Showing papers by "Frank B. Hu published in 2013"
TL;DR: Sensitivity analyses of RCTs in children showed more pronounced benefits in preventing weight gain in SSB substitution trials (compared with school-based educational programs) and among overweight children (comparing with normal-weight children).
1,327 citations
TL;DR: Owing to the scope and complexity of the obesity epidemic, prevention strategies and policies across multiple levels are needed in order to have a measurable effect and should include high-level global policies from the international community and coordinated efforts by governments, organizations, communities and individuals to positively influence behavioural change.
Abstract: The worldwide increase in obesity has been driven by global trade liberalization, economic growth and rapid urbanization. Owing to the scope and complexity of the obesity epidemic, prevention strategies and policies across multiple levels are needed in order to have a measurable effect. Although many putative causes of the obesity epidemic exist, in this Review the effect of globalization on global trends in obesity prevalence is discussed and population-based interventions from several countries are reviewed. The authors make broad policy recommendations for obesity and chronic disease prevention at the global population level.
1,153 citations
TL;DR: The evidence that decreasing SSBs will decrease the risk of obesity and related diseases such as T2D is compelling and prevention of long‐term weight gain through dietary changes such as limiting consumption of SSBs is more important than short-term weight loss in reducing the prevalence of obesity in the population.
Abstract: Summary Sugar-sweetened beverages (SSBs) are the single largest source of added sugar and the top source of energy intake in the U.S. diet. In this review, we evaluate whether there is sufficient scientific evidence that decreasing SSB consumption will reduce the prevalence of obesity and its related diseases. Because prospective cohort studies address dietary determinants of long-term weight gain and chronic diseases, whereas randomized clinical trials (RCTs) typically evaluate short-term effects of specific interventions on weight change, both types of evidence are critical in evaluating causality. Findings from well-powered prospective cohorts have consistently shown a significant association, established temporality and demonstrated a direct dose‐response relationship between SSB consumption and long-term weight gain and risk of type 2 diabetes (T2D). A recently published meta-analysis of RCTs commissioned by the World Health Organization found that decreased intake of added sugars significantly reduced body weight (0.80 kg, 95% confidence interval [CI] 0.39‐1.21; P < 0.001), whereas increased sugar intake led to a comparable weight increase (0.75 kg, 0.30‐1.19; P = 0.001). A parallel meta-analysis of cohort studies also found that higher intake of SSBs among children was associated with 55% (95% CI 32‐82%) higher risk of being overweight or obese compared with those with lower intake. Another metaanalysis of eight prospective cohort studies found that one to two servings per day of SSB intake was associated with a 26% (95% CI 12‐41%) greater risk of developing T2D compared with occasional intake (less than one serving per month). Recently, two large RCTs with a high degree of compliance provided convincing data that reducing consumption of SSBs significantly decreases weight gain and adiposity in children and adolescents. Taken together, the evidence that decreasing SSBs will decrease the risk of obesity and related diseases such as T2D is compelling. Several additional issues warrant further discussion. First, prevention of long-term weight gain through dietary changes such as limiting consumption of SSBs is more important than short-term weight loss in reducing the prevalence of obesity in the population. This is due to the fact that once an individual becomes obese, it is difficult to lose weight and keep it off. Second, we should consider the totality of evidence rather than selective pieces of evidence (e.g. from short-term RCTs only). Finally, while recognizing that the evidence of harm on health against SSBs is strong, we should avoid the trap of waiting for absolute proof before allowing public health action to be taken.
778 citations
TL;DR: The observational studies that gave rise to the idea of metabolically healthy obesity are described and the key parameters that can help to distinguish it from the general form of obesity are discussed.
580 citations
TL;DR: A genome-wide search for loci associated with the upper versus the lower 5th percentiles of body mass index, height and waist-to-hip ratio as well as clinical classes of obesity, including up to 263,407 individuals of European ancestry finds a large overlap in genetic structure and the distribution of variants between traits based on extremes and the general population and little etiological heterogeneity between obesity subgroups.
