Sweetened Beverages, Coffee, and Tea and Depression Risk among Older US Adults

<div><p>Sweetened beverages, coffee, and tea are the most consumed non-alcoholic beverages and may have important health consequences. We prospectively evaluated the consumption of various types of beverages assessed in 1995–1996 in relation to self-reported depression diagnosis after 2000 among 263,923 participants of the NIH-AARP Diet and Health Study. Odds ratios (OR) and 95% confidence intervals (CI) were derived from multivariate logistic regressions. The OR (95% CI) comparing ≥4 cans/cups per day with none were 1.30 (95%CI: 1.17–1.44) for soft drinks, 1.38 (1.15–1.65) for fruit drinks, and 0.91 (0.84–0.98) for coffee (all <i>P</i> for trend<0.0001). Null associations were observed for iced-tea and hot tea. In stratified analyses by drinkers of primarily diet versus regular beverages, the ORs were 1.31 (1.16–1.47) for diet versus 1.22 (1.03–1.45) for regular soft drinks, 1.51 (1.18–1.92) for diet versus 1.08 (0.79–1.46) for regular fruit drinks, and 1.25 (1.10–1.41) for diet versus 0.94 (0.83–1.08) for regular sweetened iced-tea. Finally, compared to nondrinkers, drinking coffee or tea without any sweetener was associated with a lower risk for depression, adding artificial sweeteners, but not sugar or honey, was associated with higher risks. Frequent consumption of sweetened beverages, especially diet drinks, may increase depression risk among older adults, whereas coffee consumption may lower the risk.</p></div

Physical Activity and Sedentary Behavior in Relation to Esophageal and Gastric Cancers in the NIH-AARP Cohort

<div><p>Introduction</p><p>Body mass index is known to be positively associated with an increased risk of adenocarcinomas of the esophagus, yet there is there limited evidence on whether physical activity or sedentary behavior affects risk of histology- and site-specific upper gastrointestinal cancers. We used the NIH-AARP Diet and Health Study to assess these exposures in relation to esophageal adenocarcinoma (EA), esophageal squamous cell carcinoma (ESCC), gastric cardia adenocarcinoma (GCA), and gastric non-cardia adenocarcinoma (GNCA). </p> <p>Methods</p><p>Self-administered questionnaires were used to elicit physical activity and sedentary behavior exposures at various age periods. Cohort members were followed via linkage to the US Postal Service National Change of Address database, the Social Security Administration Death Master File, and the National Death Index. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95 percent confidence intervals (95%CI) </p> <p>Results</p><p>During 4.8 million person years, there were a total of 215 incident ESCCs, 631 EAs, 453 GCAs, and 501 GNCAs for analysis. Strenuous physical activity in the last 12 months (HR_{<i>>5 times/week vs. never</i>}=0.58, 95%CI: 0.39, 0.88) and typical physical activity and sports during ages 15–18 years (p for trend=0.01) were each inversely associated with GNCA risk. Increased sedentary behavior was inversely associated with EA (HR_{<i>5–6 hrs/day vs. <1 hr</i>}=0.57, 95%CI: 0.36, 0.92). There was no evidence that BMI was a confounder or effect modifier of any relationship. After adjustment for multiple testing, none of these results were deemed to be statistically significant at p<0.05. </p> <p>Conclusions</p><p>We find evidence for an inverse association between physical activity and GNCA risk. Associations between body mass index and adenocarcinomas of the esophagus do not appear to be related to physical activity and sedentary behavior.</p> </div

Odds ratios^a and 95% confidence intervals of depression according to baseline consumption of caffeinated or decaffeinated beverages in the NIH-AARP Diet and Health Study, 1995–2006.

<p>Abbreviations: CI, confidence interval; OR, odds ratio.</p>a<p>Adjusted for age at baseline, sex, race, education, marital status, smoking, alcoholic beverage intake, physical activity, body mass index, and energy intake.</p>b<p>Numbers may not add up to total due to missing.</p

Odds ratios^a and 95% confidence intervals of depression according to baseline beverage consumption in the NIH-AARP Diet and Health Study, 1995–2006.

<p>Abbreviations: CI, confidence interval; OR, odds ratio;</p>a<p>Adjusted for age at baseline, sex, race, education, marital status, smoking, alcoholic beverage intake, physical activity, body mass index, and energy intake.</p>b<p>Numbers may not add up to total due to missing.</p

Odds ratios^a and 95% confidence intervals of depression according to baseline consumption of regular or diet sweetened beverages in the NIH-AARP Diet and Health Study, 1995–2006.

<p>Abbreviations: CI, confidence interval; OR, odds ratio.</p>a<p>Adjusted for age at baseline, sex, race, education, marital status, smoking, alcoholic beverage intake, physical activity and body mass index, and energy intake.</p>b<p>Numbers may not add up to total due to missing.</p

Odds ratios^a and 95% confidence intervals of depression according to types of sweetener added to coffee or tea in the NIH-AARP Diet and Health Study, 1995–2006.

