Alcohol consumption and acute myocardial infarction: A benefit of alcohol consumed with meals?

Background: The apparent favorable effect of alcohol on the risk of acute myocardial infarction (MI) may be related to its hypoinsulinemic effect when consumed with meals. We studied how the timing of alcohol consumption in relation to meals might affect the risk of MI in a population with relatively high regular alcohol consumption. Methods: We conducted a case-control study between 1995 and 1999 in Milan, Italy. Cases were 507 subjects with a first episode of nonfatal acute MI, and controls were 478 patients admitted to hospitals for other acute diseases. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multiple logistic regression models. Results: Compared with nondrinkers, an inverse trend in risk was observed when alcohol was consumed during meals only (for greater than or equal to3 drinks per day: OR=0.50; 95% CI=0.30-0.82). In contrast, no consistent trend in risk was found for subjects drinking outside of meals (for greater than or equal to3 drinks per day: 0.98; 0.49-1.96). The pattern of risk was similar when we considered people who drank only wine. Conclusions: Alcohol drinking during meals was inversely related with risk of acute MI, whereas alcohol drinking outside meals only was unrelated to risk

Dietary glycemic index and glycemic load, and breast cancer risk: A case-control study

Background: Certain types of carbohydrates increase glucose and insulin levels to a greater extent than others. In turn, insulin may raise levels of insulin-like growth factors, which may influence breast cancer risk. We analyzed the effect of type and amount of carbohydrates on breast cancer risk, using the glycemic index and the glycemic load measures in a large case-control study conducted in Italy. Patients and methods: Cases were 2569 women with incident, histologically-confirmed breast cancer interviewed between 1991 and 1994. Controls were 2588 women admitted to the same hospital network for a variety of acute, non-neoplastic conditions. Average daily glycemic index and glycemic load were calculated from a validated 78-item food frequency questionnaire. Results: Direct associations with breast cancer risk emerged for glycemic index (odds ratio, OR for highest vs. lowest quintile = 1.4; P for trend <0.01) and glycemic load (OR = 1.3; P < 0.01). High glycemic index foods, such as white bread, increased the risk of breast cancer (OR = 1.3) while the intake of pasta, a medium glycemic index food, seemed to have no influence (OR = 1.0). Findings were consistent across different strata of menopausal status, alcohol intake, and physical activity level. Conclusions: This study supports the hypothesis of moderate, direct associations between glycemic index or glycemic load and breast cancer risk and, consequently, a possible role of hyperinsulinemia/insulin resistance in breast cancer development. RI Jenkins, David/A-1992-2009; Parpinel, Maria/B-1605-201

Glycemic index and load and risk of upper aero-digestive tract neoplasms (Italy)

Background: The ability of dietary carbohydrates to affect blood glucose and insulin levels by dietary carbohydrates is best measured by the glycemic index (GI) and glycemic load (GL) which have been directly associated with risk of several chronic conditions, including cancer. Patients and methods: Three case - control studies were conducted between 1992 and 2000 in Italy. The first one included 598 hospital patients with incident, histologically confirmed oral and pharyngeal cancer and 1491 controls admitted to the same hospital networks for acute, non-neoplastic diseases; the second study included 304 subjects with squamous cell oesophageal cancer and 743 controls; the third one included 460 cases with laryngeal cancer and 1088 controls. All subjects were interviewed using a validated food frequency questionnaire. Results: The odds ratios ( OR) of upper aero-digestive tract neoplasms for the highest versus the lowest quintile of dietary GI and GL were 1.5 (95% confidence interval [CI]: 1.1 - 2.0) and 1.8 ( 95% CI: 1.1 - 2.9), respectively. The associations were in the same direction for various cancer sites. The ORs were apparently stronger in women, in those with high body mass index and reporting low alcohol consumption. Conclusions: This study supports the hypothesis that high dietary GI and GL are associated with cancers of the upper aero-digestive tract. RI Jenkins, David/A-1992-200

Dietary glycemic index and glycemic load and breast cancer risk: a case-control study

