Background 
The quality and quantity of individuals' social relationships has been linked not only to mental health but also to both morbidity and mortality.
Objectives 
This meta-analytic review was conducted to determine the extent to which social relationships influence risk for mortality, which aspects of social relationships are most highly predictive, and which factors may moderate the risk.
Data Extraction 
Data were extracted on several participant characteristics, including cause of mortality, initial health status, and pre-existing health conditions, as well as on study characteristics, including length of follow-up and type of assessment of social relationships.
Results 
Across 148 studies (308,849 participants), the random effects weighted average effect size was OR = 1.50 (95% CI 1.42 to 1.59), indicating a 50% increased likelihood of survival for participants with stronger social relationships. This finding remained consistent across age, sex, initial health status, cause of death, and follow-up period. Significant differences were found across the type of social measurement evaluated (p<0.001); the association was strongest for complex measures of social integration (OR = 1.91; 95% CI 1.63 to 2.23) and lowest for binary indicators of residential status (living alone versus with others) (OR = 1.19; 95% CI 0.99 to 1.44).
Conclusions 
The influence of social relationships on risk for mortality is comparable with well-established risk factors for mortality.

Please see later in the article for the Editors' Summary

/pdf/social-relationships-and-mortality-risk-a-meta-analytic-2ghmxi4ksm.pdf

Social Relationships and Mortality Risk: A Meta-analytic Review

IN 1974, the International Radiation Protection Association (IRPA) formed a working group on non-ionizing radiation (NIR), which examined the problems arising in the field of protection against the various types of NIR. At the IRPA Congress in Paris in 1977, this working group became the International Non-Ionizing Radiation Committee (INIRC). In cooperation with the Environmental Health Division of the World Health Organization (WHO), the IRPA/INIRC developed a number of health criteria documents on NIR as part of WHO’s Environmental Health Criteria Programme, sponsored by the United Nations Environment Programme (UNEP). Each document includes an overview of the physical characteristics, measurement and instrumentation, sources, and applications of NIR, a thorough review of the literature on biological effects, and an evaluation of the health risks of exposure to NIR. These health criteria have provided the scientific database for the subsequent development of exposure limits and codes of practice relating to NIR. At the Eighth International Congress of the IRPA (Montreal, 18–22 May 1992), a new, independent scientific organization—the International Commission on Non-Ionizing Radiation Protection (ICNIRP)—was established as a successor to the IRPA/INIRC. The functions of the Commission are to investigate the hazards that may be associated with the different forms of NIR, develop international guidelines on NIR exposure limits, and deal with all aspects of NIR protection. Biological effects reported as resulting from exposure to static and extremely-low-frequency (ELF) electric and magnetic fields have been reviewed by UNEP/ WHO/IRPA (1984, 1987). Those publications and a number of others, including UNEP/WHO/IRPA (1993) and Allen et al. (1991), provided the scientific rationale for these guidelines. A glossary of terms appears in the Appendix.

Guidelines for limiting exposure to time-varying electric, magnetic, and electromagnetic fields (up to 300 GHz)

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(08)60269-X.pdf

Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies

To revise 1998 recommendations on childhood obesity, an Expert Committee, comprised of representatives from 15 professional organizations, appointed experienced scientists and clinicians to 3 writing groups to review the literature and recommend approaches to prevention, assessment, and treatment. Because effective strategies remain poorly defined, the writing groups used both available evidence and expert opinion to develop the recommendations. Primary care providers should universally assess children for obesity risk to improve early identification of elevated BMI, medical risks, and unhealthy eating and physical activity habits. Providers can provide obesity prevention messages for most children and suggest weight control interventions for those with excess weight. The writing groups also recommend changing office systems so that they support efforts to address the problem. BMI should be calculated and plotted at least annually, and the classification should be integrated with other information such as growth pattern, familial obesity, and medical risks to assess the child’s obesity risk. For prevention, the recommendations include both specific eating and physical activity behaviors, which are likely to promote maintenance of healthy weight, but also the use of patient-centered counseling techniques such as motivational interviewing, which helps families identify their own motivation for making change. For assessment, the recommendations include methods to screen for current medical conditions and for future risks, and methods to assess diet and physical activity behaviors. For treatment, the recommendations propose 4 stages of obesity care; the first is brief counseling that can be delivered in a health care office, and subsequent stages require more time and resources. The appropriateness of higher stages is influenced by a patient’s age and degree of excess weight. These recommendations recognize the importance of social and environmental change to reduce the obesity epidemic but also identify ways healthcare providers and health care systems can be part of broader efforts.

