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ABSTRACT: BACKGROUND: The hypertriglyceridemic waist phenotype (defined using both elevated waist circumference and triglycerides) and visceral adiposity index (VAI, defined using waist circumference, body mass index, triglycerides, and high-density lipoprotein cholesterol) have been suggested to be inexpensive yet effective markers of visceral (intra-abdominal) obesity and related dysmetabolic state. These markers may be particularly useful to Asian populations who generally have a low body weight but are prone to visceral adiposity. METHODS: We examined associations of the hypertriglyceridemic waist phenotype and VAI with risk of coronary heart disease (CHD) in a nested case-control study conducted within two prospective cohort studies of Chinese adults. We identified 355 incident cases of CHD and 697controls matched for sex, age, and date and time of baseline sample collection. Anthropometric and lipid measurements were performed and used to define the hypertriglyceridemic waist phenotype and VAI according to published methods. Conditional logistic regression was used to evaluate the associations. RESULTS: Cases had a higher prevalence of the hypertriglyceridemic waist phenotype and higher VAI score than controls in both sexes. Adjusted odds ratios of CHD associated with hypertriglyceridemic waist were 5.18 (95% CI, 2.46-10.9) and 4.63 (2.03-10.5) for women and men, respectively. Adjusted odds ratios of CHD comparing the highest vs. lowest quartile of VAI were 4.44 (95% CI, 2.24-8.82) and 4.23 (1.99-9.00) for women and men, respectively. CONCLUSION: Our study demonstrates, for the first time, that the hypertriglyceridemic waist phenotype and high VAI score are associated with substantially elevated risk of CHD in Chinese men and women.
International journal of cardiology 03/2013; · 7.08 Impact Factor
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ABSTRACT: Abstract Objectives: T'ai chi is a form of mind-body practice used as exercise in China, though limited data are available on characteristics of t'ai chi users and factors associated with practice. Methods: Characteristics of and factors associated with t'ai chi practice among middle-aged and elder Chinese in Shanghai China were analyzed utilizing baseline data from the Shanghai Women's Health Study and Shanghai Men's Health Study. Logistic regression modeling was used to identify independent factors associated with the practice of t'ai chi among men and women. Results: T'ai chi is the most common form of regular exercise in Shanghai China among middle-aged and elderly persons (22%), including among women (28%) and men (15%). Other popular forms of exercise were walking (7%), dancing (4%), and jogging (3%). A majority of adults who practiced t'ai chi used it as their exclusive type of exercise (69%). Overall, t'ai chi practitioners as compared to nonpractitioners were more likely women, older, more educated, retired versus still working, and more likely to report chronic medical conditions including pulmonary, gastrointestinal, and cardiovascular conditions. T'ai chi activity was associated with other health behaviors including nonsmoking, consuming ginseng, and participating in other forms of physical exercise. Conclusions: T'ai chi is the predominant form of exercise among middle-aged and elderly Chinese in urban China, particularly among those with older age and chronic medical diseases. Future research is needed to see whether t'ai chi has similar or different benefits than conventional forms of exercise such as walking and jogging.
Journal of alternative and complementary medicine (New York, N.Y.) 01/2013; · 1.69 Impact Factor
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ABSTRACT: Most epidemiological studies evaluating the association of fruit and vegetable intakes on lung cancer risk were conducted in North American and European countries. We investigated the association of intakes of fruits, vegetables, dietary vitamins A and C, and folate with lung cancer risk among 61,491 adult Chinese men who were recruited into the Shanghai Men's Health Study, a population-based, prospective cohort study. Baseline dietary intake was assessed through a validated food frequency questionnaire during in-home visits. Multivariate Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of lung cancer risk associated with dietary intakes. During a median follow-up of 5.5 yr, 359 incident lung cancer cases accrued after the first year of follow-up and 68.8% of them were current smokers. Intakes of green leafy vegetables, β-carotene-rich vegetables, watermelon, vitamin A, and carotenoids were inversely associated with lung cancer risk; the corresponding HR (95% CI) comparing the highest with the lowest quartiles were 0.72 (0.53-0.98), 0.69 (0.51-0.94), 0.65 (0.47-0.90), 0.63 (0.44-0.88), and 0.64 (0.46-0.88). Intake of all fruits and vegetables combined was marginally associated with lower risk. Our study suggests that the consumption of carotenoid-rich vegetables is inversely associated with lung cancer risk.
