JORGE LUIS CHAVARRO CHAVARRO - Academia.edu (original) (raw)

Papers by JORGE LUIS CHAVARRO CHAVARRO

Research paper thumbnail of The association of folate, zinc and antioxidant intake with sperm aneuploidy in healthy non-smoking men

Human Reproduction, 2008

BACKGROUND: Little is known about the effect of paternal nutrition on aneuploidy in sperm. We inv... more BACKGROUND: Little is known about the effect of paternal nutrition on aneuploidy in sperm. We investigated the association of normal dietary and supplement intake of folate, zinc and antioxidants (vitamin C, vitamin E and b-carotene) with the frequency of aneuploidy in human sperm. METHODS: Sperm samples from 89 healthy, nonsmoking men from a non-clinical setting were analysed for aneuploidy using fluorescent in situ hybridization with probes for chromosomes X, Y and 21. Daily total intake (diet and supplements) for zinc, folate, vitamin C, vitamin E and b-carotene was derived from a food frequency questionnaire. Potential confounders were obtained from a self-administered questionnaire. RESULTS: After adjusting for covariates, men with high folate intake (>75th percentile) had lower frequencies of sperm with disomies X, 21, sex nullisomy, and a lower aggregate measure of sperm aneuploidy (P 0.04) compared with men with lower intake. In adjusted continuous analyses, total folate intake was inversely associated with aggregate sperm aneuploidy (-3.6% change/100 mg folate; 95% CI: 26.3, 20. 8) and results were similar for disomies X, 21 and sex nullisomy. No consistent associations were found between antioxidant or zinc intakes and sperm aneuploidy. CONCLUSIONS: Men with high folate intake had lower overall frequencies of several types of aneuploid sperm.

Research paper thumbnail of Abstract P163: Healthful Dietary Patterns and the Risk of Hypertension Among Women With a History of Gestational Diabetes

Circulation, 2015

Background: Women who developed gestational diabetes (GDM) are at an increased risk for hypertens... more Background: Women who developed gestational diabetes (GDM) are at an increased risk for hypertension, compared with parous women without GDM. The role of diet in the progression to hypertension among this highly susceptible population is unknown. Methods: We conducted a prospective cohort study among 3,818 women with a history of GDM in the Nurses’ Health Study II, as a part of the ongoing Diabetes & Women’s Health Study. These women were followed from 1991 until 2011. Incident hypertension was identified by self-report with a previously validated questionnaire. Adherence scores for the 2010 Alternative Health Eating Index (AHEI-2010), the Alternate Mediterranean Diet (aMed) and the Dietary Approaches to Stop Hypertension (DASH) were computed for each participant; higher scores indicate better diet quality. Cox proportional hazard models were used adjusting for major risk factors for hypertension, including dietary and lifestyle factors, medical history, reproductive factors and med...

Research paper thumbnail of Association of History of Gestational Diabetes With Long-term Cardiovascular Disease Risk in a Large Prospective Cohort of US Women

JAMA internal medicine, 2017

Previous studies identify gestational diabetes (GD) as a risk factor for intermediate markers of ... more Previous studies identify gestational diabetes (GD) as a risk factor for intermediate markers of cardiovascular disease (CVD) risk; however, few are prospective, evaluate hard CVD end points, or account for shared risk factors including body weight and lifestyle. To prospectively evaluate history of GD in relation to incident CVD risk. The Nurses' Health Study II (NHS II) is an observational cohort study of US female nurses established in 1989, with ongoing follow-up. Biennial questionnaires updated behavioral characteristics, health outcomes, and lifestyle factors. Multivariable Cox models estimated the hazard ratio (HR) and 95% CI for CVD risk. We included 89 479 women who reported at least 1 pregnancy and were free of CVD and cancer at baseline. Follow-up through May 31, 2015, was complete for more than 90% of eligible participants. History of GD was self-reported at baseline (1989) via questionnaire and updated every 2 years. We observed 1161 incident self-reported nonfatal ...

Research paper thumbnail of Smoking during pregnancy in relation to grandchild birth weight and BMI trajectories

PLOS ONE, 2017

Background Maternal smoking has been linked to lower birth weight and higher risk of childhood ob... more Background Maternal smoking has been linked to lower birth weight and higher risk of childhood obesity. However, it is unknown whether grand-maternal smoking during pregnancy is associated with grandchildren birth weight and body mass index (BMI) trajectories. Methods We investigated associations of smoking during pregnancy with birth weight, risks of overweight and BMI trajectories among 46,858 mother-child dyads and 6,583 grandmothermother-child triads of three cohort studies of related individuals. Smoking during pregnancy was reported by mothers, and anthropometric data were provided by participants in each cohort. Results Compared to grandchildren of non-smoking women, grandchildren of women who smoked more than 14 cigarettes per day throughout pregnancy were 70 g (95% CI: 12, 129 g; P for trend = 0.01) heavier at birth, and 18% (95% CI: 4%, 34%; P for trend = 0.01) more likely to become overweight. The mean BMI of grandchildren of women who smoked during pregnancy was 0.45 kg/m 2 (95% CI: 0.14, 0.75 kg/m 2 ; P for trend = 0.006) higher through adolescence and young adulthood than that of grandchildren of non-smoking mothers.

