Showing papers on "Body mass index published in 1990"

A prospective study of obesity and risk of coronary heart disease in women.

Abstract: We examined the incidence of nonfatal and fatal coronary heart disease in relation to obesity in a prospective cohort study of 115,886 U.S. women who were 30 to 55 years of age in 1976 and free of diagnosed coronary disease, stroke, and cancer. During eight years of follow-up (775,430 person-years), we identified 605 first coronary events, including 306 nonfatal myocardial infarctions, 83 deaths due to coronary heart disease, and 216 cases of confirmed angina pectoris. A higher Quetelet index (weight in kilograms divided by the square of the height in meters) was positively associated with the occurrence of each category of coronary heart disease. For increasing levels of current Quetelet index (less than 21, 21 to less than 23, 23 to less than 25, 25 to less than 29, and greater than or equal to 29), the relative risks of nonfatal myocardial infarction and fatal coronary heart disease combined, as adjusted for age and cigarette smoking, were 1.0, 1.3, 1.3, 1.8, and 3.3 (Mantel-extension chi for trend = 7.29; P less than 0.00001). As expected, control for a history of hypertension, diabetes mellitus, and hypercholesterolemia--conditions known to be biologic effects of obesity--attenuated the strength of the association. The current Quetelet index was a more important determinant of coronary risk than that at the age of 18; an intervening weight gain increased risk substantially. These prospective data emphasize the importance of obesity as a determinant of coronary heart disease in women. After control for cigarette smoking, which is essential to assess the true effects of obesity, even mild-to-moderate overweight increased the risk of coronary disease in middle-aged women.

Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease.

Abstract: Several epidemiological studies have reported that the regional distribution of body fat is a significant and independent risk factor for cardiovascular disease (CVD) and related mortality. Although these associations are well established, the causal mechanisms are not fully understood. Numerous studies have, however, shown that specific topographic features of adipose tissue are associated with metabolic complications that are considered as risk factors for CVD such as insulin resistance, hyperinsulinemia, glucose intolerance and type II diabetes mellitus, hypertension, and changes in the concentration of plasma lipids and lipoproteins. The present article summarizes the evidence on the metabolic correlates of body fat distribution. Potential mechanisms for the association between body fat distribution, metabolic complications, and CVD are reviewed, with an emphasis on plasma lipoprotein levels and plasma lipid transport. From the evidence available, it seems likely that subjects with visceral obesity represent the subgroup of obese individuals with the highest risk for CVD. Although body fat distribution is now considered as a more significant risk factor for CVD and related death rate than obesity per se, further research is clearly needed to identify the determinants of body fat distribution and the causal mechanisms involved in the metabolic alterations. It appears certain, however, that an altered plasma lipid transport is a significant component of the relation between body fat distribution and CVD.

Weight as a risk factor for clinical diabetes in women

Abstract: To determine the relation of body mass index (weight/height2) with the risk of clinical non-insulin-dependent diabetes, the authors analyzed data from a cohort of 113,861 US women aged 30-55 years in 1976. During 8 years of follow-up (826,010 person-years), 873 definite cases were identified among women initially free from diagnosed diabetes. Among women of average body mass index, 23-23.9 kg/m2, the relative risk was 3.6 times that of women having a body mass index less than 22 kg/m2. The risk continued to increase above this level of body mass index. The authors observed a much weaker positive association with weight at age 18, and this association was eliminated after adjustment for current body mass index. Thus, weight gain after age 18 was a major determinant of risk. For an increase of 20-35 kg, the relative risk was 11.3, and for an increase of more than 35 kg, the relative risk was 17.3. Adjusting for family history did not appreciably alter the strong relation observed among women at average levels of body mass index. These data indicate that, at even average weight, women are at increased risk of clinical non-insulin-dependent diabetes and that the relation between body mass index and risk of diabetes is continuous.

