Injecting drug use and unsafe sexual practice are both considered major risk factors for HIV infection. This study reports sexual behaviors among male "current" (i.e. using heroin and/or opium at least once in the past 3 months) and "ex-" opiate users in Chiang Rai province in Northern Thailand. Between January 1999 and August 2000, 206 male opiate users were recruited by mail callback. Of the 206 drug users, 89 (43.2%) could be classified as current users. Current users did not differ from ex-users, except for educational level and ethnicity. Current and ex-opiate users showed no difference in number of regular sexual partners, proportion of having sex with commercial and non-commercial sex partners, and reported histories of sexually transmitted diseases. This study suggests that the importance of sexual risk behaviors in HIV transmission cannot be ignored in both current and ex-opiate users. J Epidemiol 2002;12:345-350.
The serum pepsinogen I to II ratio (PG I/II) is related to the risk of stomach cancer. Smoking is an established risk factor for stomach cancer. The effect of smoking on the change in PG I/II over a 7-year span was investigated. Methods: Data were from 1889 male subjects who underwent phlebotomy in both 1989 and 1996. The subjects were classified into smoking and non-smoking groups: those who continued smoking, and those who never smoked during the span. The subjects were stratified by Helicobacter pylori status (negative or positive) and age (20-29 or 30-56 years in 1989), and the change in PG I/II was compared between the smoking and the non-smoking groups. Results: PG I/II increased less (age adjusted mean standard error of the difference was 0.209±0.069, p<0.001) and less frequently in the smoking group (65.8% versus 58.9%, p=0.002), but these differences were not clear among H. pylori-positive subjects. Conclusions: The less frequent increase (i.e. a more frequent decline) in PG I/ll may be a long-term effect of smoking, although the effect is not clear under H. pylori infection. The decline may be one of the mechanisms through which smoking elevates the risk of stomach cancer. J Epidemiol 2002;12:351-356.
The present study investigated the relationship between hyperglycemia and both serum carotenoids and intake of vegetables and fruits. Subjects with a history of diabetes mellitus (DM group, n=133) or with hyperglycemia diagnosed using a 5.6% cutoff value for hemoglobin Air (High HbAic group, n=151) were recruited from among inhabitants of a rural area in Hokkaido, Japan. Intake frequencies of vegetables and fruits were assessed using a questionnaire administered by public health nurses. Serum levels of carotenoids and retinol were measured using high-performance liquid chromatography. The relationships between high HbA1c or DM and both serum carotenoids and intake frequencies of vegetables and fruits were analyzed using logistic regression modeling for a case-control study; each case (High HbA1c or DM) was matched to two controls (healthy subjects without any history of disease) matched for sex and age (within 3 years). The odds ratio (OR) for high HbA1c was 0.49 (95% confidence interval: 0.29-0.85) on high intake frequency of carrot and pumpkin and the OR for DM was 1.21 (95% CI: 0.79-1.84). No significant relationships were observed between high HbAic and intake frequencies of other vegetables and fruits. The ORs on high serum levels of αand β-carotenes, lycopene, β-cryptoxanthin and zeaxanthin and lutein were 0.38 (0.22-0.65), 0.35 (0.21-0.59), 0.57 (0.35-0.93), 0.35 (0.20-0.59), and 0.88 (0.54-1.46) for high HbA1c, respectively. In conclusion, intake of vegetables and fruits rich in carotenoids might be a protective factor against hyperglycemia. J Epidemiol 2002;12:357-366.