Nutrition and Cancer 01/2013; 65(1):51-61. · 2.78 Impact Factor
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Qi Dai,
Xiao-Ou Shu,
Xinqing Deng,
Yong-Bing Xiang, Honglan Li,
Gong Yang,
Martha J Shrubsole,
Butian Ji,
Hui Cai,
Wong-Ho Chow,
Yu-Tang Gao,
Wei Zheng
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ABSTRACT: Magnesium (Mg) and calcium (Ca) antagonise each other in (re)absorption, inflammation and many other physiological activities. Based on mathematical estimation, the absorbed number of Ca or Mg depends on the dietary ratio of Ca to Mg intake. We hypothesise that the dietary Ca/Mg ratio modifies the effects of Ca and Mg on mortality due to gastrointestinal tract cancer and, perhaps, mortality due to diseases occurring in other organs or systems.
Prospective studies.
Population-based cohort studies (The Shanghai Women's Health Study and the Shanghai Men's Health Study) conducted in Shanghai, China.
74 942 Chinese women aged 40-70 years and 61 500 Chinese men aged 40-74 years participated in the study.
All-cause mortality and disease-specific mortality.
In this Chinese population with a low Ca/Mg intake ratio (a median of 1.7 vs around 3.0 in US populations), intakes of Mg greater than US Recommended Daily Allowance (RDA) levels (320 mg/day among women and 420 mg/day among men) were related to increased risks of total mortality for both women and men. Consistent with our hypothesis, the Ca/Mg intake ratio significantly modified the associations of intakes of Ca and Mg with mortality risk, whereas no significant interactions between Ca and Mg in relation to outcome were found. The associations differed by gender. Among men with a Ca/Mg ratio >1.7, increased intakes of Ca and Mg were associated with reduced risks of total mortality, and mortality due to coronary heart diseases. In the same group, intake of Ca was associated with a reduced risk of mortality due to cancer. Among women with a Ca/Mg ratio ≤1.7, intake of Mg was associated with increased risks of total mortality, and mortality due to cardiovascular diseases and colorectal cancer.
These results, if confirmed, may help to understand the optimal balance between Ca and Mg in the aetiology and prevention of these common diseases and reduction in mortality.
BMJ open. 01/2013; 3(2).
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ABSTRACT: Most previous studies of meat intake and total or cause-specific mortality were conducted in North America, whereas studies in other areas have been limited and reported inconsistent results. This study investigated the association of red meat or poultry intake with risk of total and cause-specific mortality, including cancer and cardiovascular disease (CVD), in two large population-based prospective cohort studies of 134,290 Chinese adult women and men in Shanghai. Meat intakes were assessed through validated food frequency questionnaires administered in person at baseline. Vital status and dates and causes of deaths were ascertained through annual linkage to the Shanghai Vital Statistics Registry and Shanghai Cancer Registry databases and home visits every 2-3 years. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of death associated with quintiles of meat intake. During 803,265 person-years of follow up for women and 334,281 person-years of follow up for men, a total of 4,210 deaths in women and 2,733 deaths in men accrued. The median intakes of red meat were 43 g/day among women and 54 g/day among men, and pork constituted at least 95% of total meat intake for both women and men. Red meat intake was associated with increased total mortality among men, but not among women; the HR (95% CI) comparing the highest with the lowest quintiles were 1.18 (1.02-1.35) and 0.92 (0.82-1.03), respectively. This sex difference was statistically significant ( = 0.01). Red meat intake was associated with increased risk of ischemic heart disease mortality (HR = 1.41, 95% CI = 1.05-1.89) and with decreased risk of hemorrhagic stroke mortality (HR = 0.62, 95% CI = 0.45-0.87). There were suggestive inverse associations of poultry intake with risk of total and all-CVD mortality among men, but not among women. Further investigations are needed to elucidate the sex-specific associations between red meat intake and mortality.