Visceral fat accumulation in men is positively associated with insulin, glucose, and C-peptide levels, but negatively with testosterone levels

Abstract: Twenty-three healthy men (age 25 to 50 years), covering a wide range of fatness and body fat distribution, were studied. An oral glucose tolerance test was performed and adipose tissue areas were calculated from computed tomography (CT) scans made at the level of L4/L5. Visceral fat area was associated with elevated concentrations of insulin and C-peptide and with glucose intolerance before and after the oral glucose load. Concentrations of sex-hormone-binding globulin (SHBG), as well as total and free testosterone, were negatively correlated with waist/hip circumference ratio and visceral fat area and also negatively associated with increased glucose, insulin, and C-peptide concentrations. In multiple linear regression, adjusting for age, body mass index, and visceral fat area, serum concentrations of free testosterone were still negatively correlated with glucose, insulin, and C-peptide levels. Without claiming any causality in the observed associations, we conclude that, unlike in women, abdominal fat distribution, insulin, glucose, and C-peptide levels are negatively associated with serum testosterone levels in men.

The 10-year incidence of overweight and major weight gain in US adults.

Abstract: • We estimated the 10-year incidence of major weight gain (a gain in body mass index of ≥5 kg/m2and overweight (a body mass index of ≥278 for men and ≥273 for women) in US adults using data from the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study Persons aged 25 to 74 years at baseline were reweighed a decade after their initial examination (men, 3727; women, 6135) The incidence of major weight gain was twice as high in women and was highest in persons aged 25 to 34 years (men, 39%; women, 84%) Initially overweight women aged 25 to 44 years had the highest incidence of major weight gain of any subgroup (142%) For persons not overweight at baseline (men, 2760; women, 4295), the incidence of becoming overweight was similar in both sexes and was highest in those aged 35 to 44 years (men, 163%; women, 135%) We conclude that obesity pervention should begin among adults in their early 20s and that special emphasis is needed for young women who are already overweight (Arch Intern Med 1990;150:665-672)

Incidence of Type II Diabetes in Mexican Americans Predicted by Fasting Insulin and Glucose Levels, Obesity, and Body-Fat Distribution

Abstract: Few data exist on predictors of non-insulin-dependent (type II) diabetes mellitus. We examined body mass index (BMI), ratio of subscapular-to-triceps skin fold (centrality index), and fasting glucose and insulin concentrations as predictors of decompensation to type II diabetes in Mexican Americans, a population at high risk for this disorder. Twenty-eight of 474 initially nondiabetic Mexican Americans developed type II diabetes after 8 yr of follow-up. Converters to diabetes were older and had higher BMIs, centrality indices, and fasting glucose and insulin concentrations than nonconverters. Subjects in the highest quartile of the insulin distribution had 6.6 times the risk of developing type II diabetes as subjects in the remaining three quartiles combined (95% confidence interval [CI] = 3.14-13.7). In multivariate analysis, fasting glucose (odds ratio [OR] = 5.80, 95% CI = 2.57-13.1) and insulin (OR = 3.12, 95% CI = 1.36-7.14) remained significantly related to conversion to diabetes. However, BMI and centrality index, which were significantly related to conversion in the univariate analysis, were no longer significant in the multivariate analysis once glucose and insulin concentrations were taken into consideration, suggesting that the effect of these variables may be mediated by insulin resistance. Nearly half of the incident cases developed in a subset of the population who were simultaneously in the highest quartile of both fasting insulin and glucose concentrations (population-attributable risk 44.2%). Our results support the insulin resistance/pancreatic exhaustion theory of type II diabetes.

Decreased bone density in adolescent girls with anorexia nervosa

Abstract: Osteoporosis develops in women with chronic anorexia nervosa. To determine whether bone mass is reduced in younger patients as well, bone density was studied in a group of adolescent patients with anorexia nervosa. With single- and dual-photon absorptiometry, a comparison was made of bone mineral density of midradius, lumbar spine, and whole body in 18 girls (12 to 20 years of age) with anorexia nervosa and 25 healthy control subjects of comparable age. Patients had significantly lower lumbar vertebral bone density than did control subjects (0.830 +/- 0.140 vs 1.054 +/- 0.139 g/cm2) and significantly lower whole body bone mass (0.700 +/- 0.130 vs 0.955 +/- 0.130 g/cm2). Midradius bone density was not significantly reduced. Of 18 patients, 12 had bone density greater than 2 standard deviations less than normal values for age. The diagnosis of anorexia nervosa had been made less than 1 year earlier for half of these girls. Body mass index correlated significantly with bone mass in girls who were not anorexic (P less than .05, .005, and .0001 for lumbar, radius, and whole body, respectively). Bone mineral correlated significantly with body mass index in patients with anorexia nervosa as well. In addition, age at onset and duration of anorexia nervosa, but not calcium intake, activity level, or duration of amenorrhea correlated significantly with bone mineral density. It was concluded that important deficits of bone mass occur as a frequent and often early complication of anorexia nervosa in adolescence. Whole body is considerably more sensitive than midradius bone density as a measure of cortical bone loss in this illness.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal obesity is associated with an impaired fibrinolytic activity and elevated plasminogen activator inhibitor-1.