Research paper thumbnail of Delineation of body mass index trajectory predicting lowest risk of mortality in U.S. men using generalized additive mixed model

Annals of epidemiology, Oct 30, 2016

Few studies have delineated body mass index (BMI) trajectories that associate with premature mort... more Few studies have delineated body mass index (BMI) trajectories that associate with premature mortality, which is defined as death occurring before age 75 years. We used generalized additive mixed model to identify BMI trajectories of individuals dying before or after age 75 years among 14,172 U.S. men. We used logistic regression to validate whether the BMI trajectory developed predicted mortality in an independent cohort of 7000 participants. Comparing to participants with age at death less than 75 years, the BMI among participants with age at death 75 years or more was lower throughout adulthood, and the mean BMI was 23.98, 24.63, 25.33, and 25.29 kg/m(2) at age 40, 50, 60, and 70 years. In the validation cohort, participants following the BMI trajectory with age at death less than 75 years had higher risks of total mortality (odds ratio: 1.35; 95% confidence interval: 1.01-1.78) and cardiovascular disease mortality (1.92; 1.10-3.35) compared to participants following the trajecto...

Research paper thumbnail of A 22-y prospective study of fish intake in relation to prostate cancer incidence and mortality

American Journal of Clinical Nutrition

Research paper thumbnail of Dairy intake after prostate cancer diagnosis in relation to disease-specific and total mortality

International journal of cancer. Journal international du cancer, Jan 20, 2015

Information regarding post-diagnostic dairy intake and prostate cancer survival is limited. We ev... more Information regarding post-diagnostic dairy intake and prostate cancer survival is limited. We evaluated intake of total, high-fat and low-fat dairy after prostate cancer diagnosis in relation to disease-specific and total mortality. We included 926 men from the Physicians' Health Study diagnosed with non-metastatic prostate cancer between 1982 and 2000 who completed a diet questionnaire a median of 5 years after diagnosis and were followed thereafter for a median of 10 years to assess mortality. Cox proportional hazards regression was used to estimate associations between dairy intake and prostate cancer specific and all-cause mortality. During 8,903 person-years of follow-up, 333 men died, 56 due to prostate cancer. Men consuming ≥3 servings/day of total dairy products had a 76% higher risk of total mortality and a 141% higher risk of prostate cancer-specific mortality compared to men who consumed less than 1 dairy product/day (relative risk (RR) = 1.76, 95% confidence interva...

Research paper thumbnail of What's next in medicine

Research paper thumbnail of Hair mercury concentrations and in vitro fertilization (IVF) outcomes among women from a fertility clinic

Reproductive Toxicology, 2015

Total hair mercury (Hg) was measured among 205 women undergoing in vitro fertilization (IVF) trea... more Total hair mercury (Hg) was measured among 205 women undergoing in vitro fertilization (IVF) treatment and the association with prospectively collected IVF outcomes (229 IVF cycles) was evaluated. Hair Hg levels (median=0.62 ppm, range: 0.03-5.66 ppm) correlated with fish intake (r=0.59), and exceeded the recommended EPA reference of 1ppm in 33% of women. Generalized linear mixed models with random intercepts accounting for within-woman correlations across treatment cycles were used to evaluate the association of hair Hg with IVF outcomes adjusted for age, body mass index, race, smoking status, infertility diagnosis, and protocol type. Hair Hg levels

Research paper thumbnail of Prepregnancy and Early Adulthood Body Mass Index and Adult Weight Change in Relation to Fetal Loss

Obstetrics & Gynecology, 2014

To examine prospectively the relationships of prepregnancy body mass index (BMI), BMI at age 18 y... more To examine prospectively the relationships of prepregnancy body mass index (BMI), BMI at age 18 years, and weight change since age 18 years with risk of fetal loss. Our prospective cohort study included 25,719 pregnancies reported by 17,027 women in the Nurses' Health Study II between 1990 and 2009. In 1989, height, current weight, and weight at age 18 years were self-reported. Current weight was updated every 2 years thereafter. Pregnancies were self-reported, with case pregnancies lost spontaneously and comparison pregnancies ending in ectopic pregnancy, induced abortion, or live birth. Incident fetal loss was reported in 4,494 (17.5%) pregnancies. Compared with those of normal BMI, the multivariate relative risks of fetal loss were 1.07 (95% CI [confidence interval] 1.00-1.15) for overweight women, 1.10 (95% CI 0.98-1.23) for class I obese women, and 1.27 (95% CI 1.11-1.45) for class II and class III obese women (P trend ≤ .001). Body mass index at age 18 years was not associated with fetal loss (P trend=.59). Compared with women who maintained a stable weight (± 4 kg) between age 18 years and before pregnancy, women who lost weight had a 20% (95% CI 9-29%) lower risk of fetal loss. This association was stronger among women who were overweight at age 18 years. Being overweight or obese before pregnancy was associated with higher risk of fetal loss. In women overweight or obese at age 18 years, losing 4 kg or more was associated with a lower risk of fetal loss. : II.