Abstract: Approaches exploiting trait distribution extremes may be used to identify loci associated with common traits, but it is unknown whether these loci are generalizable to the broader population. In a genome-wide search for loci associated with the upper versus the lower 5th percentiles of body mass index, height and waist-to-hip ratio, as well as clinical classes of obesity, including up to 263,407 individuals of European ancestry, we identified 4 new loci (IGFBP4, H6PD, RSRC1 and PPP2R2A) influencing height detected in the distribution tails and 7 new loci (HNF4G, RPTOR, GNAT2, MRPS33P4, ADCY9, HS6ST3 and ZZZ3) for clinical classes of obesity. Further, we find a large overlap in genetic structure and the distribution of variants between traits based on extremes and the general population and little etiological heterogeneity between obesity subgroups.
576 citations
01 Jan 2013
478 citations
TL;DR: The findings suggest the presence of heterogeneity in the associations between individual fruit consumption and risk of type 2 diabetes, whereas greater consumption of fruit juice is associated with a higher risk.
Abstract: Objective To determine whether individual fruits are differentially associated with risk of type 2 diabetes.
Design Prospective longitudinal cohort study.
Setting Health professionals in the United States.
Participants 66 105 women from the Nurses’ Health Study (1984-2008), 85 104 women from the Nurses’ Health Study II (1991-2009), and 36 173 men from the Health Professionals Follow-up Study (1986-2008) who were free of major chronic diseases at baseline in these studies.
Main outcome measure Incident cases of type 2 diabetes, identified through self report and confirmed by supplementary questionnaires.
Results During 3 464 641 person years of follow-up, 12 198 participants developed type 2 diabetes. After adjustment for personal, lifestyle, and dietary risk factors of diabetes, the pooled hazard ratio of type 2 diabetes for every three servings/week of total whole fruit consumption was 0.98 (95% confidence interval 0.96 to 0.99). With mutual adjustment of individual fruits, the pooled hazard ratios of type 2 diabetes for every three servings/week were 0.74 (0.66 to 0.83) for blueberries, 0.88 (0.83 to 0.93) for grapes and raisins, 0.89 (0.79 to 1.01) for prunes, 0.93 (0.90 to 0.96) for apples and pears, 0.95 (0.91 to 0.98) for bananas, 0.95 (0.91 to 0.99) for grapefruit, 0.97 (0.92 to 1.02) for peaches, plums, and apricots, 0.99 (0.95 to 1.03) for oranges, 1.03 (0.96 to 1.10) for strawberries, and 1.10 (1.02 to 1.18) for cantaloupe. The pooled hazard ratio for the same increment in fruit juice consumption was 1.08 (1.05 to 1.11). The associations with risk of type 2 diabetes differed significantly among individual fruits (P<0.001 in all cohorts).
Conclusion Our findings suggest the presence of heterogeneity in the associations between individual fruit consumption and risk of type 2 diabetes. Greater consumption of specific whole fruits, particularly blueberries, grapes, and apples, is significantly associated with a lower risk of type 2 diabetes, whereas greater consumption of fruit juice is associated with a higher risk.
443 citations
TL;DR: The meta-analysis showed an inverse and significant association between circulating 25(OH)D levels and risk of type 2 diabetes across a broad range of blood 25-hydroxy vitamin D levels in diverse populations.
Abstract: OBJECTIVE To quantitatively assess the strength and shape of the association between blood 25-hydroxy vitamin D [25(OH)D] levels and incident risk of type 2 diabetes. RESEARCH DESIGN AND METHODS A systematic search of the MEDLINE and Embase databases and a hand search of references from original reports were conducted up to 31 October 2012. Prospective observational studies that assessed the association between blood levels of 25(OH)D and risk of incident type 2 diabetes were included for meta-analysis. DerSimonian and Laird’s random-effects model was used. A quadratic spline regression analysis was used to examine the shape of the association with a generalized least-squares trend test performed for the dose-response relation. RESULTS A total of 21 prospective studies involving 76,220 participants and 4,996 incident type 2 diabetes cases were included for meta-analysis. Comparing the highest to the lowest category of 25(OH)D levels, the summary relative risk for type 2 diabetes was 0.62 (95% CI 0.54–0.70). A spline regression model showed that higher 25(OH)D levels were monotonically associated with a lower diabetes risk. This inverse association did not differ by sex, duration of follow-up, study sample size, diabetes diagnostic criteria, or 25(OH)D assay method. A linear trend analysis showed that each 10 nmol/L increment in 25(OH)D levels was associated with a 4% lower risk of type 2 diabetes (95% CI 3–6; P for linear trend CONCLUSIONS Our meta-analysis showed an inverse and significant association between circulating 25(OH)D levels and risk of type 2 diabetes across a broad range of blood 25(OH)D levels in diverse populations.
