RESUMO

PURPOSE: Adult secondhand tobacco smoke (SHS) exposure is related to stroke and coronary heart disease (CHD) risk, but long-term effects are less clear. We evaluated whether childhood SHS exposure affects subsequent stroke or CHD risk among adult black and white never-smokers followed for stroke and CHD. METHODS: In this prospective cohort study, inverse probability weights were calculated to correct for bias due to attrition and survey nonresponse. Cox proportional hazards models were used to assess hazard ratios and 95% confidence intervals for stroke or CHD, separately, by number of childhood household smokers. RESULTS: Of 13,142 eligible participants, 6136 had childhood SHS exposure assessed. Baseline mean (SD) age was 63.5 (9.0), 65% were female, 30% black, 46% reported 0 childhood household smokers, 36% reported 1, and 18% reported 2+. In 60,649 person-years, 174 strokes were observed (2.9% of participants), and in 45,195 person-years, 114 CHD events were observed (2.1% of participants). The weighted and adjusted hazard ratios (95% confidence intervals) of stroke for 2+ versus 0 childhood household smokers was 1.66 (1.29-2.13) and was 1.15 (0.82-1.59) for CHD. CONCLUSIONS: We observed a significant association between childhood SHS exposure and stroke, but not CHD, after age 45 years and adjusting for missing information.

Assuntos

População Negra/estatística & dados numéricos , Doença das Coronárias/epidemiologia , Exposição Ambiental/estatística & dados numéricos , Acidente Vascular Cerebral/epidemiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/estatística & dados numéricos , População Branca/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Doença das Coronárias/etiologia , Exposição Ambiental/efeitos adversos , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Inquéritos e Questionários

RESUMO

BACKGROUND: Most publications about low-calorie sweeteners (LCSs) focus on person-level intake prevalence. OBJECTIVE: We assessed LCS distribution in foods, beverages, and food and beverage additions (FBAs), e.g., mayonnaise, in the US adult diet as reported in the NHANES (2007-2012). METHODS: Dietary items reported in the first 24-h recall were coded for LCS and/or nutritive sweeteners (NSs) with the use of USDA What We Eat in America food files. We calculated the number of times items were reported and LCS/NS content. RESULTS: Of reported items, 56.1% were foods, 29.1% were beverages, and 14.8% were FBAs. LCS was contained in 0.7% of foods, 8.1% of beverages, and 10.4% of FBAs. This food-level analysis identified FBAs as a significant source of LCSs in the US diet. CONCLUSION: Identifying the diversity of LCS and NS sources will enhance exposure classification for examining diet and health relations, including body weight management.