<p>Abbreviations: CI, confidence interval; OR, odds ratio;</p>a<p>Adjusted for age at baseline, sex, race, education, marital status, smoking, alcoholic beverage intake, physical activity, body mass index, and energy intake.</p

Baseline population characteristics of the NIH-AARP Diet and Health Study, 1995–2006.

<p>Baseline population characteristics of the NIH-AARP Diet and Health Study, 1995–2006.</p

Time to First Morning Cigarette and Risk of Chronic Obstructive Pulmonary Disease: Smokers in the PLCO Cancer Screening Trial

<div><p>Background</p><p>Time to first cigarette (TTFC) after waking is an indicator of nicotine dependence. The association between TTFC and chronic obstructive pulmonary disease (COPD), the third leading cause of death in the United States, has not yet been reported.</p><p>Methods</p><p>We investigated the cross-sectional association between TTFC and prevalent COPD among 6,108 current smokers in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. COPD was defined as a self-reported diagnosis of emphysema, chronic bronchitis, or both. Current smokers in PLCO reported TTFC, the amount of time they typically waited before smoking their first cigarette of the day after waking, in four categories: ≤5, 6-30, 31-60, or >60 minutes. We used logistic regression models to investigate the association between TTFC and prevalent COPD with adjustments for age, gender, race, education, and smoking (cigarettes/day, years smoked during lifetime, pack-years, age at smoking initiation), and prior lung cancer diagnosis.</p><p>Results</p><p>COPD was reported by 19% of these 6,108 smokers. Individuals with the shortest TTFC had the greatest risk of COPD; compared to those with the longest TTFC (>60 minutes) the adjusted odds ratios (OR) and 95% confidence intervals (CI) for COPD were 1.48 (95% CI, 1.15-1.91), 1.64 (95% CI, 1.29-2.08), 2.18 (95% CI, 1.65-2.87) for those with TTFC 31-60 minutes, 6-30 minutes, and ≤5 minutes, respectively (P-trend <0.0001). The association between TTFC and emphysema was similar to that for bronchitis, albeit the ORs were slightly stronger for chronic bronchitis; comparing TTFC ≤5 minutes to >60 minutes, the adjusted OR (95% CI) was 2.29 (1.69-3.12) for emphysema and 2.99 (1.95-4.59) for chronic bronchitis.</p><p>Conclusions</p><p>Current smokers with shorter TTFC have increased risk of COPD compared to those with longer TTFC, even after comprehensive adjustment for established smoking covariates. Future epidemiologic studies, including prospective designs, should incorporate TTFC to better assess disease risk and evaluate the potential utility of TTFC as a COPD screening tool for smokers in the clinical setting.</p></div

Adjusted Odds Ratio for COPD according to Time to First Cigarette (TTFC) among current smokers in PLCO.

<p>COPD cases responded affirmatively to question(s) regarding diagnosis of emphysema (on study baseline questionnaire, follow-up questionnaire in 2006, or both), chronic bronchitis (on study baseline questionnaire), or both. ORs and 95% CIs were determined using logistic regression with adjustments for age, gender (except in gender-stratified analyses), race, education, cigarettes/day, years smoked during lifetime, pack-years, age at smoking initiation, and lung cancer diagnosis prior to follow-up questionnaire. TTFC was categorical (>60 minutes as reference) with the exception of P-trend assessment where TTFC was treated as an ordinal variable.</p><p>PLCO, Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. P-value for interaction between TTFC*gender interaction term. Significant P-values (P<0.05) in bold.</p><p>^a N = 6,106; 2 participants were excluded due to missing data on emphysema endpoint.</p><p>^b N = 6,070; 38 participants were excluded due to missing data on bronchitis endpoint.</p><p>Adjusted Odds Ratio for COPD according to Time to First Cigarette (TTFC) among current smokers in PLCO.</p

Characteristics of Current Smokers in the PLCO Study, by COPD Status.

<p>COPD cases responded affirmatively to question(s) regarding diagnosis of emphysema (on study baseline questionnaire, follow-up questionnaire in 2006, or both), chronic bronchitis (on study baseline questionnaire), or both. Baseline data were substituted for missing follow-up questionnaire data for the following variables (number of participants) for race (218), age at smoking initiation (108), pack-years (299), cigarettes per day (65), smoking duration (262). PLCO, Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Some values do not sum to 100 due to missing data.</p><p>^a Report prior to PLCO follow-up questionnaire in 2006</p><p>^b Self-report of emphysema and chronic bronchitis was not mutually exclusive; 201 participants reported a diagnosis of both emphysema and chronic bronchitis, thus the sum of reports of emphysema and chronic bronchitis are greater than the total 1,136 COPD cases.</p><p>Characteristics of Current Smokers in the PLCO Study, by COPD Status.</p