434 citations
Marcel den Hoed1, Mark Eijgelsheim2, Tõnu Esko3, Bianca J. J. M. Brundel4 +264 more•Institutions (85)
TL;DR: A 2-stage meta-analysis of genome-wide association studies in up to 181,171 individuals identified 14 new loci associated with heart rate and confirmed associations with all 7 previously established loci, providing fresh insights into the mechanisms regulating heart rate.
Abstract: Elevated resting heart rate is associated with greater risk of cardiovascular disease and mortality. In a 2-stage meta-analysis of genome-wide association studies in up to 181,171 individuals, we identified 14 new loci associated with heart rate and confirmed associations with all 7 previously established loci. Experimental downregulation of gene expression in Drosophila melanogaster and Danio rerio identified 20 genes at 11 loci that are relevant for heart rate regulation and highlight a role for genes involved in signal transmission, embryonic cardiac development and the pathophysiology of dilated cardiomyopathy, congenital heart failure and/or sudden cardiac death. In addition, genetic susceptibility to increased heart rate is associated with altered cardiac conduction and reduced risk of sick sinus syndrome, and both heart rate-increasing and heart rate-decreasing variants associate with risk of atrial fibrillation. Our findings provide fresh insights into the mechanisms regulating heart rate and identify new therapeutic targets.
332 citations
TL;DR: Higher consumption of eggs (up to one egg per day) is not associated with increased risk of coronary heart disease or stroke, and the increasedrisk of coronaryHeart disease among diabetic patients and reduced risk of hemorrhagic stroke associated with higher egg consumption in subgroup analyses warrant further studies.
Abstract: Objective To investigate and quantify the potential dose-response association between egg consumption and risk of coronary heart disease and stroke.
TL;DR: Lower melatonin secretion was independently associated with a higher risk of developing type 2 diabetes in women and in a cross-sectional analysis of persons without diabetes, lower nocturnal melatonin gland secretion was associated with increased insulin resistance.
Abstract: Importance Loss-of-function mutations in the melatonin receptor are associated with insulin resistance and type 2 diabetes. Additionally, in a cross-sectional analysis of persons without diabetes, lower nocturnal melatonin secretion was associated with increased insulin resistance. Objective To study the association between melatonin secretion and the risk of developing type 2 diabetes. Design, Setting, and Participants Case-control study nested within the Nurses' Health Study cohort. Among participants without diabetes who provided urine and blood samples at baseline in 2000, we identified 370 women who developed type 2 diabetes from 2000-2012 and matched 370 controls using risk-set sampling. Main Outcome Measures Associations between melatonin secretion at baseline and incidence of type 2 diabetes were evaluated with multivariable conditional logistic regression controlling for demographic characteristics, lifestyle habits, measures of sleep quality, and biomarkers of inflammation and endothelial dysfunction. Results The median urinary ratios of 6-sulfatoxymelatonin to creatinine were 28.2 ng/mg (5%-95% range, 5.5-84.2 ng/mg) among cases and 36.3 ng/mg (5%-95% range, 6.9-110.8 ng/mg) among controls. Women with lower ratios of 6-sulfatoxymelatonin to creatinine had increased risk of diabetes (multivariable odds ratio, 1.48 [95% CI, 1.11-1.98] per unit decrease in the estimated log ratio of 6-sulfatoxymelatonin to creatinine). Compared with women in the highest ratio category of 6-sulfatoxymelatonin to creatinine, those in the lowest category had a multivariable odds ratio of 2.17 (95% CI, 1.18-3.98) of developing type 2 diabetes. Women in the highest category of melatonin secretion had an estimated diabetes incidence rate of 4.27 cases/1000 person-years compared with 9.27 cases/1000 person-years in the lowest category. Conclusions and Relevance Lower melatonin secretion was independently associated with a higher risk of developing type 2 diabetes. Further research is warranted to assess if melatonin secretion is a modifiable risk factor for diabetes within the general population.
