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Among all tree nuts, walnuts contain the highest total polyphenols by weight. This secondary data analysis examined the effect of daily walnut supplementation on the total dietary polyphenols and subclasses and the urinary excretion of total polyphenols in a free-living elderly population. In this 2-year prospective, randomized intervention trial (ID NCT01634841), the dietary polyphenol intake of participants who added walnuts daily to their diets at 15% of daily energy were compared to those in the control group that consumed a walnut-free diet. Dietary polyphenols and subclasses were estimated from 24 h dietary recalls. Phenolic estimates were derived from Phenol-Explorer database version 3.6. Participants in the walnut group compared to the control group had a higher intake of total polyphenols, flavonoids, flavanols, and phenolic acids in mg/d (IQR): 2480 (1955, 3145) vs. 1897 (1369, 2496); 56 (42,84) vs. 29 (15, 54); 174 (90, 298) vs. 140 (61, 277); and 368 (246, 569) vs. 242 (89, 398), respectively. There was a significant inverse association between dietary flavonoid intake and urine polyphenol excretion; less urinary excretion may imply that some of the polyphenols were eliminated via the gut. Nuts had a significant contribution to the total polyphenols in the diet, suggesting that a single food like walnuts added to habitual diet can increase the polyphenol intake in a Western population.

Objective The aim of our study was to assess the association between a diagnosis of Systemic Lupus Erythematosus (SLE) and dietary pattern as well as demographic factors among subjects in the Adventist Health Study-2 (AHS-2) cohort. Methods Multivariable logistic regression modeling was used to assess the association between prevalence of self-reported SLE and dietary patterns (vegetarian, pesco-vegetarian and non-vegetarian). Potential confounding variables included were age, gender, race, education, and smoking history among 77,795 AHS-2 participants. Results There was a dose-response association between the prevalence of SLE with vegetarian diets, ordered by content of animal meats. The stricter vegetarians had 25% lower odds of reporting that they were currently being treated for SLE (OR = 0.75, 95% CI 0.56, 1.02) with intermediate levels for the pesco-vegetarians who eat fish (OR 0.88, 95% CI 0.57, 1.36), compared to non-vegetarians. As expected, there were also significant associations between the prevalence of SLE with sex, race, age, and smoking. Significantly fewer men were diagnosed with SLE compared to women (OR = 0.14, 95% CI: 0.08, 0.22). Compared to non-Hispanic Whites, non-Hispanic Blacks were significantly more likely to report a diagnosis of SLE (OR 1.69, 95% CI 1.29, 2.21). A significantly lower proportion of 30–39 year olds (OR 0.51, 95% CI 0.29, 0.90) reported a diagnosis of SLE when compared to those 60 or older. Also, ever smokers were more likely to report prevalent SLE than those who had never smoked (OR 1.71, 95% CI 1.27, 2.31). Conclusion We found that vegetarians had lower odds of doctor-diagnosed SLE with an increasing trend in prevalence from stricter vegetarians to pesco-vegetarians to non-vegetarians. We also note that the association with other demographic factors in AHS-2 was similar to that found in other studies. Future studies may focus on assessing the incidence and severity of the disease among vegetarians and non-vegetarians.

Background Walnut consumption counteracts oxidative stress and inflammation, 2 drivers of cognitive decline. Clinical data concerning effects on cognition are lacking. Objectives The Walnuts And Healthy Aging study is a 2-center (Barcelona, Spain; Loma Linda, CA) randomized controlled trial examining the cognitive effects of a 2-y walnut intervention in cognitively healthy elders. Methods We randomly allocated 708 free-living elders (63-79 y, 68% women) to a diet enriched with walnuts at ∼15% energy (30-60 g/d) or a control diet (abstention from walnuts). We administered a comprehensive neurocognitive test battery at baseline and 2 y. Change in the global cognition composite was the primary outcome. We performed repeated structural and functional brain MRI in 108 Barcelona participants. Results A total of 636 participants completed the intervention. Besides differences in nutrient intake, participants from Barcelona smoked more, were less educated, and had lower baseline neuropsychological test scores than those from Loma Linda. Walnuts were well tolerated and compliance was good. Modified intention-to-treat analyses (n = 657) uncovered no between-group differences in the global cognitive composite, with mean changes of -0.072 (95% CI: -0.100, -0.043) in the walnut diet group and -0.086 (95% CI: -0.115, -0.057) in the control diet group (P = 0.491). Post hoc analyses revealed significant differences in the Barcelona cohort, with unadjusted changes of -0.037 (95% CI: -0.077, 0.002) in the walnut group and -0.097 (95% CI: -0.137, -0.057) in controls (P = 0.040). Results of brain fMRI in a subset of Barcelona participants indicated greater functional network recruitment in a working memory task in controls. Conclusions Walnut supplementation for 2 y had no effect on cognition in healthy elders. However, brain fMRI and post hoc analyses by site suggest that walnuts might delay cognitive decline in subgroups at higher risk. These encouraging but inconclusive results warrant further investigation, particularly targeting disadvantaged populations, in whom greatest benefit could be expected.This trial was registered at clinicaltrials.gov as NCT01634841.

Avocado is a nutrient-rich food that has been shown to benefit the health and diet quality of adults. In this paper, we examined if habitual intake of avocado among adolescents is associated with their diet quality, food and nutrient intake, and measures of obesity and body composition. Participants aged 12–18 years old (n = 534) from selected public and Adventist middle-high schools reported their dietary intake in a web-based food frequency questionnaire (FFQ); anthropometrics were measured during school visits. Diet quality (DQI-I) and avocado intake were calculated from the FFQ; BMI z-scores (BMIz), waist-to-height ratio (WHtR), and fat mass (FM), fat-free mass (FFM), and %body fat (%BF) were determined from the anthropometric data. Compared to non-consumers, avocado consumers had significantly higher covariate-adjusted mean scores on total DQI-I (68.3 vs. 64.6) and energy-adjusted mean scores on variety (18.8 vs. 18.0) and adequacy (36.4 vs. 33.4). Avocado consumption was significantly associated with DQI-I components adequacy (β [SE] = 0.11 [0.03]) and moderation (β [SE] = 0.06 [0.03]) but not with BMIz, WHtR, FM, FFM, and %BF. Mean intakes of fruits, vegetables, and plant protein foods, total and vegetable proteins, dietary fiber, retinol, vitamin C, calcium, magnesium, iron, and potassium were significantly higher for avocado consumers; saturated and trans fats intakes were significantly higher for non-consumers. In our adolescent population, avocado consumption was associated with higher diet quality and intake of plant-based foods and shortfall nutrients, but not with measures of obesity and body composition. Studies are needed to determine the optimal amount of avocado that would confer health benefits during adolescence.

