Patrick Mullie

Meta-analysis of observational studies of serum 25-hydroxyvitamin D levels and colorectal, breast and prostate cancer and colorectal adenoma.

Epidemiological studies have suggested a reduced risk of several cancers associated with high vitamin D status. We performed a systematic review with meta‐analyses of observational studies of serum 25‐hydroxyvitamin D level and colorectal, breast and prostate cancer and colonic adenoma. The literature of December 2009 was searched without language restriction. The meta‐regression analysis was done to compute dose‐response effects. Because in case‐control studies, serum 25‐hydroxyvitamin D level is measured after the diagnosis of cancer, separate analyses for case‐control and prospective studies were done. We identified 35 independent studies. The seven studies on colorectal adenomas were heterogeneous in terms of endpoint and control for major confounding factors, and we did not perform a meta‐analysis of these data. The summary relative risk (SRR) and (95% confidence interval) for a 10 ng/ml increase in serum 25‐hydroxyvitamin D was 0.85 (0.79; 0.91) for colorectal cancer (2,630 cases in 9 studies); 0.89 (0.81;0.98) for breast cancer (6,175 cases in 10 studies); and 0.99 (0.95;1.03) for prostate cancer (3,956 cases in 11 studies). For breast cancer, case‐control studies (3,030 cases) had major limitations and obtained SRR of 0.83 (0.79; 0.87) whereas SRR of prospective studies (3,145 cases) was 0.97 (0.92; 1.03). For colorectal and breast cancer, differences between cases and controls in the season of blood draw or in overweight/obesity or physical inactivity could not explain the results. In conclusion, a consistent inverse relationship between serum 25‐hydroxyvitamin D levels and colorectal cancer was found. No association was found for breast and prostate cancer.

Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: a randomized controlled trial

BACKGROUNDnMaternal obesity and excessive gestational weight gain (GWG) are major short- and long-term risk factors for maternal and fetal complications.nnnOBJECTIVEnThe objective was to study whether a lifestyle intervention based on a brochure or on active education can improve dietary habits, increase physical activity (PA), and reduce GWG in obese pregnant women.nnnDESIGNnIn this randomized controlled trial, 195 white, obese pregnant women [age: 29 + or - 4 y; body mass index (in kg/m(2)); 33.6 + or - 4.2] were randomly assigned into 3 groups: a group that received nutritional advice from a brochure, a group that received the brochure and lifestyle education by a nutritionist, and a control group. Nutritional habits were evaluated every trimester through 7-d food records. PA was evaluated with the Baecke questionnaire.nnnRESULTSnEnergy intake did not change during pregnancy and was comparable in all groups. Fat intake, specifically saturated fat intake, decreased and protein intake increased from the first to the third trimester in the passive and active groups compared with an opposite change in the control group. Calcium intake and vegetable consumption increased during pregnancy in all groups. PA decreased in all groups, especially in the third trimester. No significant differences in GWG and obstetrical or neonatal outcome could be observed between the groups.nnnCONCLUSIONSnBoth lifestyle interventions improved the nutritional habits of obese women during pregnancy. Neither PA nor GWG was affected.

Dietary patterns and socioeconomic position

Background/Objectives:To test a socioeconomic hypothesis on three dietary patterns and to describe the relation between three commonly used methods to determine dietary patterns, namely Healthy Eating Index, Mediterranean Diet Score and principal component analysis.Subjects/Methods:Cross-sectional design in 1852 military men. Using mailed questionnaires, the food consumption frequency was recorded.Results:The correlation coefficients between the three dietary patterns varied between 0.43 and 0.62. The highest correlation was found between Healthy Eating Index and Healthy Dietary Pattern (principal components analysis). Cohens kappa coefficient of agreement varied between 0.10 and 0.20. After age-adjustment, education and income remained associated with the most healthy dietary pattern. Even when both socioeconomic indicators were used together in one model, higher income and education were associated with higher scores for Healthy Eating Index, Mediterranean Diet Score and Healthy Dietary Pattern. The least healthy quintiles of dietary pattern as measured by the three methods were associated with a clustering of unhealthy behaviors, that is, smoking, low physical activity, highest intake of total fat and saturated fatty acids, and low intakes of fruits and vegetables.Conclusions:The three dietary patterns used indicated that the most healthy patterns were associated with a higher socioeconomic position, while lower patterns were associated with several unhealthy behaviors.