Research paper thumbnail of Fat Intake After Diagnosis and Risk of Lethal Prostate Cancer and All-Cause Mortality

JAMA Internal Medicine, 2013

IMPORTANCE Nearly 2.5 million men currently live with prostate cancer in the United States, yet l... more IMPORTANCE Nearly 2.5 million men currently live with prostate cancer in the United States, yet little is known about the association between diet after diagnosis and prostate cancer progression and overall mortality. OBJECTIVE To examine postdiagnostic fat intake in relation to lethal prostate cancer and all-cause mortality. DESIGN, SETTING, AND PARTICIPANTS Prospective study of 4577 men with nonmetastatic prostate cancer in the Health Professionals Follow-up Study (1986-2010). EXPOSURES Postdiagnostic intake of saturated, monounsaturated, polyunsaturated, trans, animal, and vegetable fat. MAIN OUTCOMES AND MEASURES Lethal prostate cancer (distant metastases or prostate cancer-specific death) and all-cause mortality. RESULTS We observed 315 events of lethal prostate cancer and 1064 deaths (median follow-up, 8.4 years). Crude rates per 1000 person-years for lethal prostate cancer were as follows (highest vs lowest quintile of fat intake): 7.6 vs 7.3 for saturated, 6.4 vs 7.2 for monounsaturated, 5.8 vs 8.2 for polyunsaturated, 8.7 vs 6.1 for trans, 8.3 vs 5.7 for animal, and 4.7 vs 8.7 for vegetable fat. For all-cause mortality, the rates were 28.4 vs 21.4 for saturated, 20.0 vs 23.7 for monounsaturated, 17.1 vs 29.4 for polyunsaturated, 32.4 vs 17.1 for trans, 32.0 vs 17.2 for animal, and 15.4 vs 32.7 for vegetable fat. Replacing 10% of energy intake from carbohydrate with vegetable fat was associated with a lower risk of lethal prostate cancer (hazard ratio [HR], 0.71; 95% CI, 0.51-0.98; P = .04) and all-cause mortality (HR, 0.74; 95% CI, 0.61-0.88; P = .001). No other fats were associated with lethal prostate cancer. Saturated and trans fats after diagnosis (replacing 5% and 1% of energy from carbohydrate, respectively) were associated with higher all-cause mortality (HR, 1.30 [95% CI, 1.05-1.60; P = .02] and 1.25 [95% CI, 1.05-1.49; P = .01], respectively). CONCLUSIONS AND RELEVANCE Among men with nonmetastatic prostate cancer, replacing carbohydrates and animal fat with vegetable fat may reduce the risk of all-cause mortality. The potential benefit of vegetable fat for prostate cancer-specific outcomes merits further research.

Research paper thumbnail of Work schedule and physically demanding work in relation to menstrual function: the Nurses' Health Study 3

Scandinavian journal of work, environment & health, Jan 29, 2015

This study aimed to evaluate occupational exposures and menstrual cycle characteristics among nur... more This study aimed to evaluate occupational exposures and menstrual cycle characteristics among nurses. Using cross-sectional data collected in 2010-2012 from 6309 nurses aged 21-45 years, we investigated nurses' menstrual function in the Nurses' Health Study 3. We used multivariable regression modeling to analyze the associations between occupational exposures and prevalence of irregular cycles and long and short cycle lengths. The cohort reported cycle length as <21 (1.5%), 21-25 (15.6%), 26-31 (69.7%), and 32-50 (13.2%) days. In addition, 19% of participants reported irregular cycles. Working ≥41 hours/week was associated with a 16% [95% confidence interval (95% CI): 4-29%] higher prevalence of irregular cycles and a higher prevalence of very short (<21-day) cycles [prevalence odds ratio (OR) 1.93, 95% CI 1.24-3.01] in adjusted models. Irregular menstrual cycles were more prevalent among women working nights only (32% higher; 95% CI 15-51%) or rotating nights (27% hig...

Research paper thumbnail of History of infertility and risk of type 2 diabetes mellitus: a prospective cohort study

Diabetologia, Jan 18, 2015

We sought to evaluate the relationship between delayed conception and type 2 diabetes risk, given... more We sought to evaluate the relationship between delayed conception and type 2 diabetes risk, given that there are plausible underlying mechanisms linking the two, including inflammation and insulin resistance. Participants of the Nurses' Health Study II prospective cohort were included if they were free of chronic disease (cardiovascular disease, type 2 diabetes, cancer) at baseline. Biennial questionnaires updated information on infertility status (>12 months attempted pregnancy), lifestyle characteristics and several health-related outcomes. Self-reported cases of diabetes were confirmed using a follow-up questionnaire. Multivariable Cox proportional hazards models were used to compute the HRs and 95% CIs. Incident type 2 diabetes occurred in 5,993 of the 112,106 participants over 24 years of follow-up (1989-2013). A history of infertility was reported in 27,774 (24.8%) women and was associated with a 20% greater risk of developing diabetes, compared with those never reporti...