Abstract: Recent epidemiologic studies have shown that abdominal obesity, characterized by a high waist to hip circumference ratio (WHR), is associated with increased cardiovascular morbidity and mortality. The present study examines components of the fibrinolytic system in obese and lean middle-aged women with a high and low WHR. Ten women in each group were carefully matched with respect to age, body weight, lean body mass, and body fat. Fibrinogen and endothelial type of plasminogen activator inhibitor -1 (PAI-1) were significantly elevated in the obese women with a high WHR compared with the obese women with a low WHR or with both groups of lean women. In addition, obese women with a high WHR exhibited a greater metabolic risk profile (elevated glucose, insulin, and triglyceride levels). When all subjects were pooled for the analyses, both fibrinogen and PAI-1 levels correlated positively with glucose and insulin levels. PAI-1 was also negatively related to degree of insulin sensitivity measured with the euglycemic clamp technique. In the obese groups, WHR but not body mass index (BMI), correlated with PAI-1 levels. No such correlations were seen in the lean groups. In conclusion, the data show that a high WHR in obese, but not lean middle-aged women, is associated with an impaired fibrinolytic activity. This perturbation becomes enhanced when it is associated with hyperinsulinemia and insulin resistance, which is a typical feature of abdominal obesity.

Increased incidence of carcinoma of the breast associated with abdominal adiposity in postmenopausal women

Abstract: Epidemiologic studies have established that increased body weight is associated with a greater incidence of breast cancer in postmenopausal women. The authors hypothesized that abdominal adiposity further increases risk of postmenopausal breast cancer. They therefore investigated the waist-to-hip circumference ratio in relation to breast cancer incidence in a nested case-control study of 41,837 postmenopausal Iowa women aged 55-69 years. Women were recruited through a mail survey in January 1986 and were asked to have someone measure their body circumferences using a paper tape measure and written instructions. Cancer incidence was ascertained using a statewide cancer registry. A total of 229 incident breast cancers occurred among at-risk women during the first 2 years of follow-up (1986-1987). Compared with randomly selected controls (n = 1,839), women with incident breast cancer had a higher age-adjusted mean waist-to-hip ratio (by 0.013 units, p = 0.030), as well as greater mean weight (by 1.7 kg, p = 0.07), body mass index (by 0.6 kg/m2, p = 0.08), and weight gain since age 18 (by 2.7 kg, p less than 0.01). In multiple logistic regression models, age and current body mass index were significant effect modifiers of the association between the waist-to-hip ratio and breast cancer. A two-standard deviation increase in the waist-to-hip ratio (0.168 units) was associated with no increase in the relative risk of breast cancer in younger and lighter postmenopausal women. However, in older, heavier postmenopausal women, the same increase in the waist-to-hip ratio carried greater than a twofold excess relative risk. Adjustment for other breast cancer risk factors did not materially alter this finding. Two plausible explanations for elevated breast cancer incidence in women with abdominal adiposity include 1) increased concentrations of non-protein-bound estrogens due to reduced sex hormone binding globulin, or 2) increased conversion of adrenal androgens to estrone with abdominal adiposity.

Body mass definitions of obesity: sensitivity and specificity using self-reported weight and height.