TL;DR: In two large, independent cohorts of nurses and other health professionals, the frequency of nut consumption was inversely associated with total and cause-specific mortality, independently of other predictors of death.
Abstract: Background Increased nut consumption has been associated with a reduced risk of major chronic diseases, including cardiovascular disease and type 2 diabetes mellitus. However, the association between nut consumption and mortality remains unclear. Methods We examined the association between nut consumption and subsequent total and cause-specific mortality among 76,464 women in the Nurses’ Health Study (1980–2010) and 42,498 men in the Health Professionals Follow-up Study (1986–2010). Participants with a history of cancer, heart disease, or stroke were excluded. Nut consumption was assessed at baseline and updated every 2 to 4 years. Results During 3,038,853 person-years of follow-up, 16,200 women and 11,229 men died. Nut consumption was inversely associated with total mortality among both women and men, after adjustment for other known or suspected risk factors. The pooled multivariate hazard ratios for death among participants who ate nuts, as compared with those who did not, were 0.93 (95% confidence interval [CI], 0.90 to 0.96) for the consumption of nuts less than once per week, 0.89 (95% CI, 0.86 to 0.93) for once per week, 0.87 (95% CI, 0.83 to 0.90) for two to four times per week, 0.85 (95% CI, 0.79 to 0.91) for five or six times per week, and 0.80 (95% CI, 0.73 to 0.86) for seven or more times per week (P<0.001 for trend). Significant inverse associations were also observed between nut consumption and deaths due to cancer, heart disease, and respiratory disease. Conclusions In two large, independent cohorts of nurses and other health professionals, the frequency of nut consumption was inversely associated with total and cause-specific mortality, independently of other predictors of death. (Funded by the National Institutes of Health and the International Tree Nut Council Nutrition Research and Education Foundation.)
TL;DR: Both the traditional Mediterranean diet and a low-fat diet exerted beneficial effects on BP and could be part of advice to patients for controlling BP, however, lower values of diastolic BP were found in the two groups promoting the Mediterranean diet with extra virgin olive oil or with nuts than in the control group.
Abstract: Background
Hypertension can be prevented by adopting healthy dietary patterns. Our aim was to assess the 4-year effect on blood pressure (BP) control of a randomized feeding trial promoting the traditional Mediterranean dietary pattern.
TL;DR: Eating breakfast was associated with significantly lower CHD risk in this cohort of male health professionals, mediated by body mass index, hypertension, hypercholesterolemia, and diabetes mellitus.
Abstract: Background—Among adults, skipping meals is associated with excess body weight, hypertension, insulin resistance, and elevated fasting lipid concentrations. However, it remains unknown whether speci...
TL;DR: Increasing red meat consumption over time is associated with an elevated subsequent risk of T2DM, and the association is partly mediated by body weight.
Abstract: Importance Red meat consumption has been consistently associated with an increased risk of type 2 diabetes mellitus (T2DM). However, whether changes in red meat intake are related to subsequent T2DM risk remains unknown. Objective To evaluate the association between changes in red meat consumption during a 4-year period and subsequent 4-year risk of T2DM in US adults. Design and Setting Three prospective cohort studies in US men and women. Participants We followed up 26 357 men in the Health Professionals Follow-up Study (1986-2006), 48 709 women in the Nurses’ Health Study (1986-2006), and 74 077 women in the Nurses’ Health Study II (1991-2007). Diet was assessed by validated food frequency questionnaires and updated every 4 years. Time-dependent Cox proportional hazards regression models were used to calculate hazard ratios with adjustment for age, family history, race, marital status, initial red meat consumption, smoking status, and initial and changes in other lifestyle factors (physical activity, alcohol intake, total energy intake, and diet quality). Results across cohorts were pooled by an inverse variance–weighted, fixed-effect meta-analysis. Main Outcomes and Measures Incident T2DM cases validated by supplementary questionnaires. Results During 1 965 824 person-years of follow-up, we documented 7540 incident T2DM cases. In the multivariate-adjusted models, increasing red meat intake during a 4-year interval was associated with an elevated risk of T2DM during the subsequent 4 years in each cohort (all P Conclusions and Relevance Increasing red meat consumption over time is associated with an elevated subsequent risk of T2DM, and the association is partly mediated by body weight. Our results add further evidence that limiting red meat consumption over time confers benefits for T2DM prevention.