Atomically thin graphene is a transparent, highly electrically and thermally conductive, light-weight, and the strongest material. To date, graphene has found applications in many aspects including transport, medicine, electronics, energy, defense, and desalination. We demonstrate another disruptive application of graphene in the field of laser-ion acceleration, in which the unique features of graphene play indispensable role. Laser driven ion sources have been widely investigated for pure science, plasma diagnostics, medical and engineering applications. Recent developments of laser technologies allow us to access radiation regime of laser ion acceleration with relatively thin targets. However, the thinner target is the less durable and can be easily broken by the pedestal or prepulse through impact and heating prior to the main laser arrival. One of the solutions to avoid this is plasma mirror, which is a surface plasma created by the foot of the laser pulse on an optically transparent material working as an effective mirror only for the main laser peak. So far diamond like carbon (DLC) is used to explore the ion acceleration in extremely thin target regime (< 10 nm) with plasma mirrors, and it is necessary to use plasma mirrors even in moderately thin target regime (10-100 nm) to realize energetic ion generation. However, firstly DLC is not 2D material, and therefore, it is very expensive to make it thin and flat. Moreover, graphene is stronger than diamond at extremely thin regime, and much more reasonable for mass-production. Furthermore, installing and operating plasma mirrors at high repetition rate is also costly. Here we show another direct solution using graphene as the thinnest and strongest target ever made. We develop a facile transfer method to fabricate large-area suspended graphene (LSG) as target for laser ion acceleration with precision down to a single atomic layer. Direct irradiation of the LSG targets with an ultra intense laser generates energetic carbons and protons evidently showing the durability of graphene without plasma mirror. This extends the new frontier of science on graphene under extreme electromagnetic field, such as energy frontier and nuclear fusion.

Ambient air pollutants are known risk factors for cardiovascular disease (CVD) morbidity and mortality with significant racial disparities. However, few studies have explored racial differences among highly susceptible subpopulations, such as renal transplant recipients (RTRs). Despite improvements in quality of life after transplantation, CVD remains the major cause of mortality, especially among Black recipients. This study aimed to evaluate potential racial differences in the association between long-term levels of PM2.5 and the risk of all-cause, total CVD, and coronary heart disease (CHD) mortality among RTRs. This retrospective study consists of 93,857 non-smoking adults who received a renal transplant between 2001 and 2015. Time-dependent Cox regression was used to assess the association between annual concentrations of PM2.5 and mortality risk. In the multivariable-adjusted models, a 10 μg/m3 increase in ambient PM2.5 levels found increased risk of all-cause (HR = 3.45, 95% CI: 3.08–3.78), CVD (HR = 2.38, 95% CI: 1.94–2.92), and CHD mortality (HR = 3.10, 95% CI: 1.96–4.90). Black recipients had higher risks of all-cause (HR = 4.09, 95% CI: 3.43–4.88) and CHD mortality (HR = 6.73, 95% CI: 2.96–15.32). High levels of ambient PM2.5 were associated with all-cause, CVD, and CHD mortality. The association tended to be higher among Black recipients than non-Blacks.

Traditional Asian fermented soy food products are associated with reduced cardiovascular disease risk in prospective studies, but few randomized controlled trials have been conducted in at-risk populations. The aim of this study was to investigate the effect of a commercial non-probiotic fermented soy product on blood lipids in adults with cardiovascular risk biomarkers. In a randomized, crossover, intervention study, 27 men and women (aged 29–75 y) exhibiting at least two risk factors, consumed two packets (12.5 g each) daily of a fermented powdered soy product, or an isoenergic control powder made from germinated brown rice for 12 weeks each. The consumption of the fermented soy product resulted in a significantly greater mean change from baseline (compared to the germinated rice, all p &lt, 0.05) in total cholesterol of −0.23 mmol/L (CI: −0.40, −0.06) compared with 0.14 mmol/L (CI: −0.03, 0.31), respectively, and low density lipoprotein (LDL) cholesterol −0.18 mmol/L (CI: −0.32, −0.04) compared with 0.04 mmol/L (CI: −0.01, 0.018) respectively. This was accompanied by an increase in high density lipoprotein (HDL) cholesterol in the germinated rice group, a decrease in apolipoprotein B (ApoB) in the fermented soy group, and a between-treatment effect in apolipoprotein A1 (ApoA1), however, the ratio of the LDL:HDL and of Apo B:ApoA1 did not differ between the groups. The ratio of total cholesterol:LDL decreased in men in the fermented soy group (p &lt, 0.001). Twenty-four-hour urine collection at the end of each treatment period resulted in an increased excretion expressed as a ratio in μmol/d between treatments of 10.93 (CI: 5.07, 23.54) for daidzein, 1.24 (CI: 1.14, 4.43) for genistein, and, 8.48 (CI: 4.28, 16.80) for glycitein, all p &lt, 0.05. The fermented soy powder consumed by participants in this study without implementing other changes in their typical diets, decreased the total and LDL cholesterol, and may serve as a dietary strategy to manage blood lipids. The trial was registered at ClinicalTrials.gov as NCT03429920.

Eggs contain important compounds related to enhanced cognition, but it is not clear if egg consumption, as a whole, has a direct impact on memory decline in older adults. This study aimed to determine whether egg intake levels predict the rate of memory decline in healthy older adults after sociodemographic and dietary controls. We conducted a secondary analysis of data from 470 participants, age 50 and over, from the Biospsychosocial Religion and Health Study. Participants completed a food frequency questionnaire, which was used to calculate egg intake and divide participants into Low (

OBJECTIVES: The purpose of this study was to examine the effects of dietary nitrate and anthocyanins on exercise performance in healthy untrained individuals. METHODS: In a randomized double-blind crossover study, six men (mean age 24.3 y) and 23 women (mean age 24.1 y) were randomly assigned to Treatment A (5.05 g beetroot powder + placebo/d) or Treatment B (5.05 g beetroot powder + 480 mg tart cherry/d) for seven days. Each treatment was followed by a seven-day washout after which subjects switched treatments. At the end of each treatment period, subjects performed a modified Wingate Anaerobic Test on a Monark 928E bike. Data on speed (RPM), power (watts), and heart rate were collected and analyzed using linear mixed models adjusted for baseline subject characteristics, treatment sequence (A-B, B-A), energy (kcal), and sleep (hours). RESULTS: Average heart rate during the first five seconds of the cycling sprint was significantly lower after treatment A than after treatment B (−1.6 to 2.7 BPM, P

