[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to examine long-term trends in rates of ischaemic heart disease (IHD) mortality, a leading cause of mortality in Hungary. The study examined the effects of age, period, and cohort on IHD mortality rates and compared mortality rates between the capital (Budapest) and non-capital counties.
Data on IHD deaths and population censuses were obtained from the Hungarian Central Statistical Office. Age-period-cohort analysis utilized nine age-group classes for ages 40 to 84 years, eight time periods from 1970 to 2009, and 16 birth cohorts from 1886 to 1969.
Age-adjusted IHD mortality rates for men and for women generally increased from 1970 to 1993 and from 1980 to 1999, respectively, decreasing thereafter for both sexes. IHD mortality rates for men and for women from Budapest were lower from 1991 and from 1970, respectively, than corresponding rates in non-capital counties, with the difference increasing after 1999. Age had a more significant influence on mortality rates for women than for men. The period effect increased from 1972 to 1982 and decreased thereafter for men, while the period effect decreased consistently for women from 1972 to 2007. The decline in period effect for both sexes was larger for individuals from the capital than for those from non-capital counties. The cohort effect for both sexes declined from birth years 1890 to 1965, with a steeper decline for individuals from the capital than for those from non-capital counties.
The findings indicate a need for programs in Hungary for IHD prevention, especially for non-capital counties.
Journal of Epidemiology 05/2015; 25(6). DOI:10.2188/jea.JE20140122 · 2.86 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Rice consumption has been associated with risk of type 2 diabetes, but its relation with cardiovascular disease (CVD) is limited.
We examined the association between rice consumption and risk of CVD incidence and mortality in a Japanese population.
This was a prospective study in 91,223 Japanese men and women aged 40-69 y in whom rice consumption was determined and updated from 3 self-administered food-frequency questionnaires, each 5 y apart. Follow-up for incidence was from 1990 to 2009 in cohort I and 1993 to 2007 in cohort II and for mortality was from 1990 to 2009 in cohort I and 1993-2009 in cohort II. HRs and 95% CIs of CVD incidence and mortality were calculated according to quintiles of cumulative average rice consumption.
In 15-18 y of follow-up, we ascertained 4395 incident cases of stroke, 1088 incident cases of ischemic heart disease (IHD), and 2705 deaths from CVD. Rice consumption was not associated with risk of incident stroke or IHD; the multivariable HR (95% CI) in the highest compared with lowest rice consumption quintiles was 1.01 (0.90, 1.14) for total stroke and 1.08 (0.84, 1.38) for IHD. Similarly, there was no association between rice consumption and risk of mortality from CVD; the HR (95% CI) for mortality from total CVD was 0.97 (0.84, 1.13). There were no interactions with sex or effect modifications by body mass index for any endpoint.
Rice consumption is not associated with risk of CVD morbidity or mortality.
American Journal of Clinical Nutrition 04/2014; 100(1). DOI:10.3945/ajcn.113.079038 · 6.92 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Seafood/fish intake has been regarded as a protective factor for coronary heart disease (CHD), while smoking is a strong risk factor. To examine whether associations between smoking and risk of CHD are modified by seafood/fish intake, we studied 72,012 Japanese men and women aged 45-74 years who completed 2 food frequency questionnaires, 5 years apart, during the period 1995-2009. After 878,163 person-years of follow-up, 584 incident cases of CHD (101 fatal and 483 nonfatal), including 516 myocardial infarctions, were documented. There was a clear dose-response association between smoking and CHD risk among subjects with a low seafood/fish intake (<86 g/day) but not among those with a high seafood/fish intake (≥86 g/day). Compared with never smokers, the multivariable hazard ratios in light (1-19 cigarettes/day), moderate (20-29 cigarettes/day), and heavy (≥30 cigarettes/day) smokers were 2.39 (95% confidence interval (CI): 1.60, 3.56), 2.74 (95% CI: 1.90, 3.95), and 3.24 (95% CI: 2.12, 4.95), respectively, among low seafood/fish eaters and 1.13 (95% CI: 0.64, 1.99), 1.29 (95% CI: 0.95, 2.04), and 2.00 (95% CI: 1.18, 3.51), respectively, among high seafood/fish eaters. Compared with heavy smokers with a low seafood/fish intake, light smokers with a high seafood/fish intake had substantially reduced risk of CHD (hazard ratio = 0.57, 95% CI: 0.32, 0.98). High seafood/fish intake attenuated the positive association between smoking and risk of CHD.
American journal of epidemiology 04/2014; 179(10). DOI:10.1093/aje/kwu030 · 4.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: Soft drink intake has been associated with obesity and diabetes, but its relation with risk of cardiovascular disease (CVD) is limited. OBJECTIVE: We examined the association between soft drink intake and risk of CVD in a Japanese population. DESIGN: This was a prospective study in 39,786 Japanese men and women aged 40-59 y in which soft drink intake was determined by using a self-administered food-frequency questionnaire. Follow-up was from 1990 to 2008. HRs and 95% CIs of incidence were calculated according to categories of soft drink intake. RESULTS: During 18 y of follow-up, we ascertained 453 incident cases of ischemic heart disease (IHD) and 1922 cases of stroke, including 859 hemorrhagic and 1047 ischemic strokes. Soft drink intake was positively associated with risk of total stroke and more specifically ischemic stroke for women; the multivariable HR (95% CI) in the highest soft drink intake (almost every day) category compared with the lowest intake (never or rarely) category was 1.21 (0.88, 1.68; P-trend = 0.02) for total stroke and 1.83 (1.22, 2.75; P-trend = 0.001) for ischemic stroke. That association did not change significantly after the exclusion of early incident cases within 3-9 y from baseline. A nonsignificant inverse trend for risks of total and ischemic strokes was shown for men, and it was weakened after the exclusion of early incident cases or after the exclusion of participants with baseline comorbidities. Soft drink intake was not associated with risk of IHD or hemorrhagic stroke for either sex. CONCLUSION: Soft drink intake is associated with higher risk of ischemic stroke for women.