Research paper thumbnail of Screen time and adiposity in adolescents in Mexico

Public Health Nutrition, 2009

ObjectiveTo assess the association of time spent viewing television, videos and video games with ... more ObjectiveTo assess the association of time spent viewing television, videos and video games with measures of fat mass (BMI) and distribution (triceps and subscapular skinfold thicknesses (TSF, SSF)).DesignCross-sectional validated survey, self-administered to students to assess screen time (television, videos and video games) and lifestyle variables. Trained personnel obtained anthropometry. The association of screen time with fat mass and distribution, stratified by sex, was modelled with multivariable linear regression analysis, adjusting for potential confounders and correlation of observations within schools.SettingState of Morelos, Mexico.SubjectsMales (n 3519) and females (n 5613) aged 11 to 18 years attending urban and rural schools in Morelos.ResultsIn males, screen time of >5 h/d compared with…

Research paper thumbnail of Diet and Lifestyle in the Prevention of Ovulatory Disorder Infertility

Obstetrics & Gynecology, 2007

OBJECTIVE: To evaluate the relation of a dietary pattern and other lifestyle practices to risk of... more OBJECTIVE: To evaluate the relation of a dietary pattern and other lifestyle practices to risk of ovulatory disorder infertility. METHODS: We followed a cohort of 17,544 women without a history of infertility for 8 years as they tried to become pregnant or became pregnant. A dietary score based on factors previously

Research paper thumbnail of A prospective study of dietary fat consumption and endometriosis risk

Human Reproduction, 2010

background: Endometriosis is a prevalent but enigmatic gynecologic disorder for which few modifia... more background: Endometriosis is a prevalent but enigmatic gynecologic disorder for which few modifiable risk factors have been identified. Fish oil consumption has been associated with symptom improvement in studies of women with primary dysmenorrhea and with decreased endometriosis risk in autotransplantation animal studies. methods: To investigate the relation between dietary fat intake and the risk of endometriosis, we analyzed 12 years of prospective data from the Nurses' Health Study II that began in 1989. Dietary fat was assessed via food frequency questionnaire in 1991, 1995 and 1999. We used Cox proportional hazards models adjusted for total energy intake, parity, race and body mass index at age 18, and assessed cumulatively averaged fat intake across the three diet questionnaires. results: During the 586 153 person-years of follow-up, 1199 cases of laparoscopically confirmed endometriosis were reported. Although total fat consumption was not associated with endometriosis risk, those women in the highest fifth of long-chain omega-3 fatty acid consumption were 22% less likely to be diagnosed with endometriosis compared with those with the lowest fifth of intake [95% confidence interval (CI) ¼ 0.62-0.99; P-value, test for linear trend (Pt) ¼ 0.03]. In addition, those in the highest quintile of trans-unsaturated fat intake were 48% more likely to be diagnosed with endometriosis (95% CI ¼ 1.17-1.88; Pt ¼ 0.001). conclusion: These data suggest that specific types of dietary fat are associated with the incidence of laparoscopically confirmed endometriosis, and that these relations may indicate modifiable risk. This evidence additionally provides another disease association that supports efforts to remove trans fat from hydrogenated oils from the food supply.

Research paper thumbnail of Reply: Calcium homeostasis and anovulatory infertility

Research paper thumbnail of Trans fatty acid intake is inversely related to total sperm count in young healthy men

Human Reproduction, 2014

Is intake of fatty acids related to semen quality among young men? summary answer: The intake of ... more Is intake of fatty acids related to semen quality among young men? summary answer: The intake of trans fatty acids is inversely related to total sperm count in healthy young men. what is known already: Spain has seen an increase in the proportion of calories consumed as fat over the same period that a downward trend in semen quality has been observed. In addition, rodent models suggest that trans fat intake may severely affect testicular function. study design, size, duration: Cross-sectional study of 209 men recruited between October 2010 and November 2011. participants/materials, setting, methods: A group of 209 healthy young university students 18-23 years of age provided a semen sample and completed a previously validated food frequency questionnaire. The association between intake of fatty acids with semen quality parameters (sperm concentration, motility, morphology and total count) was assessed using multivariate linear regression. main results and the role of the chance: Trans fatty acid intake was inversely related to total sperm count after adjusting for potential confounders (P, trend ¼ 0.03). The multivariate adjusted mean (95% confidence interval) total sperm count in increasing quartiles of trans fat intake was 144 (110-190), 113 (87-148), 100 (18-130) and 89 (69-117). There also was an inverse association between cholesterol intake and ejaculate volume (P, trend ¼ 0.04). No other statistically significant relations were observed. limitations, reasons for caution: The cross-sectional design of the study limits causal inference, we cannot exclude the possibility of unmeasured confounding and there was insufficient statistical power to identify modest associations. wider implications of the findings: The results of this study, together with previous experimental work in rodents and biomarker studies among infertility patients, suggest that intake of trans fatty acids may be related to lower semen quality. Although the data provide further evidence that diet is a modifiable factor that could impact male fertility, it is not known whether the observed differences in sperm count translate into differences in fertility.

Research paper thumbnail of Use of fertility treatment modalities in a large United States cohort of professional women

Fertility and Sterility, 2014

Objective-To evaluate use of fertility treatments among a large cohort of women in the United Sta... more Objective-To evaluate use of fertility treatments among a large cohort of women in the United States. Design-Cohort study Setting-Nurses' Health Study II Patients-10,036 women who reported having utilized fertility treatment on biennial questionnaires from 1993-2009 Intervention-None Main Outcome Measure(s)-Data on patterns of treatment modality were collected via selfreport from validated mailed questionnaires. Information on clomiphene, gonadotropin injections alone, and gonadotropin injections as part of intrauterine insemination (IUI) and in-vitro fertilization (IVF) was queried. Results-Most women who reported fertility treatment utilized clomiphene (94%), with a large majority reporting clomiphene as their only form of treatment (73%). Of women who reported treatment more advanced than clomiphene, 13% had used gonadotropin injections alone, 11% IUI treatment, and 11% IVF. Several subgroups were more likely to use multiple treatment modalities