TL;DR: This report describes how changes in environment, lifestyles and diet have increased life expectancy in China, but they have also led to a higher burden of chronic, non-communicabled disease.
Abstract: China has seen rapid socio-economic and epidemiolo-gical changes over the past several decades. Economicgrowth plus shifts in environment, lifestyles and diethave increased life expectancy, but they have also ledto a higher burden of chronic, non-communicablediseases. Stroke, coronary heart disease (CHD), cancerand diabetes account for 80% of the deaths and 70%of the disability-adjusted life-years lost in China.
National Institutes of Health1, Boston University2, Erasmus University Rotterdam3, Washington University in St. Louis4, University of Alabama at Birmingham5, Wake Forest University6, Wellcome Trust Sanger Institute7, University of Washington8, Cambridge University Hospitals NHS Foundation Trust9, University of Helsinki10, Harvard University11, Lund University12, Umeå University13, University of Cambridge14, University of Virginia15, Tufts University16, University of Turku17, University of Tampere18, University of North Carolina at Chapel Hill19, Harokopio University20, IMDEA21, Carlos III Health Institute22, Johns Hopkins University23, Cedars-Sinai Medical Center24, University of Texas Health Science Center at Houston25
TL;DR: The results indicate that variants in genes involved in nutrient metabolism and obesity are associated with macronutrient consumption in humans.
TL;DR: Irrespective of the caffeine content, SSB intake was associated with a higher risk of type 2 diabetes, and coffee intake wasassociated with a lower risk of T2D.
TL;DR: Increasing water intake in place of SSBs or fruit juices is associated with lower long-term weight gain, according to an inverse-variance-weighted meta-analysis.
Abstract: To examine the long-term relationship between changes in water and beverage intake and weight change. Prospective cohort studies of 50 013 women aged 40–64 years in the Nurses’ Health Study (NHS, 1986–2006), 52 987 women aged 27–44 years in the NHS II (1991–2007) and 21 988 men aged 40–64 years in the Health Professionals Follow-up Study (1986–2006) without obesity and chronic diseases at baseline. We assessed the association of weight change within each 4-year interval, with changes in beverage intakes and other lifestyle behaviors during the same period. Multivariate linear regression with robust variance and accounting for within-person repeated measures were used to evaluate the association. Results across the three cohorts were pooled by an inverse-variance-weighted meta-analysis. Participants gained an average of 1.45 kg (5th to 95th percentile: −1.87 to 5.46) within each 4-year period. After controlling for age, baseline body mass index and changes in other lifestyle behaviors (diet, smoking habits, exercise, alcohol, sleep duration, TV watching), each 1 cup per day increment of water intake was inversely associated with weight gain within each 4-year period (−0.13 kg; 95% confidence interval (CI): −0.17 to −0.08). The associations for other beverages were: sugar-sweetened beverages (SSBs) (0.36 kg; 95% CI: 0.24–0.48), fruit juice (0.22 kg; 95% CI: 0.15–0.28), coffee (−0.14 kg; 95% CI: −0.19 to −0.09), tea (−0.03 kg; 95% CI: −0.05 to −0.01), diet beverages (−0.10 kg; 95% CI: −0.14 to −0.06), low-fat milk (0.02 kg; 95% CI: −0.04 to 0.09) and whole milk (0.02 kg; 95% CI: −0.06 to 0.10). We estimated that replacement of 1 serving per day of SSBs by 1 cup per day of water was associated with 0.49 kg (95% CI: 0.32–0.65) less weight gain over each 4-year period, and the replacement estimate of fruit juices by water was 0.35 kg (95% CI: 0.23–0.46). Substitution of SSBs or fruit juices by other beverages (coffee, tea, diet beverages, low-fat and whole milk) were all significantly and inversely associated with weight gain. Our results suggest that increasing water intake in place of SSBs or fruit juices is associated with lower long-term weight gain.