OBJECTIVES: To determine the effect of daily intake of macadamia nuts on macronutrient intake and nutrient displacement in overweight and obese adults in a randomized crossover study. METHODS: This randomized cross-over study was comprised of two phases, each lasting eight weeks. Participants (n = 35) were randomly assigned first to either the intervention (15% of calorie needs from macadamia nuts) or control (habitual diet) phase, with a two-week washout followed by the other phase. A total of six 24-hour recalls, two at baseline and two during each phase were conducted. Period adjustment t-test was used to determine the differences in macronutrient intake between the two phases. The displacement of nutrients was done by subtracting the observed intake of a particular nutrient from its’ expected intake. RESULTS: Compared to the control phase, there were marginal increases in the consumption of total energy (mean diff = 145 kcal), total fiber (mean diff = 2 g) and a significant increase in the consumption of total fat (mean diff = 35 g, P

OBJECTIVES: While touted for their health benefits, research on the effects of avocado consumption on health is limited. Given their dense content of monounsaturated fatty acids (MUFA), carotenoids, fiber, and micronutrients, avocados have the potential to boost cognitive function. It has been shown that diets rich in MUFA may improve global cognitive performance and prevent cognitive decline. The carotenoids lutein and zeaxanthin may also enhance brain function. Only one randomized trial assessing the effects of avocado intake on cognition has been published to date, and the results were positive. The objective of this current study is to determine if consuming a meal of avocado on toast yields measurable changes in cognitive performance. METHODS: Using a randomized 2 × 2 cross-over design, acute cognitive changes were assessed via a 25-minute long test battery in 27 participants after an isocaloric test meal of either avocado on wheat toast or cream cheese and jelly on wheat toast. After an approximately 2-week wash out period, participants returned to complete the study protocol with the alternate meal. Verbal learning and memory, working memory, processing speed, semantic fluency, and global cognition were measured in the fasting state and again in the postprandial state (3 hours after consumption of the breakfast test meal). Linear mixed models analysis was used to determine if meal type provided any significant boost in acute cognitive scores. RESULTS: The following fixed effects were included in the model: visit number, sequence of intervention, test meal, age, pre/post measures, and interaction between test meal and pre/post measures. Subjects were included as a random effect. No significant differences between intervention groups in pre/post measures were detected. CONCLUSIONS: These preliminary results need to be confirmed with a larger sample (currently underway). Also, given the nutrient composition of avocados, it is possible that longer term studies may yield different results. FUNDING SOURCES: Hass Avocado Board, Mission Viejo, CA.

A high consumption of added sugar has been associated with several cardiovascular risk factors, including obesity, type 2 diabetes mellitus and dyslipidemia. The main goal was to assess the association of sugary food and drink intake on the risk of stroke mortality. The Adventist Health Study-2 (AHS-2) is a prospective study with approximately 96,000 participants from the United States and Canada. Subjects were recruited from 2002 to 2007 at which time they completed a comprehensive food frequency questionnaire including intake of sugar added sweet foods and drinks. Subjects were followed with respect to National Death Index (NDI) mortality information through 2015. This is a low sugar consuming cohort where about 50% also adhere to a vegetarian dietary pattern. After applying exclusion criteria, the final analytical sample consisted of 53,482 study subjects. Cox Proportional hazard regression was used in the analyses adjusting for important demographic, lifestyle and medical variables. Four hundred and seventy two fatal strokes occurred during an average of 9.5 years or 509, 119 person-years of follow-up. Compared to the lowest quartile of sugary food intake (0 to 1.6 times/week), the hazard ratio of fatal stroke for the highest quartile (> 7 times/week) of sugary food intake was 0.86 (95% CI: 0.65 to 1.13), after adjusting for covariates. The hazard ratios did not change significantly when stratifying on gender and race. Consumption of added sugar was not associated with fatal stroke in this low sugar consuming population. Further research is needed in populations with higher intakes of sugar-sweetened foods and with diverse backgrounds and dietary patterns. Key words: Diet, sugar, stroke, cardiovascular diseases.

International audience; The detection threshold of poly(allyl dyglycol carbonate), PADC, for C ions is determined as 55 eV/nm in stopping power, which is significantly higher than that for proton and He ions. The stopping power is not a universal parameter for expressing the detection threshold of PADC. A new physical parameter of Radial Electron Fluence around Ion Tracks, REFIT, is proposed to describe the detection threshold of PADC. It is defined as the number density of electrons passing through the surface of a cylinder of a certain radius that is co-axial with the trajectory. Furthermore, preliminary calculations are presently being performed using the Monte Carlo simulation code of Geant4-DNA. The values of the REFIT at the detection thresholds for each ion are of the same order. Several issues affecting implementation of the REFIT paramter are discussed. These include the effects of impact parameter relating to the initial locations of secondary electrons, the effects of electron attachment below the cut off energy of 7.4 eV and the necessity of a more physically realistic medium than water for Monte Carlo simultaions.

G values of the losses of typical functional groups in PET films along boron ion tracks have been determined using FT-IR spectrometry. G value for the loss of aromatic-ring clearly increases above 270 eV/nm. Those of ester and ethylene increase around the slightly lower stopping power of 250 eV/nm. The detection thresholds are defined by determining the original points from which the evolution of etch pit starts along the latent track, when the chemical etching was progressing starting from the front surface of each incident ion trajectory. The thresholds for B, C, N, O, Ar and Kr ions have been determined for other kind of PET sheets. Values of the sensitivity at the thresholds are fairly higher at heavy ions with smaller atomic number.

A new diagnosis method for the discriminative detection of laser-accelerated multi-MeV carbon ions from background oxygen ions utilizing solid-state nuclear track detectors (SSNTDs) is proposed. The idea is to combine two kinds of SSNTDs having different track registration sensitivities: Bisphenol A polycarbonate detects carbon and the heavier ions, and polyethylene terephthalate detects oxygen and the heavier ions. The method is calibrated with mono-energetic carbon and oxygen ion beams from the heavy ion accelerator. Based on the calibration data, the method is applied to identify carbon ions accelerated from multilayered graphene targets irradiated by a high-power laser, where the generation of high-energy high-purity carbon ions is expected. It is found that 93 ± 1% of the accelerated heavy ions with energies larger than 14 MeV are carbons. The results thus obtained support that carbon-rich heavy ion acceleration is achieved.