PLoS ONE 01/2013; 8(2):e56963. · 4.09 Impact Factor
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ABSTRACT: BACKGROUND: Calcium has been implicated in carcinogenesis and linked to the risk of several cancers in epidemiologic studies; however, few studies have investigated the association of calcium intake with lung cancer risk, particularly among non-smokers. METHODS: We evaluated the association of intakes of calcium and related minerals, assessed through a food frequency questionnaire, with lung cancer risk among 71,267 female non-smokers who were cancer free at baseline in the Shanghai Women's Health Study, a population-based, prospective cohort study. Multivariate Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS: During follow-up through December 2009 (median follow-up time: 11.2 years), 428 incident lung cancer cases accrued. The median intakes of dietary calcium, magnesium, and phosphorus were 441, 266, and 935 mg/day, respectively. Intakes of calcium, phosphorus, and the calcium-to-magnesium (Ca:Mg) ratio were inversely associated with lung cancer risk. The corresponding HRs (95% CIs) for the highest compared with the lowest quartile were 0.66 (0.48, 0.91) for calcium, 0.55 (0.36, 0.85) for phosphorus, and 0.62 (0.47, 0.82) for the Ca:Mg ratio. No association was observed for dietary magnesium intake or the use of calcium- or vitamin D-containing supplements. Conclusions and Impact: Our study provides some of the first evidence suggesting a possible role for increasing dietary calcium intake in lung cancer prevention among female non-smokers, especially in populations with relatively low calcium intake.
Cancer Epidemiology Biomarkers & Prevention 10/2012; · 4.12 Impact Factor
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Yumie Takata,
Qiuyin Cai,
Alicia Beeghly-Fadiel, Honglan Li,
Martha J Shrubsole,
Bu-Tian Ji,
Gong Yang,
Wong-Ho Chow,
Yu-Tang Gao,
Wei Zheng,
Xiao-Ou Shu
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ABSTRACT: PURPOSE: B vitamins and methionine have been postulated to have potential effects on carcinogenesis; however, findings from previous epidemiologic studies on B vitamins, methionine, and lung cancer risk are inconsistent. We investigated associations of dietary intakes of B vitamins (i.e., riboflavin, niacin, vitamin B6, folate, and vitamin B12) and methionine with lung cancer risk among female never smokers. METHODS: The Shanghai Women's Health Study, a population-based, prospective cohort study, included 74,941 women. During a median follow-up of 11.2 years, 428 incident lung cancer cases accrued among 71,267 women with no history of smoking or cancer at baseline. Baseline dietary intakes were derived from a validated, interviewer-administered food frequency questionnaire. Cancer incidence and vital status were ascertained through annual linkage to the Shanghai Cancer Registry and Shanghai Vital Statistics Registry databases and through biennial in-person follow-ups with participants. Adjusted hazard ratios (HR) and 95 % confidence intervals (CI) were calculated using Cox regression. RESULTS: Dietary riboflavin intake was inversely associated with lung cancer risk (HR = 0.62; 95 % CI = 0.43-0.89; p trend = 0.03 for the highest quartile compared with the lowest). A higher than median intake of methionine was associated with lower risk of lung cancer (HR = 0.78; 95 % CI = 0.60-0.99); however, there was no dose-response relation. Intakes of other B vitamins were not associated with lung cancer risk. CONCLUSIONS: Our study suggests that dietary riboflavin intake may be inversely associated with lung cancer risk among female never smokers, which warrants further investigation.
Cancer Causes and Control 10/2012; · 2.88 Impact Factor
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Meira Epplein,
Wei Zheng,
Yong-Bing Xiang,
Richard M Peek, Honglan Li,
Pelayo Correa,
Jing Gao,
Angelika Michel,
Qiuyin Cai,
Michael Pawlita,
Xiao-Ou Shu
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ABSTRACT: BACKGROUND: Helicobacter pylori is the leading risk factor for gastric cancer, yet only a fraction of infected individuals ever develop neoplasia. METHODS: To identify potential predictive biomarkers, we assessed the association of 15 antibodies to Helicobacter pylori proteins and gastric cancer in a nested case-control study. Blood levels of antibodies were assessed using multiplex serology for 226 incident cases and 451 matched controls from the Shanghai Men's Health Study. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression. RESULTS: Sero-positivity to four (Omp, HP0305, HyuA, and HpaA) proteins were associated with a one-and-a-half to three-fold increased risk for gastric cancer. When excluding cases diagnosed within two years of study enrollment, sero-positivity to two additional proteins (CagA and VacA) showed significant associations with risk. Compared to individuals with ≤3 sero-positive results to the six virulent proteins identified in this population, individuals with 4-5 sero-posit ive results were at a two-fold increased risk (OR=2.08, 95% CI: 1.31-3.30) and individuals sero-positive to all 6 proteins had a three-and-a-half-fold increase in risk (OR=3.49, 95% CI: 2.00-6.11) for gastric cancer. Among individuals diagnosed at least two years after study enrollment, these associations were even stronger (OR=2.79 and OR=4.16, respectively). CONCLUSIONS: Increasing number of sero-positives to six H. pylori proteins may be a risk marker for distal gastric cancer in China. Impact: In a population with a 90% prevalence of CagA-positive H. pylori infection, assessment of additional virulent H. pylori proteins might better identify individuals at high risk for gastric cancer.