Lund University1, Novo Nordisk2, Umeå University3, Harvard University4, Karolinska Institutet5, University of Eastern Finland6, University of Copenhagen7, Cambridge University Hospitals NHS Foundation Trust8, McMaster University9, University of Michigan10, University of North Carolina at Chapel Hill11, Aarhus University12, Uppsala University13, University of Southern Denmark14
TL;DR: A meta-analysis of 111,421 individuals provides further support for an interaction between physical activity and a GRS in obesity disposition, although these findings hinge on the inclusion of cohorts from North America, indicating that these results are either population-specific or non-causal.
Abstract: Numerous obesity loci have been identified using genome-wide association studies. A UK study indicated that physical activity may attenuate the cumulative effect of 12 of these loci, but replication studies are lacking. Therefore, we tested whether the aggregate effect of these loci is diminished in adults of European ancestry reporting high levels of physical activity. Twelve obesity-susceptibility loci were genotyped or imputed in 111,421 participants. A genetic risk score (GRS) was calculated by summing the BMI-associated alleles of each genetic variant. Physical activity was assessed using self-administered questionnaires. Multiplicative interactions between the GRS and physical activity on BMI were tested in linear and logistic regression models in each cohort, with adjustment for age, age2, sex, study center (for multicenter studies), and the marginal terms for physical activity and the GRS. These results were combined using meta-analysis weighted by cohort sample size. The meta-analysis yielded a statistically significant GRS × physical activity interaction effect estimate (Pinteraction = 0.015). However, a statistically significant interaction effect was only apparent in North American cohorts (n = 39,810, Pinteraction = 0.014 vs. n = 71,611, Pinteraction = 0.275 for Europeans). In secondary analyses, both the FTO rs1121980 (Pinteraction = 0.003) and the SEC16B rs10913469 (Pinteraction = 0.025) variants showed evidence of SNP × physical activity interactions. This meta-analysis of 111,421 individuals provides further support for an interaction between physical activity and a GRS in obesity disposition, although these findings hinge on the inclusion of cohorts from North America, indicating that these results are either population-specific or non-causal.
TL;DR: Two novel type 2 diabetes loci are identified, including G-protein–coupled receptor kinase 5 (GRK5) and RASGRP1, of which the association signal at GRK5 seems to be specific to East Asians, which may shed light on the ethnic differences in T2D susceptibility.
Abstract: Substantial progress has been made in identification of type 2 diabetes (T2D) risk loci in the past few years, but our understanding of the genetic basis of T2D in ethnically diverse populations remains limited. We performed a genome-wide association study and a replication study in Chinese Hans comprising 8,569 T2D case subjects and 8,923 control subjects in total, from which 10 single nucleotide polymorphisms were selected for further follow-up in a de novo replication sample of 3,410 T2D case and 3,412 control subjects and an in silico replication sample of 6,952 T2D case and 11,865 control subjects. Besides confirming seven established T2D loci (CDKAL1, CDKN2A/B, KCNQ1, CDC123, GLIS3, HNF1B, and DUSP9) at genome-wide significance, we identified two novel T2D loci, including G-protein–coupled receptor kinase 5 (GRK5) (rs10886471: P = 7.1 × 10−9) and RASGRP1 (rs7403531: P = 3.9 × 10−9), of which the association signal at GRK5 seems to be specific to East Asians. In nondiabetic individuals, the T2D risk-increasing allele of RASGRP1-rs7403531 was also associated with higher HbA1c and lower homeostasis model assessment of β-cell function (P = 0.03 and 0.0209, respectively), whereas the T2D risk-increasing allele of GRK5-rs10886471 was also associated with higher fasting insulin (P = 0.0169) but not with fasting glucose. Our findings not only provide new insights into the pathophysiology of T2D, but may also shed light on the ethnic differences in T2D susceptibility.
