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Meat consumption and mortality – results from the European Prospective Investigation into Cancer and Nutrition
Source: BMC Medicine
Background
Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC).
Methods
Included in the analysis were 448,568 men and women without prevalent cancer, stroke, or myocardial infarction, and with complete information on diet, smoking, physical activity and body mass index, who were between 35 and 69 years old at baseline. Cox proportional hazards regression was used to examine the association of meat consumption with all-cause and cause-specific mortality.
Results
Until June 2009, 26,344 deaths were observed. After multivariate adjustment, a high consumption of red meat was related to higher all-cause mortality (HR=1.14, 95% CI 1.01-1.28, 160+ vs. 10-19.9 g/day), and the association was stronger for processed meat (HR=1.44, 95% CI 1.24-1.66, 160+ vs. 10-19.9 g/day). After correction for measurement error, higher all-cause mortality remained significant only for processed meat (HR=1.18, 95% CI 1.11-1.25, per 50 g/d). We estimated that 3.3% (95% CI 1.5-5.0%) of deaths could be prevented if all participants had a processed meat consumption of less than 20 g per day. Significant associations with processed meat intake were observed for cardiovascular diseases, cancer, and ‘other causes of death’. The consumption of poultry was not related to all-cause mortality.
Conclusions
The results of our analysis support a moderate positive association between processed meat consumption and mortality in particular due to cardiovascular diseases, but also cancer.
Health surveillance of deployed military personnel occasionally leads to unexpected findings
Health surveillance of deployed military personnel occasionally leads to unexpected findings
Source: BMC Medicine
Post-traumatic stress disorder (PTSD) can be caused by life threatening illness, such as cancer and coronary events. The study by Forbes et al. made the unexpected finding that military personnel evacuation with medical illness have similar rates of PTSD to those evacuated with combat injuries. It may be that the illness acts as a nonspecific stressor that interacts with combat exposures to increase the risk of PTSD. Conversely, the inflammatory consequence of systemic illness may augment the effects to traumatic stress and facilitate the immunological abnormalities that are now being associated with PTSD and depression. The impact of the stress on cytokine systems and their role in the onset of PTSD demands further investigation. Military personnel evacuated due to physical illness require similar screening and monitoring for the risk of PTSD to those injured who are already known to be at high risk. Please see related article: http://www.biomedcentral.com/1471-244X/12/178.
Cross-national epidemiology of DSM-IV major depressive episode
Cross-national epidemiology of DSM-IV major depressive episode
Source: BMC Medicine
Background
Major depression is one of the leading causes of disability worldwide, yet epidemiologic data are not available for many countries, particularly low-middle income countries. This paper presents data on the prevalence, impairment, and demographic correlates of depression from 18 high and low-middle income countries in the World Mental Health Survey Initiative.Methods
DSM-IV major depressive episodes (MDE) were evaluated in face-to-face interviews using the World Health Organization Composite International Diagnostic Interview (CIDI). Data from 18 countries were analyzed in this report (n = 89,037). All countries surveyed representative, population-based samples of adults.Results
The average lifetime and 12-month prevalence estimates of DSM-IV MDE were 14.6% and 5.5% in the 10 high income and 11.1% and 5.9% in the 8 low-middle income countries. The average age of onset ascertained retrospectively was 25.7 in high and 24.0 in low-middle income countries. Functional impairment was associated with recency of MDE. The female:male ratio was about 2:1. In high income countries, younger age was associated with higher 12-month prevalence; in several low-middle income countries, in comparison, older age was associated with greater likelihood of MDE. The strongest demographic correlate in high income countries was being separated and in low-middle income countries was being divorced or widowed.Conclusions
MDE is a significant public health problem across all regions of the world and is strongly linked to social conditions. Future research is needed to investigate the combination of demographic risk factors that are most strongly associated with MDE in the specific countries included in the WMH.
+ Full Paper (PDF)
Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity
Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity
Source: BMC MedicineBackground
Celiac disease (CD) is an autoimmune enteropathy triggered by the ingestion of gluten. Gluten-sensitive individuals (GS) cannot tolerate gluten and may develop gastrointestinal symptoms similar to those in CD, but the overall clinical picture is generally less severe and is not accompanied by the concurrence of tissue transglutaminase autoantibodies or autoimmune comorbidities. By studying and comparing mucosal expression of genes associated with intestinal barrier function, as well as innate and adaptive immunity in CD compared with GS, we sought to better understand the similarities and differences between these two gluten-associated disorders.Methods
CD, GS and healthy, gluten-tolerant individuals were enrolled in this study. Intestinal permeability was evaluated using a lactulose and mannitol probe, and mucosal biopsy specimens were collected to study the expression of genes involved in barrier function and immunity.Results
Unlike CD, GS is not associated with increased intestinal permeability. In fact, this was significantly reduced in GS compared with controls (P = 0.0308), paralleled by significantly increased expression of claudin (CLDN) 4 (P = 0.0286). Relative to controls, adaptive immunity markers interleukin (IL)-6 (P = 0.0124) and IL-21 (P = 0.0572) were expressed at higher levels in CD but not in GS, while expression of the innate immunity marker Toll-like receptor (TLR) 2 was increased in GS but not in CD (P = 0.0295). Finally, expression of the T-regulatory cell marker FOXP3 was significantly reduced in GS relative to controls (P = 0.0325) and CD patients (P = 0.0293).Conclusions
This study shows that the two gluten-associated disorders, CD and GS, are different clinical entities, and it contributes to the characterization of GS as a condition associated with prevalent gluten-induced activation of innate, rather than adaptive, immune responses in the absence of detectable changes in mucosal barrier function.+ Full Paper (PDF)