Background: Certain types of carbohydrates increase glucose and insulin levels to a greater extent than others. In turn, insulin may raise levels of insulin-like growth factors, which may influence breast cancer risk. We analyzed the effect of type and amount of carbohydrates on breast cancer risk, using the glycemic index and the glycemic load measures in a large case-control study conducted in Italy. Patients and methods: Cases were 2569 women with incident, histologically-confirmed breast cancer interviewed between 1991 and 1994. Controls were 2588 women admitted to the same hospital network for a variety of acute, non-neoplastic conditions. Average daily glycemic index and glycemic load were calculated from a validated 78-item food frequency questionnaire. Results: Direct associations with breast cancer risk emerged for glycemic index (odds ratio, OR for highest vs. lowest quintile = 1.4; P for trend < 0.01) and glycemic load (OR = 1.3; P < 0.01). High glycemic index foods, such as white bread, increased the risk of breast cancer (OR = 1.3) while the intake of pasta, a medium glycemic index food, seemed to have no influence (OR = 1.0). Findings were consistent across different strata of menopausal status, alcohol intake, and physical activity level. Conclusions: This study supports the hypothesis of moderate, direct associations between glycemic index or glycemic load and breast cancer risk and, consequently, a possible role of hyperinsulinemia/insulin resistance in breast cancer development

Glycemic index, glycemic load and risk of prostate cancer

Dietary carbohydrates have different glycemic and insulinemic potentials depending on type (glycemic index, GI) and amount (glycemic load, GL) of carbohydrate consumed or both. Insulin in turn has been implicated as a risk factor for several cancers, including that of the prostate. We assessed the relationship of GI and GL with prostate cancer risk in a multicenter case-control study. Cases and controls were recruited between 1991 and 2002 in the network of major teaching and general hospitals in 4 Italian areas. Cases were 1,204 men (age range 46-74 years) admitted for incident, histologically confirmed prostate cancer. Controls were 1,352 men (age range 46-74 years) admitted for acute, nonmalignant conditions unrelated to long-term modifications of diet. ORs of prostate cancer and the corresponding 95% Cls were derived using unconditional multiple logistic regression, including terms for age, study center, education, family history of prostate cancer, smoking, body mass index, physical activity, alcohol consumption, intake of energy, fiber and lycopenes. Compared to the lowest quintile of GI, the ORs were 1.23, 1.24, 1.47 and 1.57 for subsequent levels of GI. The corresponding values for GL were 0.91, 1.00, 1.20 and 1.41. No heterogeneity was found among strata of selected covariates. We found direct relations between dietary GI and GL and prostate cancer risk. Correcting for potential confounding factors did not substantially modify these associations. (C) 2004 Wiley-Liss, Inc. RI Jenkins, David/A-1992-200

Depressão e envelhecimento: estudo nos participantes do Programa Universidade Aberta à Terceira Idade Depression and aging: study comprising participants of the "Senior Citizens Open University"

OBJETIVOS: identificar a presença de depressão em idosos que freqüentaram o Programa Universidade Aberta à Terceira Idade, da Universidade Federal de Pernambuco, considerando variáveis demográficas e socioeconômicas. MÉTODOS: estudo epidemiológico, descritivo e de corte transversal. Foi realizado um censo com os 358 idosos sendo 312 mulheres e 46 homens (>60 anos), utilizando o questionário "Brasil Old Age Schedule" (BOAS), do qual foi selecionada a seção de saúde mental, quanto à depressão, verificando a freqüência das variáveis solidão, tristeza, pouca disposição, pessimismo em relação ao futuro, irritação, auto-acusação, idéias suicidas, dor de cabeça, insatisfação, distúrbios do sono e do apetite. RESULTADOS: foi encontrado um percentual importante de depressão (24,02%) na população estudada, cuja maioria está classificada em depressão menor, entre a faixa etária de 70-79 anos, do sexo feminino e separados. Foi observada associação significante entre baixa escolaridade e depressão. Os casos de depressão apresentam relevante relação com as variáveis preocupação, dor de cabeça, pouca disposição, irritação, tristeza e insatisfação. CONCLUSÕES: a presença de depressão na população estudada aponta para a importância do planejamento, por parte do Programa, de ações direcionadas à saúde de seus participantes, em particular, os transtornos mentais relativos à depressão.<br>OBJECTIVES: to identify depression in the elderly enrolled at the Senior Citizens Open University, a program of the Federal University of Pernambuco, considering demographic, social and economic variables. METHODS: epidemiological, descriptive, cross sectional cohort study. A census comprising 358 elderly subjects being 312 women and 46 men (>60 yr) through the Brasil Old Age Schedule (BOAS) was completed from which the section related to mental health was selected focusing on depression variables such as loneliness, sadness, listlessness, pessimistic view of the future, irritation, selfaccusa RESULTS: an important depression percentage was determined (24.02%) in the population under study, the majority of which, between 70-79 years old, female and single. A significant association between low education level and depression was established. Depression cases had relevant connection with distress, headache, listlessness, irritation, sadness and dissatisfaction. CONCLUSIONS: depression among the subjects of the study demonstrates the need for the Program to consider actions directed towards participants' health, particularly depression related mental disorders