TL;DR: Findings support an association between POP exposure and the risk of T2D.
Abstract: Background: Prospective data regarding persistent organic pollutants (POPs) and risk of type 2 diabetes (T2D) are limited, and the results for individual POPs are not entirely consistent across studies.
Objectives: We prospectively examined plasma POP concentrations in relation to incident T2D and summarized existing evidence in a meta-analysis.
Methods: Plasma polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloroethane (DDT), dichlorodiphenyldichloroethylene (DDE), and hexachlorobenzene (HCB) concentrations were measured in 1,095 women who were free of diabetes at blood draw in 1989–1990 and participated in two case–control studies in the Nurses’ Health Study. We identified 48 incident T2D cases through 30 June 2008. We conducted a literature search in PubMed and EMBASE through December 2011 to identify prospective studies on POPs in relation to diabetes. We used a fixed-effects model to summarize results.
Results: After multivariable adjustment, plasma HCB concentration was positively associated with incident T2D [pooled odds ratio (OR) 3.59 (95% CI: 1.49, 8.64, ptrend = 0.003) comparing extreme tertiles]. Other POPs were not significantly associated with diabetes. After pooling our results with those of six published prospective studies that included 842 diabetes cases in total, we found that HCB and total PCBs both were associated with diabetes: the pooled ORs were 2.00 (95% CI: 1.13, 3.53; I2 = 21.4%, pheterogeneity = 0.28) and 1.70 (95% CI: 1.28, 2.27; I2 = 16.3%, pheterogeneity = 0.30) for HCB and total PCBs, respectively.
Conclusions: These findings support an association between POP exposure and the risk of T2D.
TL;DR: In a genome-wide meta-analysis of a population-based discovery cohort, rs838133 in FGF21 is a potential susceptibility gene for obesity and type 2 diabetes and the potential of genetic variation for determining dietary macronutrient intake is highlighted.
Abstract: Dietary intake of macronutrients (carbohydrate, protein, and fat) has been associated with risk of chronic conditions such as obesity and diabetes. Family studies have reported a moderate contribution of genetics to variation in macronutrient intake. In a genome-wide meta-analysis of a population-based discovery cohort (n = 33 533), rs838133 in FGF21 (19q13.33), rs197273 near TRAF family member-associated NF-kappa-B activator (TANK) (2p24.2), and rs10163409 in FTO (16q12.2) were among the top associations (P < 10−5) for percentage of total caloric intake from protein and carbohydrate. rs838133 was replicated in silico in an independent sample from the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium (CHARGE) Nutrition Working Group (n = 38 360) and attained genome-wide significance in combined analysis (Pjoint = 7.9 × 10−9). A cytokine involved in cellular metabolism, FGF21 is a potential susceptibility gene for obesity and type 2 diabetes. Our results highlight the potential of genetic variation for determining dietary macronutrient intake.
Erasmus University Rotterdam1, Florida State University2, University of Helsinki3, National Institutes of Health4, Greifswald University Hospital5, Harvard University6, University of Michigan7, Wake Forest University8, University of Washington9, Emory University10, VU University Amsterdam11, Rush University Medical Center12, Boston University13, University of Mississippi14, Cedars-Sinai Medical Center15, University of Texas Health Science Center at Houston16, University of Iceland17, Hannover Medical School18, Columbia University19, University of Exeter20, Group Health Research Institute21, Translational Genomics Research Institute22, Baylor College of Medicine23, University of California, San Francisco24, University of Pittsburgh25
TL;DR: The results suggest that only a large sample comprising more than 50,000 subjects may be sufficiently powered to detect genes for depressive symptoms, as well as a combined meta-analysis of all 22 discovery and replication studies.
TL;DR: It is suggested that absolute quantity, rather than variety, in fruit and vegetable intake is associated with a significantly lower risk of CHD.