It is well established that diabetic patients with poor glycemic control have increased susceptibility to infections, but glucose levels have not been directly associated with this increase. The assessment of the effects of glycosylated hemoglobin (A1 c) on the body’s ability to fight infections may be useful directly in establishing a link between elevated blood sugar and the risk of infections. A total of 127 subjects in Heart Pilot Study (HPS), sub-study of the Adventist Health Study 2 (AHS-2) completed a lifestyle, medical and food frequency questionnaire (FFQ) at baseline between 2013 and 2014. The A1 c and phagocytic index (PI) were measured in the same blood sample and their associations were assessed using linear regression. Mean blood glucose (MBG) was estimated based on A1 c levels using a standard formula. Three levels of MBG were used to compare prediabetic and diabetic ranges to the normal range. The PI is the average number of bacteria in the cytoplasm of 50 neutrophils, manually counted under a light microscope after the whole blood was briefly exposed to a standard dose of bacteria and stained. In multivariable analysis, we found that MBG in the prediabetic (117 to137 mg/dL) and diabetic (>137 mg/dL) ranges were associated with 12.9% (b= -0.129, 95% CI: -0.30, 0.05) and 20.4% decrease in PI (b= -0.204, 95% CI: -0.592, 0.184) compared to that, observed among those with normal MBG (p for trend=0.119). Elevated MBG levels contribute a decrease in the PI among those in the prediabetic and diabetic range compared to the normal range. Although our findings were not quite statistically significant due to low power which are clinically relevant in line with observations of an increased infections among diabetics. Further research on larger populations is needed. Key words: A1 c, hemoglobin A1 c, phagocytosis, neutrophils, phagocytic index, diabetes, infection.

Background: The assessment of polyphenol intake in free-living subjects is challenging, mostly because of the difficulty in accurately measuring phenolic content and the wide presence of phenolics in foods.Objective: The aims of this study were to evaluate the validity of polyphenol intake estimated from food-frequency questionnaires (FFQs) by using the mean of 6 measurements of a 24-h dietary recall (24-HR) as a reference and to apply a unique method-of-triads approach to assess validity coefficients (VCs) between latent "true" dietary estimates, total urinary polyphenol (TUP) excretion, and a surrogate biomarker (plasma carotenoids).Design: Dietary intake data from 899 adults of the Adventist Health Study 2 (AHS-2; 43% blacks and 67% women) were obtained. Pearson correlation coefficients (r), corrected for attenuation from within-person variation in the recalls, were calculated between 24-HRs and FFQs and between 24-HRs and TUPs. VCs and 95% CIs between true intake and polyphenol intakes from FFQs, 24-HRs, and the biomarkers TUPs and plasma carotenoids were calculated.Results: Mean ± SD polyphenol intakes were 717 ± 646 mg/d from FFQs and 402 ± 345 mg/d from 24-HRs. The total polyphenol intake from 24-HRs was correlated with FFQs in crude (r = 0.51, P < 0.001) and deattenuated (r = 0.63; 95% CI: 0.61, 0.69) models. In the triad model, the VC between the FFQs and theoretical true intake was 0.46 (95% CI: 0.20, 0.93) and between 24-HRs and true intake was 0.61 (95% CI: 0.38, 1.00).Conclusions: The AHS-2 FFQ is a reasonable indicator of total polyphenol intake in the AHS-2 cohort. Urinary polyphenol excretion is limited by genetic variance, metabolism, and bioavailability and should be used in addition to rather than as a replacement for dietary intake assessment.

Accumulating evidence links nut consumption with an improved risk of metabolic syndrome (MetS), however, long-term trials are lacking. We examined the effects of a daily dose of walnuts for two years on MetS in a large elderly cohort. A total of 698 healthy elderly participants were randomly assigned to either a walnut supplemented or a control diet. The participants in the walnut group were provided with packaged walnuts (1, 1.5, or 2 oz. or ~15% of energy) and asked to incorporate them into their daily habitual diet. The participants in the control group were asked to continue with their habitual diet and abstain from eating walnuts and other tree nuts. Intake of n-3 fatty acid supplements was not permitted in either group. Fasting blood chemistries, blood pressure, and anthropometric measurements were obtained at baseline and at the end of intervention. A total of 625 participants (67% women, mean age 69.1 y) completed this two-year study (90% retention rate). Triglycerides decreased in both walnut (&minus, 0.94 mg/dl) and control (&minus, 0.96 mg/dl) groups, with no significant between-group differences. There was a non-significant decrease in systolic and diastolic blood pressure in the walnut group (&minus, 1.30 and &minus, 0.71 mm Hg, respectively) and no change in the control group. Fasting blood glucose decreased by ~1 point in both the walnut and control groups. There were no significant between-group differences in the development or reversion of MetS. In conclusion, supplementing the diet of older adults with a daily dose of walnuts had no effect on MetS status or any of its components, although the walnut group tended to have lower blood pressure.

OBJECTIVES: To assess the relationship between habitual avocado intake, and cardiometabolic risk factors and metabolic syndrome (MetS). We hypothesized that regular avocado intake is associated with a lower occurrence of elevated blood glucose (BG), TG, blood pressure (BP), and waist circumference (WC), and/or decreased HDL-cholesterol (HDL-C). METHODS: This cross-sectional analysis was done on a random sample (n = ∼850) of subjects from the Adventist Health Study-2 cohort. Diet was assessed using a quantitative FFQ, which included an item for avocado/guacamole intake. Avocado intake (g/day) was calculated: f * s * n where f = the weighted frequency of avocado; s = the weighted portion size of avocado; and n = standard serving size (32 g) of avocado. FFQ data was also used to calculate total energy intake. Medication use, fasting BG, TG, HDL-C, BP, and WC were assessed during clinics. MetS was defined as follows: ≥3 of the diagnostic criteria defined by the Adult Treatment Panel III. Descriptive statistics including differences of means were analyzed. Logistic regression was used to determine the odds of metabolic syndrome for non-consumers (0 g/day; reference) versus consumers (>0 g/day; 51% of subjects) of avocado. Covariates were measured via a questionnaire: age, gender, race, education, energy intake, and dietary patterns. RESULTS: The odds for MetS for avocado consumers was non-significantly lower compared to nonconsumers: OR (95% CI) 0.87 (0.58, 1.30). Mean diastolic BP and WC were significantly lower among avocado consumers compared to nonconsumers. Mean HDL-C, TG, BG, and systolic BP did not differ between groups. CONCLUSIONS: No relationship between habitual avocado intake and MetS has been found. However, there may be an inverse relationship between avocado intake and specific cardiometabolic risk factors: diastolic BP and WC. FUNDING SOURCES: Hass Avocado Board, NIH, National Cancer Institute.