Research paper thumbnail of Dairy food intake in relation to semen quality among active young men

Fertility and Sterility, 2012

Research paper thumbnail of The association of folate, zinc and antioxidant intake with sperm aneuploidy in healthy non-smoking men

Human Reproduction, 2008

BACKGROUND: Little is known about the effect of paternal nutrition on aneuploidy in sperm. We inv... more BACKGROUND: Little is known about the effect of paternal nutrition on aneuploidy in sperm. We investigated the association of normal dietary and supplement intake of folate, zinc and antioxidants (vitamin C, vitamin E and b-carotene) with the frequency of aneuploidy in human sperm. METHODS: Sperm samples from 89 healthy, nonsmoking men from a non-clinical setting were analysed for aneuploidy using fluorescent in situ hybridization with probes for chromosomes X, Y and 21. Daily total intake (diet and supplements) for zinc, folate, vitamin C, vitamin E and b-carotene was derived from a food frequency questionnaire. Potential confounders were obtained from a self-administered questionnaire. RESULTS: After adjusting for covariates, men with high folate intake (>75th percentile) had lower frequencies of sperm with disomies X, 21, sex nullisomy, and a lower aggregate measure of sperm aneuploidy (P 0.04) compared with men with lower intake. In adjusted continuous analyses, total folate intake was inversely associated with aggregate sperm aneuploidy (-3.6% change/100 mg folate; 95% CI: 26.3, 20. 8) and results were similar for disomies X, 21 and sex nullisomy. No consistent associations were found between antioxidant or zinc intakes and sperm aneuploidy. CONCLUSIONS: Men with high folate intake had lower overall frequencies of several types of aneuploid sperm.

Research paper thumbnail of Abstract P163: Healthful Dietary Patterns and the Risk of Hypertension Among Women With a History of Gestational Diabetes

Circulation, 2015

Background: Women who developed gestational diabetes (GDM) are at an increased risk for hypertens... more Background: Women who developed gestational diabetes (GDM) are at an increased risk for hypertension, compared with parous women without GDM. The role of diet in the progression to hypertension among this highly susceptible population is unknown. Methods: We conducted a prospective cohort study among 3,818 women with a history of GDM in the Nurses’ Health Study II, as a part of the ongoing Diabetes & Women’s Health Study. These women were followed from 1991 until 2011. Incident hypertension was identified by self-report with a previously validated questionnaire. Adherence scores for the 2010 Alternative Health Eating Index (AHEI-2010), the Alternate Mediterranean Diet (aMed) and the Dietary Approaches to Stop Hypertension (DASH) were computed for each participant; higher scores indicate better diet quality. Cox proportional hazard models were used adjusting for major risk factors for hypertension, including dietary and lifestyle factors, medical history, reproductive factors and med...

Research paper thumbnail of Association of History of Gestational Diabetes With Long-term Cardiovascular Disease Risk in a Large Prospective Cohort of US Women

JAMA internal medicine, 2017

Previous studies identify gestational diabetes (GD) as a risk factor for intermediate markers of ... more Previous studies identify gestational diabetes (GD) as a risk factor for intermediate markers of cardiovascular disease (CVD) risk; however, few are prospective, evaluate hard CVD end points, or account for shared risk factors including body weight and lifestyle. To prospectively evaluate history of GD in relation to incident CVD risk. The Nurses' Health Study II (NHS II) is an observational cohort study of US female nurses established in 1989, with ongoing follow-up. Biennial questionnaires updated behavioral characteristics, health outcomes, and lifestyle factors. Multivariable Cox models estimated the hazard ratio (HR) and 95% CI for CVD risk. We included 89 479 women who reported at least 1 pregnancy and were free of CVD and cancer at baseline. Follow-up through May 31, 2015, was complete for more than 90% of eligible participants. History of GD was self-reported at baseline (1989) via questionnaire and updated every 2 years. We observed 1161 incident self-reported nonfatal ...

Research paper thumbnail of Smoking during pregnancy in relation to grandchild birth weight and BMI trajectories

PLOS ONE, 2017

Background Maternal smoking has been linked to lower birth weight and higher risk of childhood ob... more Background Maternal smoking has been linked to lower birth weight and higher risk of childhood obesity. However, it is unknown whether grand-maternal smoking during pregnancy is associated with grandchildren birth weight and body mass index (BMI) trajectories. Methods We investigated associations of smoking during pregnancy with birth weight, risks of overweight and BMI trajectories among 46,858 mother-child dyads and 6,583 grandmothermother-child triads of three cohort studies of related individuals. Smoking during pregnancy was reported by mothers, and anthropometric data were provided by participants in each cohort. Results Compared to grandchildren of non-smoking women, grandchildren of women who smoked more than 14 cigarettes per day throughout pregnancy were 70 g (95% CI: 12, 129 g; P for trend = 0.01) heavier at birth, and 18% (95% CI: 4%, 34%; P for trend = 0.01) more likely to become overweight. The mean BMI of grandchildren of women who smoked during pregnancy was 0.45 kg/m 2 (95% CI: 0.14, 0.75 kg/m 2 ; P for trend = 0.006) higher through adolescence and young adulthood than that of grandchildren of non-smoking mothers.