American Journal of Clinical Nutrition 10/2012; 96(6). DOI:10.3945/ajcn.112.037903 · 6.92 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND & AIMS: Japan has experienced a jump in the diabetes prevalence rates. We want to examine whether increased intake of soft drink and juices have contributed to this jump. METHODS: Participants were 27,585 Japanese men and women aged 40-59 years who had no prior history of diabetes. Intakes of soft drink, 100% fruit juice and vegetable juice were measured by a validated food frequency questionnaire. Odds ratios of type 2 diabetes over 5 and 10 years were estimated by using logistic regression. RESULTS: A total of 484 men and 340 women reported newly diagnosed diabetes during10 years. High soft drink intake was associated with increased risk of type 2 diabetes in women but not men; odds ratio (95% CI) for women with almost daily consumption versus non-consumers was 2.10 (1.23-3.59; P-trend = 0.004) and 1.79 (1.11-2.89; P-trend = 0.01) at 5 and 10 years, respectively. The association was evident in overweight, highly educated and premenopausal women, and women with blue collar job. Intakes of 100% fruit juice and vegetable juice were not associated with risk of type 2 diabetes for either gender (P-trend >0.05). CONCLUSIONS: Soft drink but not pure juices consumption was associated with increased risk of type 2 diabetes in Japanese women.
[Show abstract][Hide abstract] ABSTRACT: Rice is a staple food in Japan and provides 43% of carbohydrate and 29% of energy intake in the Japanese population. In a prospective study encompassing 83,752 Japanese men and women aged 40-79 y, rice intake was determined by self-administered FFQ. Median follow-up time was 14.1 y from 1988-1990 to the end of 2003, and HR and 95% CI of mortality were calculated according to quintiles of energy-adjusted rice intake. A total of 3514 cardiovascular deaths [1640 strokes, 707 coronary heart disease (CHD), and 560 heart failure] were documented. There was a gender difference on the effect of rice intake on the risk of cardiovascular disease (CVD). Overall, rice intake was inversely associated with CHD, heart failure, and total CVD in men but not in women. Rice intake was not associated with risk of stroke in either gender. The multivariable HR (95% CI) for the extreme quintiles of rice intake in men were 0.70 [(0.49-0.99); P-trend = 0.02] for CHD, 0.70 [(0.46-1.05); P-trend = 0.05] for heart failure, and 0.82 [(0.70-0.97); P-trend = 0.006] for total CVD. For women, rice was not associated with reduced risk of mortality from CVD after adjusting for lifestyle and dietary variables. In conclusion, the consumption of steamed rice was associated with reduced risk of mortality from CVD in Japanese men but not women. This finding necessitates further investigations on the mechanisms leading to this gender difference.
Journal of Nutrition 02/2011; 141(4):595-602. DOI:10.3945/jn.110.132167 · 4.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Dietary fiber protects against coronary heart disease (CHD), but evidence in Asia is limited. We examined the association between dietary fiber intake and mortality from cardiovascular disease (CVD) in a Japanese population in a prospective study of 58,730 Japanese men and women aged 40-79 y in which dietary fiber intake was determined by a self-administered FFQ. The participants were followed up from 1988-1990 to the end of 2003. Hazard ratios (HR) and 95% CI of mortality were calculated per quintile of fiber intake. During the 14-y follow-up, a total of 2080 CVD deaths (983 strokes, 422 CHD, and 675 other CVD) were documented. Total, insoluble, and soluble dietary fiber intakes were inversely associated with risk of mortality from CHD and total CVD for both men and women. For men, the multivariable HR (95% CI) for CHD in the highest vs. the lowest quintiles were 0.81 [(95% CI, 0.61-1.09); P-trend = 0.02], 0.48 [(95% CI, 0.27-0.84); P-trend < 0.001], and 0.71 [(95% CI, 0.41-0.97); P-trend = 0.04] for total, insoluble, and soluble fiber, respectively. The respective HR (95% CI) for women were 0.80 [(95% CI, 0.57-0.97); P-trend = 0.01], 0.49 [(95% CI, 0.27-0.86); P-trend = 0.004], and 0.72 [(95% CI, 0.34-0.99); P-trend = 0.03], respectively. For fiber sources, intakes of fruit and cereal fibers but not vegetable fiber were inversely associated with risk of mortality from CHD. In conclusion, dietary intakes of fiber, both insoluble and soluble fibers, and especially fruit and cereal fibers, may reduce risk of mortality from CHD.
Journal of Nutrition 08/2010; 140(8):1445-53. DOI:10.3945/jn.110.122358 · 4.23 Impact Factor