Background Elevated plasma methylmalonic acid (MMA) is a functional biomarker of vitamin B-12 status but limited information is available on its prevalence in US vegetarians. Objectives The study examines the prevalence of plasma MMA ≥0.27 µmol/L in those consuming vegetarian diets, its associations with vitamin B-12 intake and biomarkers, and the modifying effect of vegetarian patterns on these associations. Methods In this cross-sectional study (n = 785), concentrations of MMA, vitamin B-12, holotranscobalamin (holoTC), and homocysteine (Hcy) were determined in participants of the calibration substudy of the Adventist Health Study 2 (AHS-2). Vitamin B-12 intake from food, fortified food, and supplements was assessed by six 24-h recalls. Regression models were used to estimate ORs of having high MMA as related to vitamin B-12 status biomarkers, vitamin B-12 intake, and dietary pattern. Results The prevalence of low vitamin B-12 status defined by serum vitamin B-12

Avocados contain nutrients and bioactive compounds that may help reduce the risk of becoming overweight/obese. We prospectively examined the effect of habitual avocado intake on changes in weight and body mass index (BMI). In the Adventist Health Study (AHS-2), a longitudinal cohort (~55,407, mean age ~56 years, U.S. and Canada), avocado intake (standard serving size 32 g/day) was assessed by a food frequency questionnaire (FFQ). Self-reported height and weight were collected at baseline. Self-reported follow-up weight was collected with follow-up questionnaires between four and 11 years after baseline. Using the generalized least squares (GLS) approach, we analyzed repeated measures of weight in relation to avocado intake. Marginal logistic regression analyses were used to calculate the odds of becoming overweight/obese, comparing low (&gt, 0 to &lt, 32 g/day) and high (&ge, 32 g/day) avocado intake to non-consumers (reference). Avocado consumers who were normal weight at baseline, gained significantly less weight than non-consumers. The odds (OR (95% CI)) of becoming overweight/obese between baseline and follow-up was 0.93 (0.85, 1.01), and 0.85 (0.60, 1.19) for low and high avocado consumers, respectively. Habitual consumption of avocados may reduce adult weight gain, but odds of overweight/obesity are attenuated by differences in initial BMI values.

A series of FT-IR spectrometric studies has been performed to understand the latent track structure in poly(allyl diglycol carbonate), PADC, which were exposed to proton beams with energies of 20, 30 and 70 MeV. These energies are too high to register etchable tracks in PADC. Chemical damage parameters, such as damage density, effective track core radius and radiation chemical yields, for losses of ether bond, carbonate ester bond and CH groups in PADC are evaluated as a function of the stopping power, which were compared to the previous results for 5.7 MeV proton and heavy ions, between He and Xe. Graphs of the chemical damage parameters are given at the wide stopping powers ranging from 1 to 12,000 keV/μm. The decreasing behaviors of the ether and carbonate ester bonds are on the almost identical trends with those of the heavy ions. On the contrary to this, the reducing behavior of CH groups is similar to that of the gamma rays. Different dependence of the chemical damage parameters for the loss of CH groups is found on the stopping powers between the both sides of the detection threshold as an etched track detector.

OBJECTIVES: We sought to assess the effect of daily consumption of macadamia nuts as 15% of calories on body weight, BMI, waist circumference, percent body fat and skeletal muscle mass in overweight/obese men and women with elevated cardiometabolic risk. METHODS: Utilizing a randomized crossover design, we randomized 38 subjects to consume macadamia nuts daily as 15% of calories for 8 weeks (intervention) and their usual diet for 8 weeks (control), with a 2-week washout. Three subjects dropped out early; n = 35 for analysis. Subjects were healthy men and postmenopausal women with a BMI of 25–39, a waist circumference of >101.6 cm for men and >88.9 cm for women, and one additional cardiovascular risk factor (fasting plasma glucose >100 mg/dL, triglycerides ≥150 mg/dl, total cholesterol >200 mg/dL, LDL-C > 100 mg/dL, blood pressure ≥130/85 mmHg or taking anti-hypertensive medication). Macadamia nuts were provided in pre-weighed daily portions as 15% of calories calculated using the Mifflin-St. Jeor equation. Percent body fat and skeletal muscle mass (kg) were determined by bioelectrical impedance analysis. A mixed model analysis was performed with treatment, sequence, phase, and baseline values as fixed-effect terms and subjects as a random-effects term. RESULTS: Compared to control, consumption of macadamia nuts led to a mean weight change of –348 g (84.13 vs. 83.78 kg; P = 0.15) a mean BMI change of –0.15 kg/m(2) (30.61 vs. 30.47 kg/m(2); P = 0.12), and a mean waist circumference change of 0.17 cm (107.41 vs. 107.58 cm; P = 0.61). Percent body fat increased by an average of 0.26% after eating nuts (42.70 vs. 42.96%; P = 0.16). Skeletal muscle mass was slightly but significantly lower after eating nuts with a mean change of –0.237 kg (26.33 vs. 26.09 kg; P = 0.017). CONCLUSIONS: Daily consumption of high-fat macadamia nuts for eight weeks in overweight and obese individuals did not change anthropometrics including body weight, BMI, waist circumference, and % body fat. Skeletal muscle mass was slightly lowered but likely not clinically relevant. FUNDING SOURCES: Hort Innovation, Sydney, Australia.

OBJECTIVES: Previous reports indicate that intake of some soy products may be associated with improvements in blood lipids but few studies examined fermented soy foods. Q CAN PLUS® is a functional food product derived from fermented soybeans. To evaluate the effects of fermented soy on cardiovascular risk factors, we implemented a clinical trial to compare the effects of the fermented soy powder (Q CAN PLUS®) against a placebo (sprouted brown rice powder) in individuals at risk for cardiovascular diseases. METHODS: Twenty-seven adults at risk for cardiovascular diseases (29–75 years old; 78% female; mean BMI [32.3 kg/m2 ± 7.3]) were randomized to consume either 2 pouches (12–15 g powder/pouch) per day of fermented soy powder (Q CAN PLUS®), or a sprouted brown rice powder for 12 weeks each, in a crossover design trial. The intervention phases were separated by a two week wash out period. Measurements and biospecimens were taken at baseline and at weeks 11 and 12 of each phase. Assessment included blood lipids, blood pressure, blood glucose, blood insulin, and anthropometric measures. For each of the outcomes, a mixed model was fitted to compare changes from pre- to post-treatment and between treatments. The models included treatment, time, interaction between treatment and time, phase, visit within phase and enrollment period as fixed effects terms and subjects as random effects terms. RESULTS: Between treatment results from the mixed model analysis show that fermented soy powder intake significantly reduced serum cholesterol (mean change −8.95 mg/dL; P = 0.0024), LDL (mean change −6.96 mg/dL; P = 0.0317), and HDL (−1.29 mg/dL; P = 0.0036) compared with the sprouted brown rice powder. Within treatment results indicated that fermented soy powder significantly reduced total cholesterol (P = 0.0073) and LDL (P = 0.0132), while reductions in HDL were not statistically significant. Within treatment results were not statistically different for the placebo phase except for an increase in HDL (mean change 3.61; P = 0.0026). CONCLUSIONS: These data indicate that regular intake of fermented soy powder results in a reduction in serum total and LDL cholesterol which may have beneficial implications for the reduction of cardiovascular risk factors in adults. FUNDING SOURCES: BESO Biological Research Inc. Diamond Bar, CA, USA.