Research paper thumbnail of Delineation of body mass index trajectory predicting lowest risk of mortality in U.S. men using generalized additive mixed model

Annals of epidemiology, Oct 30, 2016

Few studies have delineated body mass index (BMI) trajectories that associate with premature mort... more Few studies have delineated body mass index (BMI) trajectories that associate with premature mortality, which is defined as death occurring before age 75 years. We used generalized additive mixed model to identify BMI trajectories of individuals dying before or after age 75 years among 14,172 U.S. men. We used logistic regression to validate whether the BMI trajectory developed predicted mortality in an independent cohort of 7000 participants. Comparing to participants with age at death less than 75 years, the BMI among participants with age at death 75 years or more was lower throughout adulthood, and the mean BMI was 23.98, 24.63, 25.33, and 25.29 kg/m(2) at age 40, 50, 60, and 70 years. In the validation cohort, participants following the BMI trajectory with age at death less than 75 years had higher risks of total mortality (odds ratio: 1.35; 95% confidence interval: 1.01-1.78) and cardiovascular disease mortality (1.92; 1.10-3.35) compared to participants following the trajecto...

Research paper thumbnail of A 22-y prospective study of fish intake in relation to prostate cancer incidence and mortality

American Journal of Clinical Nutrition

Research paper thumbnail of Dairy intake after prostate cancer diagnosis in relation to disease-specific and total mortality

International journal of cancer. Journal international du cancer, Jan 20, 2015

Information regarding post-diagnostic dairy intake and prostate cancer survival is limited. We ev... more Information regarding post-diagnostic dairy intake and prostate cancer survival is limited. We evaluated intake of total, high-fat and low-fat dairy after prostate cancer diagnosis in relation to disease-specific and total mortality. We included 926 men from the Physicians' Health Study diagnosed with non-metastatic prostate cancer between 1982 and 2000 who completed a diet questionnaire a median of 5 years after diagnosis and were followed thereafter for a median of 10 years to assess mortality. Cox proportional hazards regression was used to estimate associations between dairy intake and prostate cancer specific and all-cause mortality. During 8,903 person-years of follow-up, 333 men died, 56 due to prostate cancer. Men consuming ≥3 servings/day of total dairy products had a 76% higher risk of total mortality and a 141% higher risk of prostate cancer-specific mortality compared to men who consumed less than 1 dairy product/day (relative risk (RR) = 1.76, 95% confidence interva...

Research paper thumbnail of What's next in medicine

Research paper thumbnail of Hair mercury concentrations and in vitro fertilization (IVF) outcomes among women from a fertility clinic

Reproductive Toxicology, 2015

Total hair mercury (Hg) was measured among 205 women undergoing in vitro fertilization (IVF) trea... more Total hair mercury (Hg) was measured among 205 women undergoing in vitro fertilization (IVF) treatment and the association with prospectively collected IVF outcomes (229 IVF cycles) was evaluated. Hair Hg levels (median=0.62 ppm, range: 0.03-5.66 ppm) correlated with fish intake (r=0.59), and exceeded the recommended EPA reference of 1ppm in 33% of women. Generalized linear mixed models with random intercepts accounting for within-woman correlations across treatment cycles were used to evaluate the association of hair Hg with IVF outcomes adjusted for age, body mass index, race, smoking status, infertility diagnosis, and protocol type. Hair Hg levels

Research paper thumbnail of Prepregnancy and Early Adulthood Body Mass Index and Adult Weight Change in Relation to Fetal Loss

Obstetrics & Gynecology, 2014

To examine prospectively the relationships of prepregnancy body mass index (BMI), BMI at age 18 y... more To examine prospectively the relationships of prepregnancy body mass index (BMI), BMI at age 18 years, and weight change since age 18 years with risk of fetal loss. Our prospective cohort study included 25,719 pregnancies reported by 17,027 women in the Nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; Health Study II between 1990 and 2009. In 1989, height, current weight, and weight at age 18 years were self-reported. Current weight was updated every 2 years thereafter. Pregnancies were self-reported, with case pregnancies lost spontaneously and comparison pregnancies ending in ectopic pregnancy, induced abortion, or live birth. Incident fetal loss was reported in 4,494 (17.5%) pregnancies. Compared with those of normal BMI, the multivariate relative risks of fetal loss were 1.07 (95% CI [confidence interval] 1.00-1.15) for overweight women, 1.10 (95% CI 0.98-1.23) for class I obese women, and 1.27 (95% CI 1.11-1.45) for class II and class III obese women (P trend ≤ .001). Body mass index at age 18 years was not associated with fetal loss (P trend=.59). Compared with women who maintained a stable weight (± 4 kg) between age 18 years and before pregnancy, women who lost weight had a 20% (95% CI 9-29%) lower risk of fetal loss. This association was stronger among women who were overweight at age 18 years. Being overweight or obese before pregnancy was associated with higher risk of fetal loss. In women overweight or obese at age 18 years, losing 4 kg or more was associated with a lower risk of fetal loss. : II.