/pdf/expert-committee-recommendations-regarding-the-prevention-38kyxmdgpa.pdf

Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report

The author discusses 3 variables that assess different aspects of social relationships—social support, social integration, and negative interaction. The author argues that all 3 are associated with health outcomes, that these variables each influence health through different mechanisms, and that associations between these variables and health are not spurious findings attributable to our personalities. This argument suggests a broader view of how to intervene in social networks to improve health. This includes facilitating both social integration and social support by creating and nurturing both close (strong) and peripheral (weak) ties within natural social networks and reducing opportunities for negative social interaction. Finally, the author emphasizes the necessity to understand more about who benefits most and least from socialconnectedness interventions.

/pdf/social-relationships-and-health-3l9d7bp4y3.pdf

Social relationships and health.

The incidence of breast cancer has increased dramatically over the last decade.’ It is currently estimated that one in eight women in the United States will develop breast cancer during her life.* Although numerous research studies have been conducted to investigate the etiology of breast cancer, only a portion of the variability in disease incidence has been explained, primarily by hormonal and reproductive factor^.^ To date, few investigators have taken variability in metabolism of carcinogens into account when assessing the associations between risk factors and disease outcome. It is known that individuals vary in their response to pharmaceutical and xenobiotic agents from 10to 2OO-fold,4 and this interindividual variability has been related to cancer risk at other sites5 Many carcinogens are lipophilic and are stored in adipose tissue, including that of the breast. In vitro data indicate that mammary epithelial cells totally metabolize some carcinogens.6 Thus, it is possible that inherited polymorphisms in genes involved in carcinogen metabolism and detoxification may affect breast cancer risk related to environmental exposures. Epidemiologic studies based on classification by genetic susceptibility might elucidate the etiology of breast cancer. The N-acetyltransferase gene (NAK!) is involved in the biotransformation of aromatic and heterocyclic amines. NAT2 is polymorphic, leading to differences in detoxification of aromatic amines, including those found in cigarette smoke? It also activates heterocyclic amines, mutagens formed in the cooking of meats. Both aromatic and heterocyclic amines have been found to be mammary mutagens in rodent model^.^,^ While some studies have been conducted to investigate the association between N-acetylation and breast cancer risk, these have used phenotypic, rather than genotypic, assays. Acetylation may be affected by disease status or chemotherapeutic agents, and past inconsistencies in study results may be due to inaccurately classified individuals as

The association of polymorphic N-acetyltransferase (NAT2) with breast cancer risk.

Progress report: the Arizona phase III study of the effect of wheat bran fiber on recurrence of adenomatous colon polyps

Maternal smoking increases the risk of spontaneous abortion. Polymorphic N-acetyltransferase (NAT2) and glutathione S-transferase (GSTM1) affect metabolism of some mutagens found in tobacco smoke. Genotypes and smoking were studied in women with at least two spontaneous abortions (N = 32) and those with at least two livebirths (N = 179). Smoking slightly increased risk (odds ratio = 1.3; 95% confidence interval = 0.6-2.9), but NAT2 and GSTM1 did not. NAT2 or GSTM1 polymorphisms did not appreciably modify smoking-related risk.

James R. Marshall

Papers

The association of polymorphic N-acetyltransferase (NAT2) with breast cancer risk.

Progress report: the Arizona phase III study of the effect of wheat bran fiber on recurrence of adenomatous colon polyps

Risk of recurrent spontaneous abortion, cigarette smoking, and genetic polymorphisms in NAT2 and GSTM1.

Diet and breast carcinoma survival: An abundance of hope, a dearth of evidence: reply.

Data dredging and noteworthiness.