Cancer Epidemiology Biomarkers & Prevention 10/2012; · 4.12 Impact Factor
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ABSTRACT: Abnormal sleep duration, either long or short, is associated with disease risk and mortality. Little information is available on sleep duration and its correlates among Chinese women.
Using information collected from 68,832 women who participated in the Shanghai Women's Health Study (SWHS), we evaluated sleep duration and its correlations with sociodemographic and lifestyle factors, health status, and anthropometric measurements and their indexes using polynomial logistic regression.
The mean age of the study population was 59.6years (SD=9.0; range: 44.6-79.9years) at time of sleep duration assessment. Approximately 80% of women reported sleeping 6-8h/day, 11.5% slept 5h or less, and 8.7% slept 9h or more. As expected, age was the strongest predictor for sleep duration and was negatively correlated with sleep duration. In general, sleep duration was positively associated with energy intake, intakes of total meat and fruits, body mass index (BMI), waist-hip ratio (WHR), and waist circumference (WC) after adjustment for age and other factors. Both short and long sleep duration were negatively associated with education level, family income, and leisure-time physical activity and positively associated with number of live births, history of night shift work, and certain chronic diseases, compared to sleep duration around 7h/day (6.5-7.4h/day). Short sleep duration was related to tea consumption and passive smoking. Long sleep duration was related to menopausal status and marital status.
In this large, population-based study, we found that sleep duration among middle-aged and elderly Chinese women was associated with several sociodemographic and lifestyle factors and with disease status. The main limitation of the study is the cross-sectional design that does not allow us to draw any causal inference. However, this study provides information for future investigation into the nature of these associations so that recommendations can be developed to reduce sleep problems in middle-aged and elderly Chinese women. It also provides important information on potential confounders for investigation of sleep duration on health outcomes in this population.
Sleep Medicine 08/2012; 13(9):1138-45. · 3.40 Impact Factor
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ABSTRACT: Whether soy food consumption may protect against coronary heart disease (CHD) remains controversial. No previous study has used biomarkers of soy intake in assessing the relationship between soy consumption and CHD. Biomarkers that reflect both intake and metabolism may be more informative than self-reports of dietary intake.
We examined associations of urinary isoflavonoids, a biomarker of soy or soy isoflavone intake, with risk of CHD in a case-control study nested within two prospective cohort studies of Chinese adults in Shanghai. Cases were defined as subjects with no history of CHD at baseline who developed incident CHD during follow-up. Control subjects were randomly selected from those who remained free of CHD and matched to cases by sex, age, date and time of sample collection and antibiotic use. Baseline urinary isoflavonoids (daidzein, genistein, glycitein, equol, O-desmethylangolensin, dihydrodaidzein and dihydrogenistein) were compared between cases (n = 377) and control subjects (n = 753). Conditional logistic regression was used to evaluate the associations.
Total urinary isoflavonoids were not associated with CHD in either women or men. However, urinary equol excretion showed a significant inverse association with CHD in women. The adjusted odds ratios (95% confidence intervals) for CHD across increasing quartiles of equol levels in women were 1 (reference), 0.61 (0.32, 1.15), 0.51 (0.26, 0.98) and 0.46 (0.24, 0.89) (P = 0.02 for trend).
Our study suggests for the first time that equol, a bioactive metabolite of soy isoflavone daidzein, may be inversely associated with risk of CHD in women.
International Journal of Epidemiology 08/2012; 41(5):1367-75. · 6.41 Impact Factor
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ABSTRACT: Epidemiologic studies on the relationship between vitamin intake and liver cancer risk are sparse and inconsistent.
We evaluated vitamin intake from diet and supplements and risk of liver cancer in 132,837 women and men from China who were recruited into the Shanghai Women's Health Study from 1997 to 2000 or the Shanghai Men's Health Study from 2002 to 2006. In-person interviews, using a validated food-frequency questionnaire, were conducted to collect data on dietary habits. Follow-up consisted of in-person surveys and record linkage. Hazard ratios and 95% confidence intervals were estimated using Cox proportional hazard models with adjustment for potential confounders to compare liver cancer risk among participants with high vs low vitamin intake. All statistical tests were two-sided.
