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A pooled analysis of waist circumference and mortality in 650,000 adults.
Cerhan, JR, Moore, SC, Jacobs, EJ, Kitahara, CM, Rosenberg, PS, Adami, HO, Ebbert, JO, English, DR, Gapstur, SM, Giles, GG, et al
Mayo Clinic proceedings. 2014;(3):335-45
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Abstract
OBJECTIVES To assess the independent effect of waist circumference on mortality across the entire body mass index (BMI) range and to estimate the loss in life expectancy related to a higher waist circumference. PATIENTS AND METHODS We pooled data from 11 prospective cohort studies with 650,386 white adults aged 20 to 83 years and enrolled from January 1, 1986, through December 31, 2000. We used proportional hazards regression to estimate hazard ratios (HRs) and 95% CIs for the association of waist circumference with mortality. RESULTS During a median follow-up of 9 years (maximum, 21 years), 78,268 participants died. After accounting for age, study, BMI, smoking status, alcohol consumption, and physical activity, a strong positive linear association of waist circumference with all-cause mortality was observed for men (HR, 1.52 for waist circumferences of ≥110 vs <90 cm; 95% CI, 1.45-1.59; HR, 1.07 per 5-cm increment in waist circumference; 95% CI, 1.06-1.08) and women (HR, 1.80 for waist circumferences of ≥95 vs <70 cm; 95% CI, 1.70-1.89; HR, 1.09 per 5-cm increment in waist circumference; 95% CI, 1.08-1.09). The estimated decrease in life expectancy for highest vs lowest waist circumference was approximately 3 years for men and approximately 5 years for women. The HR per 5-cm increment in waist circumference was similar for both sexes at all BMI levels from 20 to 50 kg/m(2), but it was higher at younger ages, higher for longer follow-up, and lower among male current smokers. The associations were stronger for heart and respiratory disease mortality than for cancer. CONCLUSIONS In white adults, higher waist circumference was positively associated with higher mortality at all levels of BMI from 20 to 50 kg/m(2). Waist circumference should be assessed in combination with BMI, even for those in the normal BMI range, as part of risk assessment for obesity-related premature mortality.
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Soy inclusion in the diet improves features of the metabolic syndrome: a randomized crossover study in postmenopausal women.
Azadbakht, L, Kimiagar, M, Mehrabi, Y, Esmaillzadeh, A, Padyab, M, Hu, FB, Willett, WC
The American journal of clinical nutrition. 2007;(3):735-41
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Abstract
BACKGROUND Little evidence exists regarding the effects of soy consumption on the metabolic syndrome in humans. OBJECTIVE We aimed to determine the effects of soy consumption on components of the metabolic syndrome, plasma lipids, lipoproteins, insulin resistance, and glycemic control in postmenopausal women with the metabolic syndrome. DESIGN This randomized crossover clinical trial was undertaken in 42 postmenopausal women with the metabolic syndrome. Participants were randomly assigned to consume a control diet (Dietary Approaches to Stop Hypertension, DASH), a soy-protein diet, or a soy-nut diet, each for 8 wk. Red meat in the DASH period was replaced by soy-protein in the soy-protein period and by soy-nut in the soy-nut period. RESULTS The soy-nut regimen decreased the homeostasis model of assessment-insulin resistance score significantly compared with the soy-protein (difference in percentage change: -7.4 +/- 0.8; P < 0.01) or control (-12.9 +/- 0.9; P < 0.01) diets. Consumption of soy-nut also reduced fasting plasma glucose more significantly than did the soy-protein (-5.3 +/- 0.5%; P < 0.01) or control (-5.1 +/- 0.6%; P < 0.01) diet. The soy-nut regimen decreased LDL cholesterol more than did the soy-protein period (-5.0 +/- 0.6%; P < 0.01) and the control (-9.5 +/- 0.6%; P < 0.01) diet. Soy-nut consumption significantly reduced serum C-peptide concentrations compared with control diet (-8.0 +/- 2.1; P < 0.01), but consumption of soy-protein did not. CONCLUSION Short-term soy-nut consumption improved glycemic control and lipid profiles in postmenopausal women with the metabolic syndrome.