Arch Ophthalmol. 2011 Feb 14. [Epub ahead of print]

Ramdas WD, Wolfs RC, Hofman A, de Jong PT, Vingerling JR, Jansonius NM.
Wolfs, Hofman, Vingerling, and Jansonius) and Ophthalmology (Drs Ramdas, Wolfs, and Vingerling), Erasmus Medical Center, Rotterdam, Department of Ophthalmogenetics, the Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (Dr de Jong), and Department of Ophthalmology, Academic Medical Center (Dr de Jong), Amsterdam, and Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen (Dr Jansonius).
Abstract
OBJECTIVE: To determine whether lifestyle-related risk factors, such as socioeconomic status, smoking, alcohol consumption, and obesity, are associated with open-angle glaucoma (OAG).
METHODS: Participants from the Rotterdam Study, a prospective population-based cohort study, were considered eligible if they participated at both baseline and follow-up and if they had no OAG at baseline. All participants underwent an identical ophthalmologic examination at all visits, including intraocular pressure measurements, optic nerve head assessment, and perimetry. Lifestyle-related factors were assessed by questionnaires by trained research assistants or measured during the examinations (body mass index and waist to hip ratio). Cox proportional hazard regression analysis was applied to calculate hazard ratios.
RESULTS: Of 3939 eligible participants, 108 (2.7%) developed OAG during 9.7 years’ mean follow-up. No statistically significant effect of socioeconomic status, smoking, or alcohol intake was found. In women, each unit increase in body mass index resulted in a 7% decrease in the risk of developing OAG (P = .04). There was a significant increasing effect of body mass index on intraocular pressure (P < .001) in women.
CONCLUSIONS: Obesity appears to be associated with a higher intraocular pressure and a lower risk of developing OAG. These associations were only present in women. Other lifestyle-related factors, such as socioeconomic status, smoking, and alcohol consumption, were not associated with OAG.

Tob Control. 2011 Jan 12

McCartney G , Mahmood L , Leyland AH , Batty GD , Hunt K .

MRC/CSO Social and Public Health Sciences Unit, Glasgow, UK.

Abstract

Background Women now outlive men throughout the globe, a mortality advantage that is very established in developed European countries. Debate continues about the causes of the gender gap, although smoking is known to have been a major contributor to the difference in the past. Objectives To compare the magnitude of the gender gap in all-cause mortality in 30 European countries and assess the contribution of smoking-related and alcohol-related deaths. Methods Data on all-cause mortality, smoking-related mortality and alcohol-related mortality for 30 European countries were extracted from the World Health Organization Health for All database for the year closest to 2005. Rates were standardised by the direct method using the European population standard and were for all age groups. The proportion of the gender gap in all-cause mortality attributable to smoking-related and alcohol-related deaths was then calculated. Results There was considerable variation in the magnitude of the male ‘excess’ of all-cause mortality across Europe, ranging from 188 per 100?000 per year in Iceland to 942 per 100?000 per year in Ukraine. Smoking-related deaths accounted for around 40% to 60% of the gender gap, while alcohol-related mortality typically accounted for 20% to 30% of the gender gap in Eastern Europe and 10% to 20% elsewhere in Europe. Conclusions Smoking continues to be the most important cause of gender differences in mortality across Europe, but its importance as an explanation for this difference is often overshadowed by presumptions about other explanations. Changes in smoking patterns by gender suggest that the gender gap in mortality will diminish in the coming decades.

The mechanisms by which aerobic fitness confers beneficial effects on cognition with aging are unclear but may involve cerebrovascular adaptations. In a cross-sectional study of women from the community (n = 42; age range = 50–90 years), we sought to determine whether physical fitness is associated with higher cerebrovascular function, and its relationship to cognition. Main outcome measures included resting cerebral blood flow, cerebrovascular reserve, physical fitness (i.e., View the MathML source) and cognition. Physically fit women had lower resting mean arterial pressure (MAP) and higher cerebrovascular conductance (CVC) than sedentary women. Overall cognition was negatively correlated with age and positively correlated with View the MathML source. View the MathML source was a predictor of resting CVC and MAP, and CVC and MAP when end-tidal gases were held constant at near-resting values. MAP and CVC were predictors of cognition. This study identified strong associations between physical fitness, vascular function and cognition, and provides new understanding regarding the mechanisms by which fitness positively impacts cognition with aging. The implications of this research are considerable and warrant future investigation.

Allison D. Brown, Carly A. McMorris, R. Stewart Longman, Richard Leigh, Michael D. Hill, Christine M. Friedenreich and Marc J. Poulina

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Women who developed invasive breast cancer, 350 post-menopausally and 257 pre-menopausally, during 240 959 person-years of follow-up in the UK Women’s Cohort Study (UKWCS) were studied. This cohort has 35 792 subjects with a wide range of exposure to dietary fibre with intakes of total fibre in the lowest quintile of <20 g/day up to >30 g/day in the top quintile. Fibre and breast cancer relationships were explored using Cox regression modelling adjusted for measurement error. Effects of fibre, adjusting for confounders were examined for pre- and post-menopausal women separately.

Results in pre-menopausal, but not post-menopausal women a statistically significant inverse relationship was found between total fibre intake and risk of breast cancer (P for trend = 0.01). The top quintile of fibre intake was associated with a hazard ratio of 0.48 [95% confidence interval (CI) 0.24–0.96] compared with the lowest quintile. Pre-menopausally, fibre from cereals was inversely associated with risk of breast cancer (P for trend = 0.05) and fibre from fruit had a borderline inverse relationship (P for trend = 0.09). A further model including dietary folate strengthened the significance of the inverse relationship between total fibre and pre-menopausal breast cancer.

These findings suggest that in pre-menopausal women, total fibre is protective against breast cancer; in particular, fibre from cereals and possibly fruit.

Janet Elizabeth Cade, Victoria Jane Burley, Darren Charles Greenwood the UK Women’s Cohort Study Steering Group, Centre for Epidemiology and Biostatistics, University of Leeds, 30-32 Hyde Terrace, Leeds LS2 9PL, UK.

International Journal of Epidemiology

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