1) A prospective cohort study of 88,259 U.S. women found that moderate consumption of both caffeinated and decaffeinated coffee was associated with a lower risk of type 2 diabetes. Women drinking 1 cup per day had a 13% lower risk, those drinking 2-3 cups had a 42% lower risk, and those drinking 4 or more cups had a 47% lower risk compared to nondrinkers.
2) The associations were similar for caffeinated and decaffeinated coffee, as well as for filtered and instant coffee preparations. Tea consumption was not significantly associated with diabetes risk.
3) While higher caffeine intake was also linked to a lower diabetes risk, additional analyses suggested the association was likely due
This pilot study describe the malnutrition with its double burden ( overweight and under weight ) among Egyptian population and its effect on public health.
This poster published in Duphat conference in Dubai
International Journal of Engineering Research and Applications (IJERA) is an open access online peer reviewed international journal that publishes research and review articles in the fields of Computer Science, Neural Networks, Electrical Engineering, Software Engineering, Information Technology, Mechanical Engineering, Chemical Engineering, Plastic Engineering, Food Technology, Textile Engineering, Nano Technology & science, Power Electronics, Electronics & Communication Engineering, Computational mathematics, Image processing, Civil Engineering, Structural Engineering, Environmental Engineering, VLSI Testing & Low Power VLSI Design etc.
Life Style and Nutritional profile of NIDDM patients.Runa La-Ela
Life Style and Nutritional profile of NIDDM patients.
Diabetes mellitus is one of the most burdensome chronic diseases that are increasing in epidemic proportion throughout the world.
Obesity and physical inactivity constitute part of the risk for NIDDM because of their propensity to induce insulin resistance.
Food and dietary pattern of an individual have an important role to play in the development, treatment or prevention of NIDDM
This pilot study describe the malnutrition with its double burden ( overweight and under weight ) among Egyptian population and its effect on public health.
This poster published in Duphat conference in Dubai
International Journal of Engineering Research and Applications (IJERA) is an open access online peer reviewed international journal that publishes research and review articles in the fields of Computer Science, Neural Networks, Electrical Engineering, Software Engineering, Information Technology, Mechanical Engineering, Chemical Engineering, Plastic Engineering, Food Technology, Textile Engineering, Nano Technology & science, Power Electronics, Electronics & Communication Engineering, Computational mathematics, Image processing, Civil Engineering, Structural Engineering, Environmental Engineering, VLSI Testing & Low Power VLSI Design etc.
Life Style and Nutritional profile of NIDDM patients.Runa La-Ela
Life Style and Nutritional profile of NIDDM patients.
Diabetes mellitus is one of the most burdensome chronic diseases that are increasing in epidemic proportion throughout the world.
Obesity and physical inactivity constitute part of the risk for NIDDM because of their propensity to induce insulin resistance.
Food and dietary pattern of an individual have an important role to play in the development, treatment or prevention of NIDDM
Evaluation of the Glycaemic Index of some Staple Foods of South Eastern NigeriaPremier Publishers
Excessive release of glucose into the blood from food substances associates with metabolic disorders like diabetes. This study assessed the Glycaemic index (GI) of some staple carbohydrates foods consumed in Calabar and Southern part of Nigeria. Sixty (60) healthy volunteers aged 16 to 70 years. The test diets consisted of five food samples: Fried ripe plantain with stew and meat (FPSM); unripe plantain porridge with meat (UPPM), Garri and afang soup with meat (GASM), Fufu afang soup with meat (FASM), Abacha and fried groundnut (AFG). Fasting blood glucose, GI and available carbohydrate were estimated using standard methods. Results show that GASM and FASM had the highest GI, while FPSM had the least GI relative to glucose. The glycaemic load (GL) measured in 2 hours was highest in AFG, while FPSM had least GL. After 30 minutes, AFG had significantly (p<0.05) higher GI (6.74 ±0.12) compared with other subjects. But 120 minutes after, FPSM consumers recorded the lowest GI (4.829 ±0.10), while GASM (7.61 ±0.12) and FASM (7.34 ±0.14) were the highest. In conclusion, garri and fufu diets (AFG, FASM and GASM) have very high GI, yielding high levels of blood glucose compared with plantain diets (FPSM and UPPM) consumed in Calabar, Nigeria.
Effects of moderate doses of vitamin A as an adjunct to the treatment of pneu...ISAMI1
Effects of moderate doses of vitamin A as an adjunct to the treatment of pneumonia in underweight and normal-weight children: a randomized, double-blind, placebo-controlled trial
Correlation between Blood group, Hypertension, Obesity, Diabetes, and combina...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Join Doc Andrew to see what's new in health research that supports plant based diet recommendations. Share your questions via @DenverWWAD or email FreemanA@njhealth.org
Andrew Freeman, MD, FACC, FACP is a cardiologist and Director of Clinical Cardiology and Operations at National Jewish Health in Denver, Colorado. He holds leadership roles in the American College of Cardiology at the local and national levels. Dr. Freeman founded Denver's chapter of the Walk with a Doc program and heads Walk with a Doc-Colorado.