After excluding the first 2 years of follow-up, 267 participants (including 118 women and 149 men) developed liver cancer during an average of 10.9 (Shanghai Women's Health Study) or 5.5 (Shanghai Men's Health Study) years of follow-up. Dietary vitamin E intake was inversely associated with liver cancer risk (P(trend) = .01), as was vitamin E supplement use (hazard ratio = 0.52, 95% confidence interval = 0.30 to 0.90). This association was consistent among participants with and without self-reported liver disease or a family history of liver cancer. Vitamin C and multivitamin use was associated with increased risk among participants with self-reported liver disease or family history of liver cancer, whereas intake of vitamin C and other vitamins from dietary sources was unrelated to liver cancer risk.
Vitamin E intake, either from diet or supplements, may reduce the risk of liver cancer.
CancerSpectrum Knowledge Environment 07/2012; 104(15):1173-81. · 14.07 Impact Factor
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Tsogzolmaa Dorjgochoo,
Yu-Tang Gao,
Wong-Ho Chow,
Xiao-ou Shu,
Gong Yang,
Qiuyin Cai,
Nathaniel Rothman,
Hui Cai, Honglan Li,
Xinqing Deng,
Adrian Franke,
L Jackson Roberts,
Ginger Milne,
Wei Zheng,
Qi Dai
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ABSTRACT: There is limited literature on the contributors to isoprostane metabolite 2,3-dinor-5,6-dihydro-15-F(2t)-isoprostane (15-F(2t)-IsoP-M) compared with F(2)-isoprostanes (F(2)-IsoPs) as an oxidative stress biomarker.
The objective of this study was to investigate whether plasma concentrations of antioxidants, urinary excretion rates of polyphenols, and antioxidants in food and dietary supplements are attributable to both urinary F(2)-IsoP and 15-F(2t)-IsoP-M concentrations.
Dietary intake information and blood and urine samples were obtained from 845 healthy middle-aged and elderly female participants of the Shanghai Women's Health Study. Urinary isoprostanes (F(2)-IsoPs and 15-F(2t)-IsoP-M) were measured and adjusted for creatinine concentrations.
Urinary 15-F(2t)-IsoP-M and F(2)-IsoP concentrations were lower in subjects who used a multivitamin. Lower F(2)-IsoP concentrations were observed in ginseng users, whereas lower concentrations of 15-F(2t)-IsoP-M were shown in subjects who used a vitamin E supplement. Plasma concentrations of several antioxidants (ie, β-carotenes, both trans and cis β-carotenes, lycopene other than trans, 5-cis and 7-cis isomers, cis anhydrolutein, and cis β-cryptoxanthin) were inversely associated with 15-F(2t)-IsoP-M but not with F(2)-IsoPs, whereas β-, γ-, and δ-tocopherols were positively associated with 15-F(2t)-IsoP-M but not with F(2)-IsoPs. Urinary polyphenol quercetin was positively associated with both F(2)-IsoPs and 15-F(2t)-IsoP-M.
The results suggest that the F(2)-IsoP major metabolite 15-F(2t)-IsoP-M may be a more sensitive marker of endogenous oxidative stress status than are F(2)-IsoPs in the assessment of effects of antioxidants on age-related diseases.
American Journal of Clinical Nutrition 07/2012; 96(2):405-14. · 6.67 Impact Factor
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Jianfeng Luo,
Yu-Tang Gao,
Wong-Ho Chow,
Xiao-Ou Shu, Honglan Li,
Gong Yang,
Qiuyin Cai,
Nathaniel Rothman,
Hui Cai,
Martha J. Shrubsole,
Adrian A. Franke,
Wei Zheng,
Qi Dai
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ABSTRACT: Polyphenols, the most abundant dietary antioxidants, also possess many other anticarcinogenic activities. Urinary metabolites
of polyphenols could complement dietary assessment of the bioavailability of these nutrients. We conducted a study of 353
incident breast cancer cases and 701 individually matched controls nested within the Shanghai Women’s Health Study cohort
of women aged 40–70years at baseline. Liquid chromatography photo-diode array electrospray mass spectrometry was used to
measure tea polyphenols (epicatechin, epigallocatechin, and their metabolites) and flavonols (e.g., quercetin and kaempferol).
