Abstract:
STUDY OBJECTIVE:It has been frequently noted that overweight and obesity have a stronger relationship to hypertension and diabetes mellitus than to the risk of stroke. The reason for this observation has not been clear. This study aimed to examine the lifelong relation between body fat and stroke to shed light on why the public health risks of overweight and obesity have tended to be obscured in previous epidemiological studies. DESIGN:Case-control study. SETTING:Eleven general practices in west Birmingham. PARTICIPANTS:Altogether 125 men and women who had just had their first stroke and were aged 35-74 years and 198 controls frequency matched for age and sex were recruited over 24 months during 1988-90. MAIN RESULTS:Those in both the thinnest and fattest quartiles of subscapular skinfold thickness were at increased risk of stroke compared with those in the middle quartiles (age adjusted odds ratios 2.12 (95% confidence interval (CI) 1.2, 3.9) and 2.08 (1.1, 3.8) respectively). When lifelong maximum reported body mass index was assessed the hazards of obesity but not leanness were seen (odds ratio for the highest versus the lowest quartile were--age adjusted, 1.54 (0.8, 3.0) and multiple risk factor adjusted, 2.25 (1.1, 4.5). This lifelong pattern of risk seemed to be established early, the odds ratios for the highest versus the lowest quartile of reported body mass index aged 21 years were--age adjusted, 2.18 (1.1, 4.4) and multiple risk factor adjusted 2.13 (1.1, 4.2). The risks of both maximum reported body mass index and reported body mass index aged 21 years were more clear in those who had never smoked cigarettes (test for trend in odds ratio, p = 0.009 and p = 0.02 respectively). CONCLUSIONS:Potentially important risks of excessive body fat for stroke can be obscured by both a history of cigarette smoking and thinness associated with deteriorating health. The results seem to explain why excess body fat has previously been consistently related to hypertension and diabetes mellitus but less consistently to stroke. Avoiding overweight and obesity during adult life offers protection against stroke.
journal_name
J Epidemiol Community Healthjournal_title
Journal of epidemiology and community healthauthors
Shinton R,Sagar G,Beevers Gdoi
10.1136/jech.49.3.259subject
Has Abstractpub_date
1995-06-01 00:00:00pages
259-64issue
3eissn
0143-005Xissn
1470-2738journal_volume
49pub_type
临床试验,杂志文章,随机对照试验abstract:BACKGROUND:Diagnosis of cancer through emergency presentation is associated with poorer prognosis. While reductions in emergency presentations have been described, whether known sociodemographic inequalities are changing is uncertain. METHODS:We analysed 'Routes to Diagnosis' data on patients aged ≥25 years diagnosed ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech-2017-210371
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:There is concern about the health of populations living close to nuclear waste reprocessing plants. A comparative study was conducted on reproductive life events in the general population living near the nuclear waste reprocessing plant in Beaumont-Hague, France and a reference area in Brittany. DESIGN, SETT...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2007.061069
更新日期:2008-06-01 00:00:00
abstract::One of the findings of this study is that regional variations in the infant mortality rates of Sri Lanka are large, ranging from 26 per 1000 live births in Jaffna to 91 per 1000 in Nuwara Eliya, a tea estate district. These differences are more strongly associated with regional variations in environmental determinants...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.34.2.76
更新日期:1980-06-01 00:00:00
abstract:BACKGROUND:A highly sensitive and simple screening procedure is required for early detection of low birthweight and small for gestational age, especially in developing countries. METHODS:A meta-analysis was performed to evaluate use of symphysis-fundal height for prediction of low birthweight and small for gestational...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,meta分析
doi:10.1136/jech-2012-202141
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:To estimate the degree to which the proportion of homicides and suicides committed with a gun is associated with reported availability of firearms across Chicago neighbourhoods. METHODS:Data were collected as part of the Project on Human Development in Chicago Neighborhoods (PHDCN), a combined neighbourhood ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2005.039149
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:Health inequalities can be observed in early life as unfavourable birth outcomes. Evidence indicates that neighbourhood socioeconomic circumstances influence health. However, studies looking into temporal trends in inequalities in birth outcomes including neighbourhood socioeconomic conditions are scarce. ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2019-213162
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:To describe the situation of the influenza in Portugal through the estimates of the incidence rates and the identification of the viral strains implicated on it during the period 1990-1996. DESIGN:The integrated clinical and laboratory surveillance system for influenza in Portugal is based on the Portuguese...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:Injuries have been recognised as important public health concerns, particularly among adolescents and young adults. Few studies have examined injuries using a multilevel perspective that addresses individual socioeconomic status (SES) and health behaviours and local socioeconomic conditions in early adolesce...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2017-210259
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Adolescent drinking in Western countries has been associated with older age and high socioeconomic status, but the association with family structure was inconsistent. METHODS:In a 2012-2013 school-based survey in Hong Kong, 23,096 students (mean age 14.7 years, SD 1.8 years) completed an anonymous questionn...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2015-206418
更新日期:2016-04-01 00:00:00
abstract:STUDY OBJECTIVE:This study aimed to examine whether the high mortality in lower salaried men in Norway was related to an inflow into this group of unskilled workers with high mortality. DESIGN:Individual information on occupation was derived from the 1970 and the 1980 censuses and linked to mortality data for the peri...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.47.3.192
更新日期:1993-06-01 00:00:00
abstract::Many cancers and other chronic diseases are associated with a long delay between exposure to a putative risk factor and subsequent diagnosis. This presents well recognised problems in the elucidation of suspected risk factors by epidemiological methods. In this paper we discuss the interpretation in epidemiological st...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.40.4.289
更新日期:1986-12-01 00:00:00
abstract::Applying research to guide evidence-based practice is an ongoing and significant challenge for public health. Developments in the emerging field of 'translation' have focused on different aspects of the problem, resulting in competing frameworks and terminology. In this paper the scope of 'translation' in public healt...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2011-200038