Abstract: A high correlation between continuous measures of self-reported and measured weight and height has led investigators to infer that self-report of these variables is appropriate in epidemiologic studies. We evaluated the sensitivity and specificity of categorical definitions of body mass defined using self-reported height and weight on 7,455 adult participants of the Lipid Research Clinics Family Study (1975-1978) on whom both self-reported and measured height and weight were available. The categorical definition of obesity used here was a body mass index of at least 30 kg/m2. Overall, the sensitivity of the obese category when defined with self-reported weight and height was 74% (95% CI = 72%-76%), and the specificity was 99%. The sensitivities of the categories defined using self-reported measures varied considerably by sex, age, and educational level. Overall, the sensitivities were higher for women compared with men, as men were less accurate in reporting height. The sensitivity of the categorical definitions of obesity decreased with increasing age and education in both men and women. The sensitivity for elderly obese men was below 50%. These results suggest that substantial misclassification can occur when self-reported information is used to define body mass categories.

The population mean predicts the number of deviant individuals.

Abstract: OBJECTIVE--To examine the relation between the prevalence of deviation and the mean for the whole population in characteristics such as blood pressure and consumption of alcohol. DESIGN--Re-examination of standardised data from the Intersalt study, an international, multicentre study on the determinants of blood pressure. SETTING AND SUBJECTS--Samples of adults representing 52 populations in 32 countries. MAIN OUTCOME MEASURES--The relations, expressed as correlation coefficients, between the mean population values for blood pressure, body mass index, alcohol consumption, and sodium intake and the prevalence of, respectively, hypertension (greater than or equal to 140 mm Hg), obesity (body mass index greater than or equal to 30 kg/m2), high alcohol intake (greater than or equal to 300 ml/week), and high sodium intake (greater than or equal to 250 mmol/day). RESULTS--There were close and independent associations between the population mean and the prevalence of deviance for each of the variables examined: correlation coefficients were 0.85 for blood pressure, 0.94 for body mass index, 0.97 for alcohol intake, and 0.78 for sodium intake. CONCLUSIONS--These findings imply that distributions of health related characteristics move up and down as a whole: the frequency of "cases" can be understood only in the context of a population's characteristics. The population thus carries a collective responsibility for its own health and well being, including that of its deviants.

Close correlation of intra-abdominal fat accumulation to hypertension in obese women.

Abstract: The relation between intra-abdominal visceral fat accumulation and blood pressure was investigated in 67 obese women (mean body mass index, 33.6 +/- 3.1; average age, 50 +/- 11 years). As an index of intra-abdominal fat accumulation, the ratio of the intra-abdominal visceral fat area to subcutaneous fat area was determined using a computed tomographic section at the level of the umbilicus. When the obese subjects were divided into a hypertensive group and a normotensive group, the ratio of the intra-abdominal visceral fat area to subcutaneous fat area in the hypertensive group was significantly higher (0.53 +/- 0.33 versus 0.29 +/- 0.12, p less than 0.01). Significant correlations between the ratio of intra-abdominal visceral fat area to subcutaneous fat area and systolic blood pressure (r = 0.62, p less than 0.001) and diastolic blood pressure (r = 0.53, p less than 0.001) also were found. However, no significant difference existed in either the body mass index or the waist-to-hip circumference ratio between the hypertensive and normotensive groups. Plasma renin activity, aldosterone, epinephrine, and norepinephrine levels were not significantly different between the two groups. Moreover, the correlation between the ratio of the intra-abdominal visceral fat area to subcutaneous fat area ratio and blood pressure was found independent of age and body mass index by multiple regression analyses. We conclude that intra-abdominal fat accumulation itself may play an important role in the pathogenesis of hypertension in obesity.

Could saponins be a useful treatment for hypercholesterolaemia

Abstract: Body mass index (BMI) is used widely as an index of fatness (the proportion of the body as fat) but its application to the low weight and stature populations in developing countries has not been established. As BMI is an indicator of size (the amounts of fat and fat free masses) as well as fatness, its relation to fatness and interpretation as a measure of energy stores may vary in different groups. Very low BMI reflects low fat and fat free mass, a state for greater concern than low fat mass alone, and possibly more typical of chronic energy deficiency.

Incidence of hypertension and stroke in relation to body fat distribution and other risk factors in older women.