This study examined the validity of nursery teachers1 report on the physical activity of young children. Subjects were twenty-one children aged 3 to 4 years (12 boys and 9 girls) at a nursery in Toyama Prefecture, Japan. Children wereequipped with the Actiwatch (Mini-mitter Company Inc.) activity monitor and the Caloriecounter Select U (Kenz, Co, Ltd) for three consecutive weekdaysto assess their daily physical activity levels. Nursery teachers completed a questionnaire containing questions on chil-dren's activity level during the measurement periods at the nursery. The results showed that subjects with a high frequency of physical activity were significantly associated with an increasing trend in total energy expenditure and activity counts per day. Children whose physical activity was rated as "very often11 had a significantly higher activity level per day from the Actiwatch instrument, compared with peers whose physical activity was rated as "not often" (570.5q•192.8 counts vs. 334.9*123.4 counts, p<0.05). Regarding energy expenditure originating from physical activity and steps per day from the Caloriecounter, a significant difference was found between "very active" children and "inactive" children as rated by the nursery teachers (140.7*17.5 kcal vs. 78.2*17.4 kcal, p<0.05; 16103*1896 steps vs. 10038*32 steps, p<0.05). This study indicates that children's physical activity level as reported by their teachers in nursery surroundings is in accordance with the objective data from the Actiwatch and the Caloriecounter. The results suggest that nursery teachers' respondent for children in physical activity may be used as a valid measure to evaluate young children's physical activity levels, especially in nursery setting. J Epidemiol2002;12:367-374.
A case-control study was conducted between July and August 2001 in Ho Chi Minh City to investigate factors associated with having induced abortions among primigravid women aged 16 to 38 years. Interviews were conducted with 87 women undergoing abortion (cases) and 81 pregnant women coming for antenatal care (controls). Multiple logistic regression analysis revealed that older age (odds ratio [OR]=0.84) and being married (OR=0.05) decreased the risk of getting unintended pregnancy leading to abortion. Risk factors of obtaining an abortion were not being exposed to family planning promotion on television (OR=2.28) and not knowing the adverse effects of abortion (OR=10.26). Descriptive analysis of contraceptive behavior showed that 41% of cases had never used contraceptives and the reason for non-usage was lack of knowledge of any type of contraceptives in 43% of the cases. Additionally, only 24% of cases had discussed about family planning with their partners. Effective contraceptive methods shouldbe promoted among young population, both females and males, and they need tobe informed of the consequences of abortion. Television programs might be an effective mode of providing the information. J Epidemiol2002;12:375-382.
Objective: To examine the present status and trends in physical condition and activity of daily living (ADL) among patients infected HIV by blood products in Japan. Methods: Data from a survey of 605 HIV patients infected through blood products were available quarterly between April 1997 and March 2000. Physical condition (summary index of 13 symptoms) and ADL in the first quarter of 2000 were assessed by comparing proportions of patients in good physical condition and having good ADL according to the level of CD4 counts and the use of antiretroviral treatments. Trends in those proportions during the study period were investigated, and these trends were also assessed by the changes in CD4 counts and antiretroviral treatments. Results and Conclusions: The proportion of patients in good physical condition was 70.6% and having good ADL was 65.7% in the first quarter of 2000, which was associated with the CD4 counts and antiretroviral therapy. The proportion of patients in good physical condition decreased from 79.2% to 66.2%, and ADL also decreased from 72.1% to 61.3% during the study period. These declines were presumably associated with the changes in CD4 counts and antiretroviral treatments. J Epidemiol 2002;12:383-393.
We evaluated the performance of a 22-item food frequency questionnaire (FFQ) administered in 1980-81 to 3, 005 members of the Adult Health Study cohort, part of the Life Span Study. The questionnaire was compared with the records of a 24-hour dietary survey that was performed in 1984-85. From the dietary records, food and nutrient intakes were estimated. The association between the two measures of dietary intake was assessed using Mantel-Haenszel chi-square test and the Spearman's rank correlation coefficient. The frequency of food intake as measured by the FFQ was linearly associated with food intake as measured by the 24-hour diary, with the exception of dry fish. The highest correlations were observed for beverages, including coffee (0.51), milk (0.32) and black tea (0.26). Foods such as fruit (0.27), confectionery (0.23), rice (0.34) and bread (0.28) were also moderately correlated. These results show that, with the exception of dry fish, the FFQ is moderately correlated with the 24hour diary and can be used to assess diet intake in this cohort. J Epidemiol2002;12:394-401.