It has been confirmed that the density of carbonate ester in poly(allyl diglycol carbonate) (PADC), which is a well-known polymeric nuclear track detector CR-39, begins decreasing above a critical dose of about 60 kGy during exposures to Co-60 gamma rays and Ultra Soft X-rays (USX: Kα (Al) with energy 1.49 keV). After exposure to Co-60 gamma rays at 77 K and room temperature (RT), a significant difference in Electron Spin Resonance (ESR) spectra has been observed at both sides of a critical dose of 60 kGy, where is a threshold for the degradation of carbonate ester in PADC. Namely, the types of free radicals in PADC are different from each other below and above this critical dose. Changes in FT-IR spectra of carbonate ester in PADC above critical doses for gamma ray and USX exposures have also been observed, while that of ether decreases linearly with increasing absorbed dose. These results are well concordant with previous results obtained with 28 MeV electron beams. They also indicate that at least two hits of electrons are needed to destroy the carbonate ester in PADC. The layered structure of ion tracks in PADC can be explained thanks to these experimental results. Also, some clues for the identification of created radicals have been obtained from the results using both ESR and IR.

To investigate the association between plasma concentration of vitamin B12 and B12 intake from supplements, fortified foods, and animal source foods among vegetarians and non-vegetarians, we conducted a cross-sectional analysis among 728 participants of the Adventist Health Study 2 (AHS-2) calibration study. The median age of participants was 58 years, 65.4% were female, and 50.3% were White. We used six 24 h dietary recalls to measure B12 intake, serum vitamin B12, and holotranscobalamin (holoTC) concentration. B12 supplements had a significantly positive association with plasma B12 among all subjects (p trend &lt, 0.001), especially among vegans and lacto-ovo vegetarians (p trend &lt, 0.001). Among non-users of B12 supplements, B12 intake from milk substitutes was significantly positively associated with holoTC (p trend &lt, 0.004) and serum B12 (p trend &lt, 0.030). In non-vegetarians, holoTC was significantly positively associated with B12 intake from eggs, while serum B12 was significantly positively associated with B12 intake from milk in the upper tertile compared to the lower, and B12 intake from meat in the middle compared to the lower tertile intake (p &lt, 0.011). Supplements containing B12 followed by B12 intake from milk substitutes were significant contributors of plasma vitamin B12 concentration.

Background Meat intake is associated with increased risk of type 2 diabetes (T2D). It is not clear if egg intake is associated with T2D risk because purported associations may be due to concurrent consumption of eggs with meat. Objective Our aim was to differentiate any associations between meat and egg consumption and the risk of T2D. Design In this longitudinal study, 55,851 participants of the Adventist Health Study 2 who were free of diabetes provided demographic, anthropometric, and dietary data at baseline. Meat and egg intakes were assessed with a validated quantitative food-frequency questionnaire. Responses to 2 follow-up questionnaires determined incident T2D cases. Multivariate-adjusted logistic regression was used to determine relations between meat and egg intake and incident T2D. Results T2D cases identified during a mean 5.3 y of follow-up totaled 2772. Meat intake of >0 to

ObjectiveVegetarian diets may be associated with low prevalence of autoimmune disease, as observed in rural sub-Saharan Africans. Graves’ disease, an autoimmune disorder, is the most common cause of hyperthyroidism. We studied prevalence of hyperthyroidism according to dietary pattern in a population with a high proportion of vegetarians.DesignCross-sectional prevalence study. The association between diet and prevalence of hyperthyroidism was examined using multivariate logistic regression analyses controlling for sociodemographic characteristics and salt use.SettingThe Adventist Health Study-2 conducted in the USA and Canada.SubjectsChurch members (n 65 981) provided demographic, dietary, lifestyle and medical history data by questionnaire.ResultsThe prevalence of self-reported hyperthyroidism was 0·9 %. Male gender (OR=0·32; 95 % CI 0·26, 0·41) and moderate or high income (OR=0·67; 95 % CI 0·52, 0·88 and OR=0·73; 95 % CI 0·58, 0·91, respectively) protected against hyperthyroidism, while obesity and prevalent CVD were associated with increased risk (OR=1·25; 95 % CI 1·02, 1·54 and OR=1·92; 95 % CI 1·53, 2·42, respectively). Vegan, lacto-ovo and pesco vegetarian diets were associated with lower risk compared with omnivorous diets (OR=0·49; 95 % CI 0·33, OR=0·72, 0·65; 95 % CI 0·53, 0·81 and OR=0·74; 95 % CI 0·56, 1·00, respectively).ConclusionsExclusion of all animal foods was associated with half the prevalence of hyperthyroidism compared with omnivorous diets. Lacto-ovo and pesco vegetarian diets were associated with intermediate protection. Further study of potential mechanisms is warranted.

Protein plays a crucial role in the growth and development of adolescents. However, being a secondary energy source, protein&rsquo, s role in obesity has been sidelined. We examined whether intake of protein (total, animal, plant), branched-chain (BCAAs), and sulfur-containing (SCAAs) amino acids are associated with general body and central obesity and body composition in a cross-sectional study among healthy adolescents. Students aged 12&ndash, 18 years old (n = 601) in schools near two major Adventist universities in California and Michigan provided dietary data via a validated web-based food frequency questionnaire (FFQ) and anthropometric data during school visits. Intakes of total, animal, and plant proteins, and BCAAs and SCAAs were derived from FFQ data. We defined general body obesity with body-mass-index-for-age (BMIz) z-scores and central obesity with waist-to-height ratios (WHtR). After full adjustment for covariates, multiple regression analyses showed significant positive associations between intakes of total protein (&beta, = 0.101, 95% CI: 0.041, 0.161), animal protein (&beta, = 0.118, 95% CI: 0.057, 0.178), BCAAs (&beta, = 0.056, 95% CI: 0.025, 0.087), and SCAAs (&beta, = 0.025, 95% CI: 0.012, 0.038) with general body adiposity. Animal protein (&beta, = 0.017, 95% CI: 0.001, 0.033) and SCAAs (&beta, = 0.004, 95% CI: 0.000, 0.008) were also associated with central obesity. Total and animal protein and BCAA and SCAA were also significantly associated with fat mass. Our findings suggest that high protein intake may pose a possible detriment to adolescent health. Longitudinal and safety evaluation studies are recommended.