Abstract: The relation between body fat distribution, as measured by the waist-to-hip circumference ratio, and the 2-year incidences of hypertension and stroke were examined in a cohort of 41,837 women aged 55-69 years. Women who developed hypertension were 2.1 (95% confidence interval 1.7-2.6) times more likely to be in the upper tertile of waist-to-hip ratio than those who did not. Adjustment for age, body mass index (kilograms per meter squared), cigarette smoking, physical activity, alcohol intake, and education level reduced this odds ratio to 1.6 (95% confidence interval 1.3-2.1). Women who developed a stroke were also 2.1 (95% confidence interval 1.5-2.9) times more likely to be in the upper tertile of waist-to-hip ratio than those who did not. Adjustment for the same covariates also lowered this odds ratio to 1.6 (95% confidence interval 1.1-2.4). Further adjustment for hypertension and diabetes mellitus reduced the estimated risk of stroke due to elevated waist-to-hip ratio to 1.3 (95% confidence interval 0.8-2.1). Hypertension, diabetes mellitus, and cigarette smoking remained significantly associated with stroke incidence in the multivariate model. These results indicate that abdominal adiposity, as measured by an increased waist-to-hip ratio, increases the risks of hypertension and stroke, even after accounting for overall body mass. The association of abdominal adiposity with risk of stroke is related, in part, to the association of abdominal adiposity with hypertension and diabetes.

Risk of disability and mortality due to overweight in a Finnish population.

Abstract: OBJECTIVE--To investigate the effect of overweight on premature mortality and work disability in young and middle aged Finns. DESIGN--Prospective cohort study based on data collected in the multiphasic health examinations by the Social Insurance Institution of Finland from 1966 to 1972 and follow up until 1982. SETTING--34 Communities throughout Finland. SUBJECTS--12,053 Women and 19,076 men who were employed and aged 25-64 at baseline. MAIN OUTCOME MEASURES--Mortality and work disability pensions from all and specified causes. RESULTS--Body mass index was a weak predictor of death but a strong predictor of early work disability, which increased linearly with body mass index. After adjustment for age, geographical region, occupation, and smoking the relative risks of work disability for women and men with a body mass index greater than or equal to 30 kg/m2 were, respectively, 2.0 (95% confidence interval 1.8 to 2.3) and 1.5 (1.3 to 1.7) when compared with those of subjects with body mass index less than 22.5 kg/m2. The increased risks were due to an excess of cardiovascular and musculoskeletal diseases but not of mental diseases. One fourth of all disability pensions from cardiovascular and musculoskeletal causes in women and half as many in men could be attributed to overweight (body mass index greater than 25 kg/m2) alone. CONCLUSIONS--Though modest overweight has little impact on mortality it predicts severe functional impairment. A considerable proportion of work disability pensions could probably be prevented by efficient weight control.

Effects of weight lifting on bone mineral density in premenopausal women.

Abstract: A group of 68 premenopausal women participated in a controlled 12 month exercise program. Two groups were matched according to age, body size (body mass index), and typical activity level. Data collection included bone mineral density (BMD) of the lumbar spine with dual-photon absorptiometry and of the os calcis with single-photon absorptiometry, lean body mass, urinary calcium/creatinine, and urinary gamma-carboxyglutamic acid (Gla). Subjects were given a daily 500 mg supplement of elemental calcium. There was no significant difference between groups in terms of diet, in urinary calcium/creatinine or Gla, or in lean body mass. The weight lifting group had a nonsignificant increase in mean lumbar BMD of 0.81% and the control group exhibited a nonsignificant decrease of 0.5%. However, a paired t-test revealed a significant change in the means in either group or as matched pairs. The relatively small change seen as a result of this modified Nautilus exercise program may prevent moderate weight lifting from being a practical answer for osteoporosis, even in a highly motivated population.