Multivariate conditional logistic regression analyses were used to assess associations between breast cancer risk and urinary
excretion rates of polyphenols. Urinary excretion of tea polyphenols increased with increasing tea leaves consumed among controls,
but not among breast cancer cases. Compared with cases, controls had higher levels of urinary total polyphenols and tea polyphenols,
particularly epicatechin. In contrast, we did not find any dose–response relationship between urinary polyphenols and breast
cancer risk. Urinary excretion of epicatechin was inversely associated with breast cancer risk [odds ratio (OR) and 95% confidence
interval (CI) of 0.59 (0.39–0.88) for the intermediate tertile]. In spline regression, we found an overall dose–response relationship
between epicatechin level and risk of breast cancer, although it was not apparent in low and middle urinary excretion range.
In conclusion, high epicatechin may be related to a reduced risk of breast cancer. Further studies are warranted to confirm
our findings.
KeywordsBreast cancer-Urinary polyphenols-Flavanols-Flavonols
Breast Cancer Research and Treatment 04/2012; 120(3):693-702. · 4.43 Impact Factor
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ABSTRACT: Little is known about the association of circulating 25-hydroxyvitamin D (25(OH)D) and blood pressure (BP) parameters, including systolic and diastolic BP, pulse pressure (PP), mean arterial pressure (MAP) and hypertension in non-Western populations that have not yet been exposed to foods fortified with vitamins and seldom use vitamin D supplements. A cross-sectional analysis of plasma 25(OH)D levels in association with BP measures was performed for 1460 participants (1055 women and 405 men, aged 40-74 years) of two large cohort studies in Shanghai. Multivariable linear and logistic regressions were conducted. Overall, the prevalence of vitamin D deficiency was 55·8 % using National Health and Nutrition Examination Survey, USA criteria and 29·9 % using WHO criteria. The median plasma 25(OH)D level in the population was 38·0 nmol/l for men and 33·6 nmol/l for women (P < 0·01) among participants who were not on antihypertensive drugs. Among men, BP parameters (systolic BP, diastolic BP and MAP) were significantly and inversely associated with higher quintiles of 25(OH)D compared with the lowest quintile (P trend < 0·05 for all). Vitamin D non-deficient status (WHO criteria) was inversely associated with hypertension (ORadjusted = 0·29; 95 % CI 0·10, 0·82). An inverse association was also found between hypertension and the highest quintile of 25(OH)D (ORadjusted = 0·16; 95 % CI 0·04, 0·65 for ≥ 50·6 nmol/l; P trend = 0·02). Among women, no significant associations were found for BP parameters and hypertension. The present study shows that vitamin D deficiency is common among adults in urban China. Circulating 25(OH)D levels were inversely related to the levels of individual BP parameters and hypertension among middle-aged and elderly men but not among women. More research is needed to investigate the potential sex differential associations.
The British journal of nutrition 02/2012; 108(3):449-58. · 3.45 Impact Factor
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ABSTRACT: Isoflavones and lignans, two major groups of phytoestrogens, have been postulated to have multiple health benefits, including anti-estrogenic, anti-cancer, pro-cardiovascular health, and ameliorating menopausal symptoms. Urinary excretion of isoflavonoids, including daidzein, genistein, glycitein, O-desmethylangolensin (O-DMA), dihydro-daidzein, dihydrogenistein, and equol, and lignans, including enterodiol and enterolactone, have been used as biomarkers of phytoestrogen exposure in epidemiologic studies. We evaluated the urinary excretion of phytoestrogens and their correlations with lifestyle and dietary factors among 2,165 women who participated in the Shanghai Women's Health Study (SWHS), a population-based prospective cohort study of 74,942 urban Chinese women aged 40-70 years at study enrollment (1996-2000). The medians (in nmol/mg creatinine) were: isoflavonoids, 17.13; daidzein, 5.57; genistein, 2.41; glycitein, 0.94; O-DMA, 1.52; dihydrodaidzein, 0.81; dihydrogenistein, 0.19; equol, 0.11; enterodiol, 0.30; and enterolactone, 1.18. These levels are 2- (enterodiol) to 126- (O-DMA) fold higher than levels among US women similar in age range with the exception of enterolactone, for which a similar level was observed for both populations. Urinary isoflavonoid excretion was higher among older women and women who engaged in regular exercise and significantly associated with soy food intake, but was inversely related to fruit intake. Urinary excretions of dihydrodaidzein, dihydrogenistein, equol, enterodiol, and enterolactone were inversely associated with body mass index (BMI). Urinary excretion of isoflavones correlated with soy food intake and healthy lifestyle but was inversely associated with fruit intake among middle-aged and elderly Chinese women. Our study adds important information to the rapidly growing body of research on the potential health benefits of phytoestrogens.