TL;DR: Approximate prevalence ratios for short sleep duration in blacks compared with whites for each of 8 industry categories were estimated by using adjusted Poisson regression models with robust variance, suggesting the need for further investigation of racial/ethnic differences in the work-sleep relationship.
Abstract: Short sleep duration, which is associated with increased morbidity and mortality, has been shown to vary by occupation and industry, but few studies have investigated differences between black and white populations. By using data from a nationally representative sample of US adult short sleepers (n = 41,088) in the National Health Interview Survey in 2004–2011, we estimated prevalence ratios for short sleep duration in blacks compared with whites for each of 8 industry categories by using adjusted Poisson regression models with robust variance. Participants' mean age was 47 years; 50% were women and 13% were black. Blacks were more likely to report short sleep duration than whites (37% vs. 28%), and the black-white disparity was widest among those who held professional occupations. Adjusted short sleep duration was more prevalent in blacks than whites in the following industry categories: finance/information/real estate (prevalence ratio (PR) = 1.44, 95% confidence interval (CI): 1.30, 1.59); professional/administrative/management (PR = 1.30, 95% CI: 1.18, 1.44); educational services (PR = 1.39, 95% CI: 1.25, 1.54); public administration/arts/other services (PR = 1.30, 95% CI: 1.21, 1.41); health care/social assistance (PR = 1.23, 95% CI: 1.14, 1.32); and manufacturing/construction (PR = 1.14, 95% CI: 1.07, 1.20). Short sleep generally increased with increasing professional responsibility within a given industry among blacks but decreased with increasing professional roles among whites. Our results suggest the need for further investigation of racial/ethnic differences in the work-sleep relationship.
TL;DR: Strong evidence from numerous studies supports a positive association between increased consumption of sugar-sweetened beverages and the risk of obesity and it is unclear whether in
Abstract: The worldwide obesity epidemic has been largely attributed to marked changes in diet and lifestyle in the last 3 decades. Strong evidence from numerous studies supports a positive association between increased consumption of sugar-sweetened beverages and the risk of obesity. It is unclear whether in
TL;DR: It is suggested that higher walnut consumption is associated with a significantly lower risk of type 2 diabetes in women and the associations were largely explained by BMI.
Abstract: Walnuts are rich in polyunsaturated fatty acids and have been shown to improve various cardiometabolic risk factors. We aimed to investigate the association between walnut intake and incident type 2 diabetes in 2 large cohort studies: the Nurses’ Health Study (NHS) and NHS II. We prospectively followed 58,063 women aged 52–77 y in NHS (1998–2008) and 79,893 women aged 35–52 y in NHS II (1999–2009) without diabetes, cardiovascular disease, or cancer at baseline. Consumption of walnuts and other nuts was assessed every 4 y using validated food frequency questionnaires. Selfreported type 2 diabetes was confirmed by a validated supplemental questionnaire. We documented a total of 5930 incident type 2 diabetes cases during 10 y of follow-up. In the multivariable-adjusted Cox proportional hazards model without body mass index (BMI), walnut consumption was associated with a lower risk of type 2 diabetes, and the HRs (95% CIs) for participants consuming 1–3 servings/mo (1 serving = 28 g), 1 serving/wk, and $2 servings/wk of walnuts were 0.93 (0.88–0.99), 0.81 (0.70–0.94), and 0.67 (0.54–0.82) compared with women who never/rarely consumed walnuts (P-trend < 0.001). Further adjustment for updated BMI slightly attenuated the association and the HRs (95% CIs) were 0.96 (0.90–1.02), 0.87 (0.75–1.01), and 0.76 (0.62–0.94), respectively (P-trend = 0.002). The consumption of total nuts (P-trend < 0.001) and other tree nuts (P-trend = 0.03) was also inversely associated with risk of type 2 diabetes, and the associations were largely explained by BMI. Our results suggest that higher walnut consumption is associated with a significantly lower risk of type 2 diabetes in women. J. Nutr. 143: 512–518, 2013.
TL;DR: Irregular breakfast consumption was associated with a higher T2D risk in women, which was partially but not entirely mediated by BMI.