Body Weight as a Risk Factor in the Elderly

Abstract: To determine whether body weight is a risk factor for mortality among older persons, we analyzed body mass index (weight [kilogram]/height [square meter]) data for 4710 white, National Health and Nutrition Examination Survey respondents who were aged 55 to 74 years during 1971 through 1975, in relation to their survival over an average of 8.7 years of follow-up. In a multivariate analysis that controlled for elevated blood pressure, smoking, and poverty, we found no additional risk associated with weight among women and a statistically significant, but moderate, additional risk (relative risk, 1.1 to 1.2) among men in the upper decile (body mass index, greater than or equal to 30 kg/m2). In contrast, low weight (body mass index, less than 22 kg/m2) was associated with increased mortality (relative risk, 1.3 to 1.6) except for women aged 55 to 64 years. We conclude that the accepted definition of overweight (body mass index, greater than or equal to 27.8 kg/m2 [men] or greater than or equal to 27.3 kg/m2 [women]) lacks specificity and may be inappropriate for older persons who do not have weight-related medical conditions. The low-weight mortality association, consistently demonstrated, deserves serious scrutiny.

Determinants of cardiac involvement in children and adolescents with essential hypertension.

Abstract: Left ventricular hypertrophy is often found in association with systemic hypertension and may be an independent risk factor for cardiovascular disease morbidity and mortality. Few studies have investigated the determinants of left ventricular mass (LVM) in young patients with essential hypertension. Therefore, we studied 104 children and adolescents with blood pressure persistently greater than the 90th percentile for age and sex and with no known cause of blood pressure elevation. LVM was determined by echocardiography and was indexed by height to account for body size. The mean LVM index was 90.2 +/- 26.0 g/m. Using the gender-specific 95th percentile from normal children, 40 subjects (38.5%) had left ventricular hypertrophy. Using multiple regression analysis, the significant independent direct correlates of LVM index were male sex, body mass index, dietary sodium intake, age at diagnosis, and systolic blood pressure at maximum exercise. The significant independent inverse correlate of LVM index was resting heart rate (p less than 0.05). These variables accounted for a substantial portion of the LVM index variance in this population (multiple R2 = 0.56, p less than 0.001). The results indicate that left ventricular hypertrophy is prevalent in children and adolescents with essential hypertension. The direct association of LVM index with body mass index and dietary sodium intake suggests weight reduction and dietary salt restriction might be useful to prevent or treat the development of left ventricular hypertrophy in pediatric patients with essential hypertension.

Association of echocardiographic left ventricular mass with body size, blood pressure and physical activity (the Framingham study)

Abstract: Left ventricular (LV) hypertrophy has been found to predispose to increased cardiovascular morbidity and mortality. To assess the clinical correlates and potential determinants of LV mass, the relation of echocardiographically determined LV mass to a variety of clinical parameters was examined in a general population. From 1979 to 1983 Framingham Heart Study participants underwent routine evaluation including medical history, physical examination and M-mode echocardiography. LV mass was determined using an anatomically validated formula that incorporates measurements of LV wall thickness and LV internal diameter. The study population consisted of 2,226 men and 2,746 women (mean age 51 years, range 17 to 90). Age, height, systolic blood pressure and body mass index (a measure of obesity) were statistically significant and independent correlates of LV mass in both sexes (p less than 0.001). In men under age 50, leisure-time physical activity was associated with LV mass (p less than 0.05), but this was not observed in women. Results from multivariate analyses in which body mass index and subscapular skinfold thickness were included suggest that lean body mass is correlated with LV mass. Maintenance of ideal body weight and normal blood pressure, weight reduction in obese persons and blood pressure control in hypertensive patients may contribute to the primary and secondary prevention of LV hypertrophy and its sequelae. Clinical interpretation of echocardiograms should include consideration of the correlates of LV mass to gain better insight into the pathogenesis of LV hypertrophy.

Association between certain foods and risk of acute myocardial infarction in women.

