A prospective study of alcohol, smoking, caffeine, and the risk of symptomatic diverticular disease in men.

The relationship between smoking, caffeine, and alcohol intake and the risk of symptomatic diverticular disease has not been investigated directly. We examined these associations in a prospective cohort of 47,678 US men, 40 to 75 years old. During 4 years of follow-up (1988 to 1992), we documented 382 newly diagnosed cases of symptomatic diverticular disease. After adjustments for age, physical activity, and energy-adjusted intake of dietary fiber and total fat, alcohol intake (comparing those who drink > 30 g of alcohol/d to nondrinkers) was only weakly and nonsignificantly associated with risk of symptomatic diverticular disease (relative risk (RR) = 1.36; 95 percent confidence interval (CI), 0.94 to 1.97; P for trend = 0.37). We observed no association between caffeine, specific caffeinated beverages, and decaffeinated coffee and the risk of symptomatic diverticular disease. Current smoking was not appreciably associated with risk of symptomatic diverticular disease compared to nonsmokers (RR = 1.25; 95 percent CI, 0.75 to 2.09) after adjustment for age, physical activity, and energy-adjusted intake of dietary fiber and total fat. In a subset analysis restricted to men who had undergone sigmoidoscopy or colonoscopy, a modest positive association was seen between smoking and risk of symptomatic diverticular disease. These results suggest that smoking, caffeine, and alcohol intake are not associated with any substantially increased risk of symptomatic diverticular disease.

Prospective study of physical activity and the risk of symptomatic diverticular disease in men.

The relationship between physical activity and risk of symptomatic diverticular disease has not been investigated directly. This association was examined in a prospective cohort of 47,678 American men, 40 to 75 years of age, and free of diagnosed diverticular disease, colon or rectal polyp, ulcerative colitis, and cancer before 1988. During four years of follow up, 382 newly diagnosed cases of symptomatic diverticular disease were documented. After adjustment for age, energy adjusted dietary fibre, and energy adjusted total fat, overall physical activity was inversely associated with the risk of symptomatic diverticular disease (for highest versus lowest extremes, relative risk (RR) = 0.63 (95% confidence interval (CI) 0.45, 0.88). Most of the inverse association was attributable to vigorous activity, for extreme categories RR = 0.60 (95% CI 0.41, 0.87). For activity that was not vigorous the RR was 0.93 (95% CI 0.67, 1.69). Several specific activities were inversely associated with the risk of diverticular disease, but jogging and running combined was the only individual activity that was statistically significant (p for trend = 0.03). For men in the lowest quintile for dietary fibre intake and total physical activity (compared with those in the opposite extreme), the RR was 2.56 (95% CI 1.36, 4.82). Physical activity, along with a high fibre diet, may be an important factor in the prevention of symptomatic diverticular disease.

A prospective study of diet and the risk of symptomatic diverticular disease in men.

To examine the association between dietary fiber, sources of fiber, other nutrients, and the diagnosis of symptomatic diverticular disease, we analyzed data from a prospective cohort of 47,888 US men. During 4 y of follow-up we documented 385 new cases of symptomatic diverticular disease. Total dietary fiber intake was inversely associated with the risk of diverticular disease after adjustment for age, energy-adjusted total fat intake, and physical activity [relative risk (RR) 0.58; 95% CI 0.41, 0.83; P for trend = 0.01 for men in the highest as compared with the lowest quintile of dietary fiber]. This inverse association was primarily due to fruit and vegetable fiber. For men on a high-total-fat, low-fiber diet, the RR was 2.35 (95% CI 1.38, 3.98) compared with those on a low-total-fat, high-fiber diet, and for men on a high-red-meat, low-fiber diet the RR was 3.32 (95% CI 1.46, 7.53) compared with those on a low-red-meat, high-fiber diet. These prospective data support the hypothesis that a diet low in total dietary fiber increases the incidence of symptomatic diverticular disease. They also provide evidence that the combination of high intake of total fat or red meat and a diet low in total dietary fiber particularly augments the risk.

Birth order sibship size and socio-economic factors in risk of schizophrenia in Greece.

A case-control study was undertaken to evaluate the effects, if any, of sibship size, birth order and parents' age at birth on the risk of a person's developing schizophrenia. Information was obtained, during an 18-month period, from 221 schizophrenic patients in the only mental-health hospital of the region of Peloponese, Greece, and from an equal number of matched patients. The data were analysed by modelling through logistic regression. No relationship was found between the occurrence of schizophrenia in a patient and either father's or mother's age at patient's birth, or sibship size, or birth order, when demographic and socio-economic variables were accounted for in the analysis. Although patients with schizophrenia were of similar socio-economic status to the comparison patients, they came from families with higher original socio-economic status, a fact which appears to reflect the decline of both schizophrenic and pre-schizophrenic people in the social ladder.

An investigation of family size and birth order as risk factors in leprosy.

To investigate if early exposure to Mycobacterium leprae is a factor determining development of Hansen's disease in general, or of a particular form of the disease, we have studied the sibship size and birth order distribution of 187 leprosy cases and 528 hospitalized control patients. By the Greenwood-Yule analysis, a small deficit of cases in the earlier birth order in the tuberculoid form was observed. Such a deficit was not observed in lepromatous leprosy patients. In the multivariate analysis, where socioeconomic factors, current age, and leprosy status of the parents were taken into account, it was found that sibship size becomes a nonsignificant and nonconsistent predictor of leprosy in general or of a particular form of the disease. On the other hand, the logistic analysis supports the impression that tuberculoid leprosy patients belong to the later birth order in both sexes. Although the contrast is statistically nonsignificant in either sex, it suggests that early exposure in life predisposes to the tuberculoid form of leprosy.