OBJECTIVES: To determine if consuming walnuts daily for 2 years would improve the omega-3 index in healthy elderly compared to habitual diet without walnuts. METHODS: Design: Secondary analysis of the Walnuts and Healthy Aging (WAHA) study, a 2-year, randomized controlled clinical trial, conducted in Loma Linda University, CA, USA and Hospital Clinic, Barcelona, Spain. Subjects were randomly assigned to either a walnut or a control group. STUDY POPULATION: Included 193 WAHA study subjects from the Loma Linda center only, whose blood samples were collected and analyzed for RBC fatty acids. STATISTICAL ANALYSIS: To assess whether the changes of the Omega-3 index from baseline to year 1 and baseline to year 2 are significantly different between the walnut and control groups. Unstructured covariance model best fitted the data and was utilized. Then, repeated measures analyses were conducted to assess the delta change differences based on generalized least squares model. RESULTS: Omega-3 index did not significantly change between baseline and year 1 in either group. The index significantly increased by 1.5% (P 0.05). CONCLUSIONS: Preliminary findings suggest that consuming walnuts, a rich source of ALA, may not be adequate to improve the omega-3 index compared to a walnut free habitual diet. Background intake of EPA and DHA may have a more pronounced influence on the index and needs to be further explored. FUNDING SOURCES: California Walnut Commission, Folsom, CA.

Diets eliminating animal products have rarely been associated with hypothyroidism but may protect against autoimmune disease. Thus, we investigated whether risk of hypothyroidism was associated with vegetarian compared to omnivorous dietary patterns. The Adventist Health Study-2 was conducted among church members in North America who provided data in a self-administered questionnaire. Hypothyroidism was queried at baseline in 2002 and at follow-up to 2008. Diet was examined as a determinant of prevalent (n = 4237 of 65,981 [6.4%]) and incident cases (1184 of 41,212 [2.9%]) in multivariate logistic regression models, controlled for demographics and salt use. In the prevalence study, in addition to demographic characterstics, overweight and obesity increased the odds (OR 1.32, 95% CI: 1.22-1.42 and 1.78, 95% CI: 1.64-1.93, respectively). Vegan versus omnivorous diets tended to be associated with reduced risk (OR 0.89, 95% CI: 0.78-1.01, not statistically significant) while a lacto-ovo diet was associated with increased risk (OR 1.09, 95% CI: 1.01-1.18). In the incidence study, female gender, white ethnicity, higher education and BMI were predictors of hypothyroidism. Following a vegan diet tended to be protective (OR 0.78, 95% CI: 0.59-1.03, not statistically significant). In conclusion, a vegan diet tended to be associated with lower, not higher, risk of hypothyroid disease.

A new diagnosis method for high energy ions utilizing a single CR-39 detector mounted on plastic plates is demonstrated to identify the presence of the high energy component beyond the CR-39's detection threshold limit. On irradiation of the CR-39 detector unit with a 25 MeV per nucleon He ion beam from conventional rf-accelerators, a large number of etch pits having elliptical openings are observed on the rear surface of the CR-39. Detailed investigations reveal that these etch pits are created by heavy ions inelastically backscattered from the plastic plates. This ion detection method is applied to laser-driven ion acceleration experiments using cluster-gas targets, and ion signals with energies up to 50 MeV per nucleon are identified.

The latent track structure of 28 MeV electrons in poly(allyl diglycol carbonate), PADC, has been investigated using FT-IR spectral method. The density of ether decreases linearly with increasing the fluence. Chemical damage parameters of effective track radius, damage density and radiation chemical yield, for loss of ether are evaluated as 0.023 nm, 0.01 scissions/nm and 19 scissions/100 eV, respectively. The derived values are compared to that of previous ones from gamma ray, protons and heavy ions exposures. The density of carbonate ester and CH groups decreases above the fluence of 1.6 × 1015 electrons/cm2, which corresponds to the critical fluence in which the track overlapping becomes significant. This implies that the carbonate ester can be lost following the damage on neighboring ether.

BACKGROUND: Dietary assessment during adolescence is crucial in determining how adolescents’ consumption habits potentially affect current and long-term health. However, assessment methods for adolescents need to be relevant to their emerging technological culture. We developed a web-based food frequency questionnaire (webFFQ) to assess the habitual soy isoflavones and nutrient intake of adolescents. Our purpose was to validate this webFFQ against multiple 1-day photograph-assisted food records (FR). METHODS: Adolescents aged 12–18 years (n = 70) attending middle and high schools completed the webFFQ and provided six 1-day FR. Fifteen participants were excluded due to improbable energy intake. Statistical agreements were determined using Wilcoxon signed-ranks test, Pearson’s bivariate correlations of normalized values with energy-adjustment and correction for attenuation, cross-classification, and Bland-Altman plots. RESULTS: Based on n = 55, the webFFQ had higher intake estimates for all isoflavones and most nutrients compared to the FR. Energy-adjusted and deattenuated correlations were moderately strong for total isoflavones (r = 0.67), daidzein (r = 0.63), genistein (r = 0.64), and glycitein (r = 0.54). They ranged from a high of 0.82 (animal proteins) to a low of 0.11 (vitamin B12) for nutrients. Cross-classification agreement up to within 1 quartile ranged from 99.0 % (vegetable protein) to 61.8 % (vitamin B12) with low gross misclassifications (0.0–12.7 %). Bland-Altman plots for the isoflavones showed consistent overestimation and wide variation but nevertheless good agreement between the two methods. CONCLUSIONS: The webFFQ is relatively valid in ranking adolescents according to their isoflavones and nutrient intake. However, while it significantly overestimates the absolute intake of most nutrients, results are comparable to other food frequency questionnaires developed for adolescents.