Abstract: STUDY OBJECTIVE--To examine the relation between selected foods and acute myocardial infarction in women. DESIGN--Case-control study conducted over five years. SETTING--30 Hospitals with coronary care units in northern Italy. SUBJECTS--287 Women who had had an acute myocardial infarction (median age 49, range 22-69 years) and 649 controls with acute disorders unrelated to ischaemic heart disease (median age 50, range 21-69 years) admitted to hospital during 1983-9. MAIN OUTCOME MEASURES--Frequency of consumption of various foods and odds ratios of risks associated with these foods. RESULTS--The risk of acute myocardial infarction was directly associated with frequency of consumption of meat (odds ratio 1.5 for upper v lower thirds of consumption), ham and salami (1.4), butter (2.3), total fat added to food (1.6), and coffee (2.8). Significant inverse relations were observed for fish (0.6), carrots (0.4), green vegetables (0.6), and fresh fruit (0.4). The risk was below one for moderate alcohol consumption (0.7) and above one for heavier intake (1.2). Allowance for major non-dietary covariates, including years of education, smoking, hyperlipidaemia, diabetes, hypertension, and body mass index, did not appreciably alter the estimates of risk for most of the foods; for coffee, however, the odds ratio fell to 1.8 on account of its high correlation with smoking. CONCLUSIONS--The frequency of consumption of a few simple foods may provide useful indicators of the risk of myocardial infarction. Furthermore, specific foods such as fish, alcohol, or vegetables and fruits may have an independent protective role in the risk of cardiovascular diseases.

A prospective population-based study of alcohol use and non-insulin-dependent diabetes mellitus.

Abstract: The effect of alcohol use on risk of non-insulin-dependent diabetes mellitus was assessed in a defined population. A 24-hour recall of alcohol intake and past-week alcohol intake were obtained by separate interviewers between 1973 and 1975, and responses were coded by the Nutrition Coordinating Center, University of Minnesota. Of the 524 adults aged 30-79 years without diabetes at baseline, 31 men and 44 women were identified as diabetic by means of a glucose tolerance test (World Health Organization criteria) between 1984 and 1987. Men, but not women, who developed diabetes reported significantly more alcohol intake in the past week and in the past 24 hours. The highest rate of diabetes among alcohol users was in heavy drinkers--statistically significant only in men. Alcohol use remained a significant predictor of diabetes in men after adjustment for baseline age, body mass index (weight (kg)/height (m)2), cigarette smoking, family history of diabetes, and systolic blood pressure with a logistic regression model. The relative risk associated with past-week alcohol intake was 1.5 per 137.8 g; for past-24-hour alcohol intake, it was 1.5 per 24.5 g. Adjustment for baseline fasting plasma glucose and triglycerides did not change the results. Alcohol intake appears to be associated with risk of non-insulin-dependent diabetes mellitus in men.

Cardiovascular disease risk factors prior to the diagnosis of impaired glucose tolerance and non-insulin-dependent diabetes mellitus in a community of older adults

Abstract: Cardiovascular disease risk factors were measured 10-15 years (mean, 11.9 years) prior to the diagnosis of impaired glucose tolerance and non-insulin-dependent diabetes mellitus in Rancho Bernardo, California. There were 1,847 men and women aged 40-79 years who had no known diabetes or fasting hyperglycemia at baseline (1972-1974). At the follow-up examination (1984-1987), 1,115 men and women (60.4%) had normal glucose tolerance, 513 (27.8%) had impaired glucose tolerance, and 219 (11.9%) had non-insulin-dependent diabetes mellitus as defined by World Health Organization criteria. Rates of impaired glucose tolerance and non-insulin-dependent diabetes mellitus increased with age, and impaired glucose tolerance was approximately twice as common as non-insulin-dependent diabetes mellitus. Those with non-insulin-dependent diabetes mellitus were older and more overweight and had higher levels of blood pressure, fasting plasma glucose, and triglyceride at baseline than those whose glucose tolerance remained normal; those with impaired glucose tolerance generally had intermediate levels of the same risk factors. When it was examined in a prospective fashion, in general, the age-adjusted risk of non-insulin-dependent diabetes mellitus increased with increasing quartile of each risk factor, and the risk of non-insulin-dependent diabetes mellitus in a given quartile was greater than that for impaired glucose tolerance. Logistic regression analyses showed these factors to be positively associated with a subsequent diagnosis of impaired glucose tolerance as well as non-insulin-dependent diabetes mellitus in women, and to a lesser degree in men, independent of baseline age and body mass index (weight (kg)/height (m)2). These data illustrate that a less favorable cardiovascular risk factor profile precedes the diagnosis of both non-insulin-dependent diabetes mellitus and impaired glucose tolerance.