International Journal of Molecular Epidemiology and Genetics 01/2012; 3(1):18-29.
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ABSTRACT: To evaluate the associations of age at menarche and the leg length-to-sitting-height ratio, markers of adolescent growth, with risk of diabetes in later life.
Information from 69,385 women and 55,311 men, aged 40-74 years from the Shanghai Women's Health Study and Shanghai Men's Health Study, were included in the current analyses. Diabetes status was ascertained through biennial in person follow-up. Cox models, with age as the time scale, were used.
There were 2369 cases of diabetes (1831 women; 538 men) during an average of 7.3 and 3.6 years of follow-up of the women and men, respectively. In females, menarche age was inversely associated with diabetes risk after adjustment for birth cohort, education, and income (HR = 0.95, 0.92-0.98). In both genders, leg length-to-sitting-height ratio was inversely related to diabetes (HR = 0.88, 0.80-0.97 for men; HR = 0.91, 0.86-0.96 for women) after adjustment for birth cohort, education, and income. Further adjustment for adult BMI at study enrollment completely eliminated the associations of age at menarche (HR = 0.99, 0.96-1.02) and the leg length-to-sitting-height ratio (HR = 1.00, 0.91-1.10 for men; HR = 1.01, 0.96-1.07 for women) with diabetes risk.
Our study suggests that markers of an early age at peak height velocity, i.e. early menarche age and low leg-length-to-sitting height ratio, may be associated with diabetes risk later in life and this association is likely to be mediated through obesity.
PLoS ONE 01/2012; 7(3):e30625. · 4.09 Impact Factor
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Raquel Villegas,
Scott Williams,
Yutang Gao,
Qiuyin Cai, Honglan Li,
Tom Elasy,
Hui Cai,
Todd Edwards,
Yong-Bing Xiang,
Wei Zheng,
Jirong Long,
Xiao Ou Shu
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ABSTRACT: Animal studies have shown that the peroxime proliferator-activated receptor delta (PPARD) gene regulates glucose metabolism and insulin sensitivity. Genetic variation in the PPARD gene might affect physical endurance and has been associated with obesity. We investigated the independent and modifying effect of variants in the PPARD gene with exercise participation and body mass index (BMI) on type 2 diabetes (T2D), using data from a genome-wide association study (GWAS) of middle-aged women living in Shanghai, China, with 1019 T2D cases and 1709 controls. The genotyping was performed using the Affymetrix Genome-Wide Human SNP Array 6.0 platform. Imputation was used to determine missing genotypes. Participation in exercise was assessed by a questionnaire. Anthropometric variables were measured by trained interviewers. The association between polymorphisms and T2D was assessed by logistic regression analyses. The combined effects of polymorphisms in the PPARD gene with exercise participation and BMI on T2D risk was assessed by conducting stratified analysis with exercise participation and BMI categories. No significant associations between PPARD and T2D were found in either genotyped or imputed SNPs and no effect modification between exercise participation and PPARD genetic variation was found, suggesting that PPARD is not a risk factor for T2D in this population.
Annals of Human Genetics 08/2011; 75(5):621 - 629. · 2.57 Impact Factor
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ABSTRACT: Asian populations habitually consume a large amount of cruciferous vegetables and other plant-based foods. Few epidemiologic investigations have evaluated the potential health effects of these foods in Asian populations.
We aimed to examine the associations of cruciferous vegetables, noncruciferous vegetables, total vegetables, and total fruit intake with risk of all-cause and cause-specific mortality.
The analysis included 134,796 Chinese adults who participated in 2 population-based, prospective cohort studies: the Shanghai Women's Health Study and the Shanghai Men's Health Study. Dietary intakes were assessed at baseline through in-person interviews by using validated food-frequency questionnaires. Deaths were ascertained by biennial home visits and linkage with vital statistics registries.