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:To perform the first European overview of educational inequalities in the use of blood pressure and cholesterol screening. METHODS:Data were obtained on the use of screening services according to educational level from nationally representative cross-sectional surveys in Belgium, Czech Republic, Denmark, Es...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2011-200273
更新日期:2012-11-01 00:00:00
abstract:STUDY OBJECTIVE:To examine the impact of non-fatal war related injuries on physical disability in a group of war wounded civilians and to assess their needs. DESIGN:Cross sectional study. Home interviews were conducted using a structured interview schedule around one month after the injury, to assess impairments, disa...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.54.1.35
更新日期:2000-01-01 00:00:00
abstract::Social position is known to play a role in the quality of ageing, notably through the stimulation/dysregulation of key physiological systems in response to external stresses. Using data from one wave of Understanding Society including 9088 participants, we defined, as an extension of the allostatic load, a synthetic B...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2018-212010
更新日期:2019-08-01 00:00:00
abstract::We examined the relation between questionnaire answers concerning living conditions during childhood and coronary risk factors in 7405 men and 7247 women. Poverty during childhood was positively associated with age-adjusted levels (p less than 0.05) of total cholesterol and percentage of current smokers (men only) and...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.39.3.210
更新日期:1985-09-01 00:00:00
abstract:STUDY OBJECTIVE:The aim was to investigate suicide and "undetermined" deaths by age, economic activity status, and social class in Great Britain among males of working age. DESIGN:The study was a cross sectional analysis of Registrar General's data for England and Wales around 1981, repeated for around 1971, and for S...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.45.3.195
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:Several studies have examined the effects of sample selection on the exposure-outcome association estimates in cohort studies, but the reasons why this selection may induce bias have not been fully explored. AIMS:To investigate how sample selection of the web-based NINFEA birth cohort may change the confoun...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2011-200065
更新日期:2012-11-01 00:00:00
abstract::Data from the Glasgow Register of Congenital Malformations were used to investigate the extent of the recent decline in the prevalence of anencephaly and spina bifida, and the contribution of antenatal screening to it. Over the period 1974-85 inclusive, 303 pregnancies with an anencephalic foetus were diagnosed, repre...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.42.3.271
更新日期:1988-09-01 00:00:00
abstract::The Global Polio Eradication Initiative to eradicate polio completely by the year 2000 has been successful, except for three endemic and some non-endemic countries. Pakistan, one of the three endemic polio reservoirs, is posing a serious threat to the success of the initiative. Currently, the expanded programme on imm...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech-2012-202162
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Literacy, the ability to access, understand and utilise information and concepts from diverse sources in ways that promote good outcomes is key to successful ageing. Domain-specific health and financial literacy are particularly relevant to older adults as they face increasingly complex health and financial ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2018-210977
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:It is generally acknowledged that conventional estimates of the potential number of life years to be gained by elimination of causes of death are too generous. This is because these estimates fail to take into account the fact that those who are saved from the cause are likely to have one or more other condi...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.53.1.32
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:This paper aims to assess whether 7-year-olds' physical activity is associated with family and area-level measures of the physical and socioeconomic environments. METHODS:We analysed the association of environments with physical activity in 6497 singleton children from the UK Millennium Cohort Study with re...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2014-204287
更新日期:2015-01-01 00:00:00
abstract:STUDY OBJECTIVE:The aim was to test a large set of childhood leukaemia and lymphoma registrations for the presence of short radius spacial clusters. DESIGN:The study was a geographical cluster analysis. SETTING:England, Wales and Scotland. PATIENTS:All registrations for leukaemia and lymphoma between 1966 and 1983 i...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.46.6.573
更新日期:1992-12-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the short term relationship between air pollution and the daily number of emergency hospital admissions for respiratory disease. DESIGN:Data were analysed using autoregressive Poisson regression allowing for overdispersion and controlling for possible confounding factors such as seasonal and ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.50.suppl_1.s22
更新日期:1996-04-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the ways in which institutions devoted to international development influence epidemiological studies. DESIGN:This article takes a descriptive epidemiological study of El Salvador, Epidemiological Profile, conducted in 1994 by the US Agency for International Development, as a case study. T...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.55.3.164
更新日期:2001-03-01 00:00:00
abstract:STUDY OBJECTIVE:To examine the effect of deprivation, crowding, maternal smoking, and breast feeding on morbidity from wheeze and diarrhoea in the first six months after birth. DESIGN:A geographically located population survey using maternal responses on self completion questionnaires. SETTING:The three health distri...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.52.7.451
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:The Smokefree Class Competition, the largest school-based smoking prevention programme in Europe, aims to create a class climate that denormalises smoking. An analysis was carried out to assess whether it increases bullying or perception of isolation. METHODS:A cluster randomised controlled trial was conduc...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,随机对照试验
doi:10.1136/jech.2009.089185
更新日期:2010-03-01 00:00:00
abstract::In 1999 a great multi-site clinical trial known as the randomised Aldactone evaluation study (RALES) showed that the use of spironolactone importantly reduced complications attributable to chronic heart failure without major negative side effects. Recently, RALES has been questioned by a large scale observational stud...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech.2004.031633
更新日期:2005-11-01 00:00:00
abstract:STUDY OBJECTIVE:This study aimed to estimate the health and social costs of tobacco use in Ontario, Canada. DESIGN:This was a cost-benefit analysis based on cross sectional data in 1988, stratified by age and sex, using an attributable risk model. The total cost of the consequences of tobacco use in the society includ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.50.1.81
更新日期:1996-02-01 00:00:00