Research paper thumbnail of Fat Intake After Diagnosis and Risk of Lethal Prostate Cancer and All-Cause Mortality

JAMA Internal Medicine, 2013

IMPORTANCE Nearly 2.5 million men currently live with prostate cancer in the United States, yet l... more IMPORTANCE Nearly 2.5 million men currently live with prostate cancer in the United States, yet little is known about the association between diet after diagnosis and prostate cancer progression and overall mortality. OBJECTIVE To examine postdiagnostic fat intake in relation to lethal prostate cancer and all-cause mortality. DESIGN, SETTING, AND PARTICIPANTS Prospective study of 4577 men with nonmetastatic prostate cancer in the Health Professionals Follow-up Study (1986-2010). EXPOSURES Postdiagnostic intake of saturated, monounsaturated, polyunsaturated, trans, animal, and vegetable fat. MAIN OUTCOMES AND MEASURES Lethal prostate cancer (distant metastases or prostate cancer-specific death) and all-cause mortality. RESULTS We observed 315 events of lethal prostate cancer and 1064 deaths (median follow-up, 8.4 years). Crude rates per 1000 person-years for lethal prostate cancer were as follows (highest vs lowest quintile of fat intake): 7.6 vs 7.3 for saturated, 6.4 vs 7.2 for monounsaturated, 5.8 vs 8.2 for polyunsaturated, 8.7 vs 6.1 for trans, 8.3 vs 5.7 for animal, and 4.7 vs 8.7 for vegetable fat. For all-cause mortality, the rates were 28.4 vs 21.4 for saturated, 20.0 vs 23.7 for monounsaturated, 17.1 vs 29.4 for polyunsaturated, 32.4 vs 17.1 for trans, 32.0 vs 17.2 for animal, and 15.4 vs 32.7 for vegetable fat. Replacing 10% of energy intake from carbohydrate with vegetable fat was associated with a lower risk of lethal prostate cancer (hazard ratio [HR], 0.71; 95% CI, 0.51-0.98; P = .04) and all-cause mortality (HR, 0.74; 95% CI, 0.61-0.88; P = .001). No other fats were associated with lethal prostate cancer. Saturated and trans fats after diagnosis (replacing 5% and 1% of energy from carbohydrate, respectively) were associated with higher all-cause mortality (HR, 1.30 [95% CI, 1.05-1.60; P = .02] and 1.25 [95% CI, 1.05-1.49; P = .01], respectively). CONCLUSIONS AND RELEVANCE Among men with nonmetastatic prostate cancer, replacing carbohydrates and animal fat with vegetable fat may reduce the risk of all-cause mortality. The potential benefit of vegetable fat for prostate cancer-specific outcomes merits further research.

Research paper thumbnail of Work schedule and physically demanding work in relation to menstrual function: the Nurses' Health Study 3

Scandinavian journal of work, environment & health, Jan 29, 2015

This study aimed to evaluate occupational exposures and menstrual cycle characteristics among nur... more This study aimed to evaluate occupational exposures and menstrual cycle characteristics among nurses. Using cross-sectional data collected in 2010-2012 from 6309 nurses aged 21-45 years, we investigated nurses' menstrual function in the Nurses' Health Study 3. We used multivariable regression modeling to analyze the associations between occupational exposures and prevalence of irregular cycles and long and short cycle lengths. The cohort reported cycle length as <21 (1.5%), 21-25 (15.6%), 26-31 (69.7%), and 32-50 (13.2%) days. In addition, 19% of participants reported irregular cycles. Working ≥41 hours/week was associated with a 16% [95% confidence interval (95% CI): 4-29%] higher prevalence of irregular cycles and a higher prevalence of very short (<21-day) cycles [prevalence odds ratio (OR) 1.93, 95% CI 1.24-3.01] in adjusted models. Irregular menstrual cycles were more prevalent among women working nights only (32% higher; 95% CI 15-51%) or rotating nights (27% hig...

Research paper thumbnail of History of infertility and risk of type 2 diabetes mellitus: a prospective cohort study

Diabetologia, Jan 18, 2015

We sought to evaluate the relationship between delayed conception and type 2 diabetes risk, given... more We sought to evaluate the relationship between delayed conception and type 2 diabetes risk, given that there are plausible underlying mechanisms linking the two, including inflammation and insulin resistance. Participants of the Nurses' Health Study II prospective cohort were included if they were free of chronic disease (cardiovascular disease, type 2 diabetes, cancer) at baseline. Biennial questionnaires updated information on infertility status (>12 months attempted pregnancy), lifestyle characteristics and several health-related outcomes. Self-reported cases of diabetes were confirmed using a follow-up questionnaire. Multivariable Cox proportional hazards models were used to compute the HRs and 95% CIs. Incident type 2 diabetes occurred in 5,993 of the 112,106 participants over 24 years of follow-up (1989-2013). A history of infertility was reported in 27,774 (24.8%) women and was associated with a 20% greater risk of developing diabetes, compared with those never reporti...

Research paper thumbnail of Screen time and adiposity in adolescents in Mexico

Public Health Nutrition, 2009

ObjectiveTo assess the association of time spent viewing television, videos and video games with ... more ObjectiveTo assess the association of time spent viewing television, videos and video games with measures of fat mass (BMI) and distribution (triceps and subscapular skinfold thicknesses (TSF, SSF)).DesignCross-sectional validated survey, self-administered to students to assess screen time (television, videos and video games) and lifestyle variables. Trained personnel obtained anthropometry. The association of screen time with fat mass and distribution, stratified by sex, was modelled with multivariable linear regression analysis, adjusting for potential confounders and correlation of observations within schools.SettingState of Morelos, Mexico.SubjectsMales (n 3519) and females (n 5613) aged 11 to 18 years attending urban and rural schools in Morelos.ResultsIn males, screen time of >5 h/d compared with…

