Rising Stroke Rates Among Middle-Aged Women in the United States

Peningkatan prevalensi obesitas dan sindroma metabolik menyebabkan peningkatan prevalensi stroke pada wanita

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Stroke. 2010;41:1371

Weight of the Obesity Epidemic
Rising Stroke Rates Among Middle-Aged Women in the United States
Amytis Towfighi, MD; Ling Zheng, PhD Bruce Ovbiagele, MD

From the Department of Neurology (A.T., L.Z.), University of Southern California, Los Angeles, Calif; and the Department of Neurology (B.O.), University of California at Los Angeles, Los Angeles, Calif.

Background and Purpose— Recent US nationally representative data revealed that among individuals aged 45 to 54 years, women's stroke prevalence was double that of men's. The purpose of this study was to determine if the sex disparity existed previously.
Methods— We assessed sex-specific stroke and vascular risk factor prevalence among individuals aged 35 to 64 years who participated in the National Health and Nutrition Examination Surveys (NHANES), a cross-sectional, nationally representative survey conducted in 2 waves: 1988 to 1994 (n=7234) and 1999 to 2004 (n=6499).
Results— Women aged 35 to 54 years who participated in NHANES from 1999 to 2004 were 3 times more likely to have experienced a stroke compared with similarly aged women in NHANES 1988 to 1994 (1.8% versus 0.6%,P=0.003), but stroke prevalence among men did not change (0.9% versus 1.0%, nonsignificant). Among women, the prevalence of obesity (15.2% versus 17.9%, P=0.08), morbid obesity (12.8% versus 17.5%, P=0.003), abdominal obesity (47.4% versus 58.9%, P<0.0001), hypertriglyceridemia (22.91% versus 26.78%, P=0.035), and hypertension (33.04% versus 37.43%, P=0.03) was lower in NHANES 1988 to 1994 compared with the morerecent NHANES wave. Higher waist circumference was the only independent stroke risk factor for women aged 35 to 54 years in NHANES 1999 to 2004 (OR per 15-cm increase in waist circumference=1.02, 95% CI 1.00 to 1.04).
Conclusions— Stroke prevalence among women aged 35 to 54 years has tripled over the past 2 decades, at the same time remaining stable among men. Prevalence of obesity and 3 metabolic syndrome components increased; they may be key factors in the increase in women's stroke prevalence.

Low-Carbohydrate Diets and All-Cause and Cause-Specific Mortality

Diet rendah karbohidrat kaya sayuran menurunkan risiko kematian termasuk kematian akibat penyakit kardiovaskuler. Sebaliknya, diet rendah karbohidrat kaya sumber hewani meningkatkan risiko kematian pada pria dan wanita.

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Annals of Internal Medicine

September 7, 2010 vol. 153 no. 5 289-298

 

Low-Carbohydrate Diets and All-Cause and Cause-Specific Mortality
Two Cohort Studies
Teresa T. Fung, ScD; Rob M. van Dam, PhD; Susan E. Hankinson, ScD;Meir Stampfer, MD, DrPH; Walter C. Willett, MD, DrPH; and Frank B. Hu, MD, PhD

Abstract

Background: Data on the long-term association between low-carbohydrate diets and mortality are sparse.
Objective: To examine the association of low-carbohydrate diets with mortality during 26 years of follow-up in women and 20 years in men.
Design: Prospective cohort study of women and men who were followed from 1980 (women) or 1986 (men) until 2006. Low-carbohydrate diets, either animal-based (emphasizing animal sources of fat and protein) or vegetable-based (emphasizing vegetable sources of fat and protein), were computed from several validated food-frequency questionnaires assessed during follow-up.
Setting: Nurses' Health Study and Health Professionals' Follow-up Study.
Participants: 85 168 women (aged 34 to 59 years at baseline) and 44 548 men (aged 40 to 75 years at baseline) without heart disease, cancer, or diabetes.
Measurements: Investigators documented 12 555 deaths (2458 cardiovascular-related and 5780 cancer-related) in women and 8678 deaths (2746 cardiovascular-related and 2960 cancer-related) in men.
Results: The overall low-carbohydrate score was associated with a modest increase in overall mortality in a pooled analysis (hazard ratio [HR] comparing extreme deciles, 1.12 [95% CI, 1.01 to 1.24]; P for trend = 0.136). The animal low-carbohydrate score was associated with higher all-cause mortality (pooled HR comparing extreme deciles, 1.23 [CI, 1.11 to 1.37]; P for trend = 0.051), cardiovascular mortality (corresponding HR, 1.14 [CI, 1.01 to 1.29]; P for trend = 0.029), and cancer mortality (corresponding HR, 1.28 [CI, 1.02 to 1.60]; P for trend = 0.089). In contrast, a higher vegetable low-carbohydrate score was associated with lower all-cause mortality (HR, 0.80 [CI, 0.75 to 0.85]; P for trend ≤ 0.001) and cardiovascular mortality (HR, 0.77 [CI, 0.68 to 0.87]; P for trend < 0.001).
Limitations: Diet and lifestyle characteristics were assessed with some degree of error. Sensitivity analyses indicated that results were probably not substantively affected by residual confounding or an unmeasured confounder. Participants were not a representative sample of the U.S. population.
Conclusion: A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates.

Fish and n-3 Polyunsaturated Fatty Acid Intake and Depressive Symptoms

Asupan omega 3 dapat menurunkan tingkat depresi pada remaja pria

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PEDIATRICS Vol. 126 No. 3 September 2010, pp. e623-e630

Fish and n-3 Polyunsaturated Fatty Acid Intake and Depressive Symptoms: Ryukyus Child Health Study

Kentaro Murakami, PhDa,Yoshihiro Miyake, MD, PhDb,Satoshi Sasaki, MD, PhDa,Keiko Tanaka, DDS, PhDb,Masashi Arakawa, PhDc
a Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan;
b Department of Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan; and
c Field Science for Health and Recreation, Faculty of Tourism Sciences and Industrial Management, University of the Ryukyus, Okinawa, Japan

BACKGROUND Epidemiologic evidence on the role of fish and long-chain n-3 polyunsaturated fatty acid intake on depression during adolescence is sparse.
OBJECTIVE We examined the association between fish, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) intake and depressivesymptoms in a group of adolescents.
SUBJECTS AND METHOD This cross-sectional study, conducted in all public junior high schools in Naha City and Nago City, Okinawa, Japan, included3067 boys and 3450 girls aged 12 to 15 years (52.3% of the eligible sample). Dietary intake was assessed by using a validated, self-administered diet-history questionnaire. Depressive symptoms were defined as present when participants had a Center for Epidemiologic Studies Depression scale score of 16.
RESULTS The prevalence of depressive symptoms was 22.5% for boys and 31.2% for girls. For boys, fish intake was inversely associated with depressive symptoms (adjusted odds ratio [OR] for depressive symptoms in the highest [compared with the lowest] quintile of intake: 0.73 [95% confidence interval (CI): 0.55–0.97]; P for trend = .04). EPA intake showed an inverse associationwith depressive symptoms (OR: 0.71 [95% CI: 0.54–0.94]; P = .04). DHA intake also showed a similar inverse, albeit nonsignificant, association (OR: 0.79 [95% CI: 0.59–1.05]; P = .11). Inaddition, intake of EPA plus DHA was inversely associated with depressive symptoms (OR: 0.72 [95% CI: 0.55–0.96]; P = .08). Conversely, no such associations were observed among girls.
CONCLUSIONS Higher intake of fish, EPA, and DHA was independently associated with a lower prevalence of depressive symptoms in early male, but not female, adolescents.