We identified 3442 deaths among women during a mean follow-up of 10.2 y and 1951 deaths among men during a mean follow-up of 4.6 y. Overall, fruit and vegetable intake was inversely associated with risk of total mortality in both women and men, and a dose-response pattern was particularly evident for cruciferous vegetable intake. The pooled multivariate hazard ratios (95% CIs) for total mortality across increasing quintiles of intake were 1 (reference), 0.91 (0.84, 0.98), 0.88 (0.77, 1.00), 0.85 (0.76, 0.96), and 0.78 (0.71, 0.85) for cruciferous vegetables (P < 0.0001 for trend) and 0.88 (0.79, 0.97), 0.88 (0.79, 0.98), 0.76 (0.62, 0.92), and 0.84 (0.69, 1.00) for total vegetables (P = 0.03 for trend). The inverse associations were primarily related to cardiovascular disease mortality but not to cancer mortality.
Our findings support recommendations to increase consumption of vegetables, particularly cruciferous vegetables, and fruit to promote cardiovascular health and overall longevity.
American Journal of Clinical Nutrition 07/2011; 94(1):240-6. · 6.67 Impact Factor
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Jianfeng Luo,
Yu-Tang Gao,
Wong-Ho Chow,
Xiao-ou Shu, Honglan Li,
Gong Yang,
Qiuyin Cai,
Guoliang Li,
Nathaniel Rothman,
Hui Cai,
Martha J Shrubsole,
Adrian A Franke,
Wei Zheng,
Qi Dai
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ABSTRACT: In vitro studies have found that flavanol epigallocatechin (EGC) and flavonols, but not flavanol epicatechin (EC), activate glutathione S-transferases (GSTs), a family of phase II enzymes that detoxify reactive oxygen species, such as catechol estrogen metabolites. This study was designed to investigate prospectively whether urinary excretion of tea polyphenols interacts with GST polymorphisms to influence breast cancer risk. We conducted a study of 352 incident breast cancer cases and 701 individually matched controls nested within the Shanghai Women's Health Study cohort of women aged 40-70 yr at baseline. Liquid chromatography tandem mass spectrometry was used to measure urinary excretion of flavanols and flavonols. Real-time multiplex PCR was used to quantify the copy number variation in the GSTM1 and GSTT1 genes. Urinary excretion of flavonols and flavanols, particularly EGC (P = 0.02), was significantly higher among women null for GSTM1 than those positive for GSTM1. Flavonols and flavanols (EGC in particular) were associated with a reduced risk of breast cancer among those null for GSTM1 and GSTT1, with a P-value of 0.04 for the interaction between EGC and GSTM1 polymorphism. In contrast, among women possessing both GSTM1 and GSTT1, breast cancer risk increased with levels of flavonols, particularly kaempferol. The differential associations between polyphenols and breast cancer risk by GST polymorphisms, if confirmed, may provide a new avenue for the personalized prevention of breast cancer.
Molecular Carcinogenesis 05/2011; 51(5):379-88. · 3.16 Impact Factor
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ABSTRACT: We sought to determine the association of hip circumference with risk of type 2 diabetes in a relatively lean population.
The relationship between hip circumference for a given waist circumference or BMI and risk of type 2 diabetes was investigated in 56,100 men and 68,273 women, aged 40 to 74, from the Shanghai Men's Health Study and the Shanghai Women's Health Study. Cox analyses were used.
Over an average of 4.0 years and 7.8 years of follow-up of the men and women, respectively, 2754 new diabetes cases (955 males; 1799 females) were documented. After adjustment for body mass index (BMI), waist circumference, and other potential confounders, the hazard ratios (HRs) and 95% confidence intervals (CIs) for type 2 diabetes in quintiles 2 to 5 compared with the first quintile of hip circumference were 0.95 (95% CI, 0.76-1.18), 0.72 (95% CI, 0.57-0.91), 0.83 (95% CI, 0.67-1.04), 0.78 (95% CI, 0.63-0.97), respectively, among men and 0.83 (95% CI, 0.72-0.96), 0.74 (95% CI, 0.64-0.86), 0.72 (95% CI, 0.62-0.84), and 0.65 (95% CI, 0.56-0.75) among women. This relationship was stronger for men and women with a BMI less than or equal to the median (23.6 kg/m(2) for each gender; interaction p-value = .04 for men and .01 for women).
A greater hip circumference for a given waist circumference and BMI is associated with a reduced risk of type 2 diabetes.
Annals of epidemiology 05/2011; 21(5):358-66. · 2.95 Impact Factor