Research paper thumbnail of Diet and Lifestyle in the Prevention of Ovulatory Disorder Infertility

Obstetrics & Gynecology, 2007

OBJECTIVE: To evaluate the relation of a dietary pattern and other lifestyle practices to risk of... more OBJECTIVE: To evaluate the relation of a dietary pattern and other lifestyle practices to risk of ovulatory disorder infertility. METHODS: We followed a cohort of 17,544 women without a history of infertility for 8 years as they tried to become pregnant or became pregnant. A dietary score based on factors previously

Research paper thumbnail of A prospective study of dietary fat consumption and endometriosis risk

Human Reproduction, 2010

background: Endometriosis is a prevalent but enigmatic gynecologic disorder for which few modifia... more background: Endometriosis is a prevalent but enigmatic gynecologic disorder for which few modifiable risk factors have been identified. Fish oil consumption has been associated with symptom improvement in studies of women with primary dysmenorrhea and with decreased endometriosis risk in autotransplantation animal studies. methods: To investigate the relation between dietary fat intake and the risk of endometriosis, we analyzed 12 years of prospective data from the Nurses' Health Study II that began in 1989. Dietary fat was assessed via food frequency questionnaire in 1991, 1995 and 1999. We used Cox proportional hazards models adjusted for total energy intake, parity, race and body mass index at age 18, and assessed cumulatively averaged fat intake across the three diet questionnaires. results: During the 586 153 person-years of follow-up, 1199 cases of laparoscopically confirmed endometriosis were reported. Although total fat consumption was not associated with endometriosis risk, those women in the highest fifth of long-chain omega-3 fatty acid consumption were 22% less likely to be diagnosed with endometriosis compared with those with the lowest fifth of intake [95% confidence interval (CI) ¼ 0.62-0.99; P-value, test for linear trend (Pt) ¼ 0.03]. In addition, those in the highest quintile of trans-unsaturated fat intake were 48% more likely to be diagnosed with endometriosis (95% CI ¼ 1.17-1.88; Pt ¼ 0.001). conclusion: These data suggest that specific types of dietary fat are associated with the incidence of laparoscopically confirmed endometriosis, and that these relations may indicate modifiable risk. This evidence additionally provides another disease association that supports efforts to remove trans fat from hydrogenated oils from the food supply.

Research paper thumbnail of Reply: Calcium homeostasis and anovulatory infertility

Research paper thumbnail of Trans fatty acid intake is inversely related to total sperm count in young healthy men

Human Reproduction, 2014

Is intake of fatty acids related to semen quality among young men? summary answer: The intake of ... more Is intake of fatty acids related to semen quality among young men? summary answer: The intake of trans fatty acids is inversely related to total sperm count in healthy young men. what is known already: Spain has seen an increase in the proportion of calories consumed as fat over the same period that a downward trend in semen quality has been observed. In addition, rodent models suggest that trans fat intake may severely affect testicular function. study design, size, duration: Cross-sectional study of 209 men recruited between October 2010 and November 2011. participants/materials, setting, methods: A group of 209 healthy young university students 18-23 years of age provided a semen sample and completed a previously validated food frequency questionnaire. The association between intake of fatty acids with semen quality parameters (sperm concentration, motility, morphology and total count) was assessed using multivariate linear regression. main results and the role of the chance: Trans fatty acid intake was inversely related to total sperm count after adjusting for potential confounders (P, trend ¼ 0.03). The multivariate adjusted mean (95% confidence interval) total sperm count in increasing quartiles of trans fat intake was 144 (110-190), 113 (87-148), 100 (18-130) and 89 (69-117). There also was an inverse association between cholesterol intake and ejaculate volume (P, trend ¼ 0.04). No other statistically significant relations were observed. limitations, reasons for caution: The cross-sectional design of the study limits causal inference, we cannot exclude the possibility of unmeasured confounding and there was insufficient statistical power to identify modest associations. wider implications of the findings: The results of this study, together with previous experimental work in rodents and biomarker studies among infertility patients, suggest that intake of trans fatty acids may be related to lower semen quality. Although the data provide further evidence that diet is a modifiable factor that could impact male fertility, it is not known whether the observed differences in sperm count translate into differences in fertility.

Research paper thumbnail of Use of fertility treatment modalities in a large United States cohort of professional women

Fertility and Sterility, 2014

Objective-To evaluate use of fertility treatments among a large cohort of women in the United Sta... more Objective-To evaluate use of fertility treatments among a large cohort of women in the United States. Design-Cohort study Setting-Nurses' Health Study II Patients-10,036 women who reported having utilized fertility treatment on biennial questionnaires from 1993-2009 Intervention-None Main Outcome Measure(s)-Data on patterns of treatment modality were collected via selfreport from validated mailed questionnaires. Information on clomiphene, gonadotropin injections alone, and gonadotropin injections as part of intrauterine insemination (IUI) and in-vitro fertilization (IVF) was queried. Results-Most women who reported fertility treatment utilized clomiphene (94%), with a large majority reporting clomiphene as their only form of treatment (73%). Of women who reported treatment more advanced than clomiphene, 13% had used gonadotropin injections alone, 11% IUI treatment, and 11% IVF. Several subgroups were more likely to use multiple treatment modalities

Research paper thumbnail of Dairy food intake in relation to semen quality among active young men

Fertility and Sterility, 2012