Evaluation of Body Fat Estimated from Body Mass Index and Impedance in Belgian Male Military Candidates: Comparing Two Methods for Estimating Body Composition

OBJECTIVEnThe study objective was to evaluate whether a classification based on body mass index (BMI) agrees with a classification based on body fat mass, estimated by bioelectrical impedance.nnnMETHODSnA random sample of 448 male candidates between 18 and 20 years was selected during their medical visit in a military recruitment center. BMI was determined as weight/height2 and was considered normal between 20.0 and 25.0 kg/m2 (cfr. WHO classification). Percentage of body fat was estimated with bioelectrical impedance, using the Omron Body Fat Analyzer HBF-306. Subjects with a body fat percentage measured by bipolar bioelectrical impedance analysis (BF%(IMP)) < or = 20.9% were considered normal weight, while subjects with a BF%(IMP) > or = 21.0% were considered overweight. We used the following classification: true positives were normal scores for BMI and impedance; false positives were normal scores for BMI but not for impedance; true negatives were overweight scores for BMI and for impedance; and false negatives were overweight scores for BMI but not for impedance. Data were analyzed using the SPSS statistical program.nnnRESULTSnBMI ranged from 17.0 to 29.4 kg/m2; percentage of fat mass varied between 5.3 and 31.4% of body weight. Of the total sample, 328 (73.2%) candidates were classified as true positive, 29 (6.5%) as false negative, 47 (10.5%) as false positive, and finally 44 (9.8%) as true negative. The difference in classification in normal weight versus overweight between the BMI method and the bipolar bioelectrical impedance method was statistically significant (chi2 with one df = 86.04; p < 0.001).nnnCONCLUSIONSnTo limit false-negative classifications, additional impedance measurements in the BMI category between 25.0 and 27.0 kg/m2 is mandatory to determine whether there is really an excess fat mass.

Socioeconomic, health, and dietary determinants of multivitamin supplements use in Belgium.

ObjectiveThis study aimed at investigating the use of multivitamin supplements in relationship to dietary pattern, socio-economic conditions and some health indicators.MethodsA cross-sectional design was used. Mailed questionnaires were sent to 5,000 Belgian military men. Use of multivitamins, frequency and food consumption were recorded during the past year, together with health (BMI, smoking, physical activity) and socioeconomic indicators (education, income). Dietary patterns were determined using the Mediterranean Diet Score (MDS).ResultsUse of multivitamin supplements was associated with healthy lifestyle characteristics, such as a higher physical activity level and non smoking. Moreover, it was found that on average more participants with a Flemish cultural background (19.8%) used supplements compared with participants with a French cultural background (9.3%). The MDS was related to multivitamin supplement use, with 34.9% of users having the highest score range. The socioeconomic indicators ‘education’ and ‘income’ were not related to vitamin supplement use.ConclusionA low BMI, healthy diet, regular physical activity, non-smoking status and cultural background were associated with a higher intake of multivitamin supplements.

Distribution of Cardiovascular Risk Factors in Belgian Army Men

ABSTRACT The objective was to determine the prevalence of cardiovascular risk factors in Belgian army men. Biomedical data and cardiovascular risk factors were obtained by a mailed questionnaire and by data collected from a medical software program (Total Health). The number of responders to the mailing was 1852; 974 of the 1852 responders and 420 of the 3148 nonresponders were registered in Total Health. The prevalence of obesity was 5.6%, 15.0%, and 19.5%, respectively, for officers, noncommissioned officers, and soldiers. There was a strong socioeconomic gradient in the prevalence of smoking: 12.7% of the officers were smokers, compared with 19.7% of the noncommissioned officers and 29.5% of the soldiers (p < .001). Only 8.5% of the officers had a 10-year risk of more than 5% of developing fatal cardiovascular disease, compared with 18% of the lower socioeconomic positions. In conclusion, high-risk groups in Belgian army men are younger than 40 years of age, and smokers. Active prevention should focus on this group with special attention to the specificity of each rank category.