMI and skinfold thickness were more relevant to the prediction of atherogenic risk factors than WHR in young adult Japanese women.     

Therapeutic failures after gastric bypass operations for morbid obesity

BACKGROUND: Although gastric bypass is an effective treatment for morbid obesity, the postoperative results are unsatisfactory in 10% of all patients. Therapeutic failures after an operation performed with the sole purpose of reducing the risk of obesity-associated diseases have to be taken seriously. The goal of this study was to investigate the causes of these failures. METHOD: From 1979 to 1993, 165 gastric bypass operations (technique: Mason-Griffen) were performed. Long-term results were obtained in 60 patients after an average of 6.6 years (range 3-13). On follow-up all patients were examined and asked about their level of satisfaction with the weight loss achieved and changes in eating habits. RESULTS: In 6 patients the weight reduction was regarded as insufficient (BMI > 35 and reduction of BMI < 10). The causes of these failures were technical in 3 cases (gastric pouch to 0 large in 1, dilatation of gastrojejunostomy in 2). Three patients had a high calorie intake through an intact gastric bypass by snacking. Three patients regarded the operation as a failure although they had achieved significant weight loss, because they could no longer eat the usual amounts of food. CONCLUSION: Correct surgical technique and preoperative information on the changes in eating habits after a gastric bypass operation are the most important steps in preventing therapeutic failures.     

Prevalence and risk factors of obesity in adults

INTRODUCTION: A population-based cross-sectional study was conducted in Pelotas, Southern Brazil, with the objective of determining the prevalence of obesity and identify associated, variables as this condition increased markedly in the country between 1974 and 1989. MATERIAL AND METHODS: One thousand and thirty-five adults between 20 and 69 years of age were studied. Obesity was defined as a Body Mass Index--BMI--equal to or over 30 Kg/square meter). The multivariate analyses took into account the hierarchical model of the variables associated with obesity for both men and women. RESULTS: The prevalence for the overall population was of 21% (CI 18-23). It was higher among women--25% (CI 22-29) than for men--15% (CI 12-18). Socioeconomic status was positively associated with obesity among men, whereas the opposite situation was reported for women, with those belonging to the poorest social strata presenting increased BMI. Reported obesity in their parents was associated with increased BMI in the subjects, and this association remained statistically significant even after compensating for the effect of possible confounding variables. Self-reported diabetes and arterial hypertension doubled the risk of obesity, whereas non-smoking was associated with obesity only among women. Variables which were not associated with obesity after adjusting for confounders were alcohol consumption, marital status and parity. Women having more daily meals were less prone to obesity, even after controlling for confounders, and this association was not quite significant for men (p = 0.07). CONCLUSIONS: The prevalence of obesity was higher among women, and important differences in risk factors were noticed when the population was considered by sex.     

Cigarette smoking, weight gain, and coronary mortality: results from the Chicago Western Electric Study

BACKGROUND: Prospective studies of overweight and coronary heart disease (CHD) have presented inconsistent findings. Previous inconsistencies may be explained by the modifying effect of cigarette smoking on the association between weight gain and coronary mortality. METHODS AND RESULTS: We prospectively studied 1531 men 40 to 59 years of age who were employed at the Hawthorne Works of the Western Electric Company in Chicago, Ill. Information collected at the initial examination in 1958 included recalled weight at age 20, present weight, height, smoking status, and other CHD risk factors. Vital status was known for all men on the 25th anniversary: 257 CHD deaths occurred over 31,644 person-years of experience. Cox regression analysis was used to investigate risk of coronary mortality associated with change in body mass index (deltaBMI) and its modification by smoking status after adjustment for age, major organ system disease, family history of CHD, and BMI at age 20. Adjustment was not performed for blood pressure or serum total cholesterol because these are intervening variables. DeltaBMI was positively associated with risk of coronary mortality in never-smokers but not in current-smokers (P for interaction =.088). For never-smokers with deltaBMI classified as stable, low gain, moderate gain, or high gain, adjusted relative risks of coronary mortality were 1.00, 1.75, 1.75, and 3.07, respectively (P for trend=.010). For current-smokers, the respective adjusted relative risks were 1.00, 0.78, 1.05, and 1.03 (P for trend=.344). CONCLUSIONS: These results support the hypothesis that cigarette smoking modifies the association between weight gain and coronary mortality. Future investigations of weight gain and coronary mortality should account for the modifying effect of cigarette smoking.     

Dose-dependent induction of both pepsinogen-altered pyloric glands and adenocarcinomas in the glandular stomach of C3H mice treated with N-methyl-N-nitrosourea

BACKGROUND: Cigarette smoking has been shown to increase oxidative DNA damage in human sperm cells. Assessment of the role of cigarette smoking in the etiology of childhood cancer has focused primarily on the effect of maternal smoking. Similar studies in relation to paternal smoking, however, have been inconclusive. Few studies have evaluated the effect of paternal smoking in the preconception period, and most of these could not disentangle the effects of paternal from maternal smoking. PURPOSE: We investigated the relationship of paternal smoking, particularly in the preconception period, with childhood cancer among offspring of the nonsmoking mothers. METHODS: We conducted a population-based, case-control study in Shanghai, People's Republic of China, where the prevalence of smoking is high among men but extremely low among women. The study included 642 childhood cancer case patients (<15 years of age) and their individually matched control subjects. Information concerning parental smoking, alcohol drinking, and other exposures of the index child was obtained by direct interview of both parents of the study subjects. Odds ratios (ORs), derived from conditional logistic regression models, were used to measure the association between paternal smoking and risk of childhood cancers. RESULTS AND CONCLUSIONS: Paternal preconception smoking was related to a significantly elevated risk of childhood cancers, particularly acute leukemia and lymphoma. The risks rose with increasing pack-years of paternal preconception smoking for acute lymphocytic leukemia (ALL) (P for trend = .01), lymphoma (P for trend = .07), and total cancer (P for trend = .006). Compared with children whose fathers had never smoked cigarettes, children whose fathers smoked more than five pack-years prior to their conception had adjusted ORs of 3.8 (95% confidence interval [CI] = 1.3-12.3) for ALL, 4.5 (95% CI = 1.2-16.8) for lymphoma, 2.7 (95% CI = 0.8-9.9) for brain tumors, and 1.7 (95% CI = 1.2-2.5) for all cancers combined. Statistically significant increased risks of cancer were restricted to children under the age of 5 years at diagnosis or those whose fathers had smoked during all of the 5 years prior to conception. IMPLICATIONS: Further studies are needed to confirm the association of paternal smoking with increased risk of cancer in offspring, to clarify the pattern of risks in relation to the timing of cigarette smoking, and to elucidate the biologic mechanism involved in predisposing the offspring to cancer. For example, it may be that paternal smoking induces prezygotic genetic damage that, in turn, acts as the predisposing factor.