*In order to design an active-type personal dosemeter having sufficient sensitivity to high-energy neutrons up to 100 MeV, the characteristic response of several types of silicon (Si) semiconductor detectors has been investigated experimentally and theoretically. At first, the response of each detector has been checked to protons accelerated by a Van de Graff accelerator installed at Kobe University. A fully-depleted Si detector was selected as a promising detector element owing to a simple structure and comprehensive characteristics. In the next step, neutron irradiation experiments were carried out in a monoenergetic reference field in JAEA. On the other hand, theoretical distributions of the deposited energy were estimated in a simplified geometry consisting of Si and PE layers. An agreement in the relative shape was confirmed between the theoretical and experimental results. Applying this calculation procedure to other neutron energies and various thickness of sensitive layer, it was found that the energy dependence could be improved by the two-window technique by setting different discrimination levels on the pulse height. Another important characteristic of the angular dependence was also discussed for practical application of a personal dosemeter for high energy neutrons.

Bioactive constituents of pecan nuts such as γ-tocopherol and flavan-3-ol monomers show antioxidant properties in vitro, but bioavailability in humans is not known. We examined postprandial changes in plasma oxygen radical absorbance capacity (ORAC) and in concentrations of tocopherols, catechins, oxidized LDL, and malondialdehyde (MDA) in response to pecan test meals. Sixteen healthy men and women (23-44 y, BMI 22.7 ± 3.4) were randomly assigned to 3 sequences of test meals composed of whole pecans, blended pecans, or an isocaloric meal of equivalent macronutrient composition but formulated of refined ingredients in a crossover design with a 1-wk washout period between treatments. Blood was sampled at baseline and at intervals up to 24 h postingestion. Following the whole and blended pecan test meals, plasma concentrations of γ-tocopherols doubled at 8 h (P < 0.001) and hydrophilic- and lipophilic-ORAC increased 12 and 10% at 2 h, respectively. Post whole pecan consumption, oxidized LDL decreased 30, 33, and 26% at 2, 3, and 8 h, respectively (P < 0.05), and epigallocatechin-3-gallate concentrations at 1 h (mean ± SEM; 95.1 ± 30.6 nmol/L) and 2 h (116.3 ± 80.5 nmol/L) were higher than at baseline (0 h) and after the control test meal at 1 h (P < 0.05). The postprandial molar ratio of MDA:triglycerides decreased by 37, 36, and 40% at 3, 5, and 8 h, respectively (P < 0.05), only when whole and blended pecan data were pooled. These results show that bioactive constituent of pecans are absorbable and contribute to postprandial antioxidant defenses.

Objective. To identify correlates of perceived pain-related restrictions in a community sample of women with fibromyalgia. Method. The fibromyalgia group was composed of white women with a self-reported, physician-given fibromyalgia diagnosis ( N = 238) from the Biopsychosocial Religion and Health Study (BRHS). BRHS respondents had participated in the larger Adventist Health Study-2. To identify associations with pain-related restrictions, we used hierarchical linear regression. The outcome measure was subjects' pain-related restrictions (one SF-12 version 2 item). Predictors included age, education, body mass index (BMI), sleep apnea, and fibromyalgia treatment in the last year, as well as standardized measures for trauma, major life stress, depression, and hostility. To better interpret the findings, pain-related restrictions also were predicted in women with osteoarthritis and no fibromyalgia. Results. Women with fibromyalgia reporting the more severe pain-related restrictions were those who had experienced trauma accompanied by physical pain, were older, less educated, more depressed, more hostile, had high BMI scores, and had been treated for fibromyalgia in the last 12 months (adjusted R 2 = 0.308). Predictors in women with osteoarthritis were age, BMI, treatment in the last 12 months, experience of a major life stressor, and greater depression symptom severity (adjusted R 2 = 0.192). Conclusions. In both groups, age, BMI, treatment in the last 12 months, and depression predicted pain-related restrictions. Experience of a traumatic event with physical pain was the strongest predictor in the fibromyalgia group. These findings may be useful in constructing novel treatments and prevention strategies for pain-related morbidity in fibromyalgia patients.

The purpose of the study was to investigate the association between incident self-reported fibromyalgia (FM) and prior somatic diseases, lifestyle factors, and health behaviors among 3,136 women who participated in 2 cohort studies 25 to 26 years apart (the Adventist Health Study 1 and 2). The women completed a comprehensive lifestyle and medical history questionnaire at baseline in 1976. Information on new diagnosis of doctor-told FM was obtained at the second survey in 2002. A total of 136 women reported a diagnosis of FM during 25 years of follow-up, giving a period incidence of 43/1,000 or 1.72/1000 per year. In multivariable logistic regression analyses, a significant, dose-response association was found with number of allergies with OR of 1.61 (95% CI: .92-2.83) and 3.99 (95% CI: 2.31-6.88), (P[trend].0001), respectively, for 1 and 2 or more allergies versus none. A history of hyperemesis gravidarum was also associated with FM with OR of 1.32 (95% CI: .75-2.32) and 1.73 (95% CI: .99-3.03), (P[trend].05), respectively, for some or all pregnancies versus none. A positive association with smoking was also found with OR of 2.37 (95% CI: 1.33-4.23) for ever smokers versus never smokers. No significant association was found with number of surgeries, history of peptic ulcer, or taking medications to control various symptoms.Smoking as well as prevalent allergies, and a history of hyperemesis gravidarum, seem to predict development of FM in women during 25 years of follow-up. This information may help in identifying persons at high risk of developing FM and thus initiate effective prevention strategies.

The contribution of stress to the pathophysiology of fibromyalgia has been the subject of considerable debate. The primary purpose of the present study was to evaluate the relationship between traumatic and major life stressors and a fibromyalgia diagnosis in a large group of older women and men. Data were from the federally-funded Biopsychosocial Religion and Health Study, and subjects were 10,424 of the 10,988 survey respondents—two-thirds women and one-third men—providing responses to a fibromyalgia question. Average age was 61.0 ± 13.5 years. A physician-given fibromyalgia diagnosis in a subject’s lifetime was reported by 3.7% of the sample, 4.8% of the women and 1.3% of the men. In two multivariable logistic regression models (all respondents and women only, controlling for age, sex, race/ethnicity, and education), two traumatic experience types (sexual and physical assault/abuse) were associated with a fibromyalgia diagnosis. Two other trauma types (life-threatening and emotional abuse/neglect) and major life stress experiences were not. The highest odds ratios in both models were those for sexual assault/abuse followed by physical assault/abuse. The relationship between age and fibromyalgia was curvilinear in both models (odds ratios rising until approximately age 63 and declining thereafter). In the all-subjects model, being a woman increased the odds of a fibromyalgia diagnosis, and in both models, fibromyalgia was associated with being White (versus non-White) and lower education. We recommend that researchers investigate the relationship between stress and fibromyalgia in concert with genetic and biomarker studies.