Walk with a Doc-Denver is a cost-free empowerment initiative powered by people improving their health, local doctors, and other health professionals who prescribe exercise-as-medicine. The mission? To elevate community health--one walk at a time! The program's Saturday walks include expert talks, health screenings, refreshments, and motivational giveaways. For more info visit: http://walkwithadoc.org/our-locations/denver/
Evaluation of the Glycaemic Index of some Staple Foods of South Eastern NigeriaPremier Publishers
Excessive release of glucose into the blood from food substances associates with metabolic disorders like diabetes. This study assessed the Glycaemic index (GI) of some staple carbohydrates foods consumed in Calabar and Southern part of Nigeria. Sixty (60) healthy volunteers aged 16 to 70 years. The test diets consisted of five food samples: Fried ripe plantain with stew and meat (FPSM); unripe plantain porridge with meat (UPPM), Garri and afang soup with meat (GASM), Fufu afang soup with meat (FASM), Abacha and fried groundnut (AFG). Fasting blood glucose, GI and available carbohydrate were estimated using standard methods. Results show that GASM and FASM had the highest GI, while FPSM had the least GI relative to glucose. The glycaemic load (GL) measured in 2 hours was highest in AFG, while FPSM had least GL. After 30 minutes, AFG had significantly (p<0.05) higher GI (6.74 ±0.12) compared with other subjects. But 120 minutes after, FPSM consumers recorded the lowest GI (4.829 ±0.10), while GASM (7.61 ±0.12) and FASM (7.34 ±0.14) were the highest. In conclusion, garri and fufu diets (AFG, FASM and GASM) have very high GI, yielding high levels of blood glucose compared with plantain diets (FPSM and UPPM) consumed in Calabar, Nigeria.
Effects of moderate doses of vitamin A as an adjunct to the treatment of pneu...ISAMI1
Effects of moderate doses of vitamin A as an adjunct to the treatment of pneumonia in underweight and normal-weight children: a randomized, double-blind, placebo-controlled trial
Correlation between Blood group, Hypertension, Obesity, Diabetes, and combina...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Join Doc Andrew to see what's new in health research that supports plant based diet recommendations. Share your questions via @DenverWWAD or email FreemanA@njhealth.org
Andrew Freeman, MD, FACC, FACP is a cardiologist and Director of Clinical Cardiology and Operations at National Jewish Health in Denver, Colorado. He holds leadership roles in the American College of Cardiology at the local and national levels. Dr. Freeman founded Denver's chapter of the Walk with a Doc program and heads Walk with a Doc-Colorado.
Walk with a Doc-Denver is a cost-free empowerment initiative powered by people improving their health, local doctors, and other health professionals who prescribe exercise-as-medicine. The mission? To elevate community health--one walk at a time! The program's Saturday walks include expert talks, health screenings, refreshments, and motivational giveaways. For more info visit: http://walkwithadoc.org/our-locations/denver/
Dietary guidelines are accused to be the key reason for obesity and diabetes epidemic. This slide deck shows why they are not. Junk food diet is the key reason.
Diabetes is a rapidly and serious health problem in Pakistan. This chronic condition is associated with serious long-term complications, including higher risk of heart disease and stroke. Aggressive treatment of hypertension and hyperlipideamia can result in a substantial reduction in cardiovascular events in patients with diabetes 1. Consequently pharmacist-led diabetes cardiovascular risk (DCVR) clinics have been established in both primary and secondary care sites in NHS Lothian during the past five years. An audit of the pharmaceutical care delivery at the clinics was conducted in order to evaluate practice and to standardize the pharmacists’ documentation of outcomes. Pharmaceutical care issues (PCI) and patient details were collected both prospectively and retrospectively from three DCVR clinics. The PCI`s were categorized according to a triangularised system consisting of multiple categories. These were ‘checks’, ‘changes’ (‘change in drug therapy process’ and ‘change in drug therapy’), ‘drug therapy problems’ and ‘quality assurance descriptors’ (‘timer perspective’ and ‘degree of change’). A verified medication assessment tool (MAT) for patients with chronic cardiovascular disease was applied to the patients from one of the clinics. The tool was used to quantify PCI`s and pharmacist actions that were centered on implementing or enforcing clinical guideline standards. A database was developed to be used as an assessment tool and to standardize the documentation of achievement of outcomes. Feedback on the audit of the pharmaceutical care delivery and the database was received from the DCVR clinic pharmacist at a focus group meeting.
Systematic Reviews and Meta- and Pooled AnalysesEffects of.docxssuserf9c51d
Systematic Reviews and Meta- and Pooled Analyses
Effects of Low-Carbohydrate Diets Versus Low-Fat Diets on Metabolic Risk
Factors: A Meta-Analysis of Randomized Controlled Clinical Trials
Tian Hu, Katherine T. Mills, Lu Yao, Kathryn Demanelis, Mohamed Eloustaz, William S. Yancy, Jr,
Tanika N. Kelly, Jiang He, and Lydia A. Bazzano*
* Correspondence to Dr. Lydia A. Bazzano, Department of Epidemiology, Tulane University School of Public Health and Tropical
Medicine. 1440 Canal Street, SL-18, Suite 2000, New Orleans, LA 70112 (e-mail: [email protected]).
Initially submitted December 16, 2011; accepted for publication May 11, 2012.
The effects of low-carbohydrate diets (≤45% of energy from carbohydrates) versus low-fat diets (≤30% of
energy from fat) on metabolic risk factors were compared in a meta-analysis of randomized controlled trials.
Twenty-three trials from multiple countries with a total of 2,788 participants met the predetermined eligibility crite-
ria (from January 1, 1966 to June 20, 2011) and were included in the analyses. Data abstraction was conducted
in duplicate by independent investigators. Both low-carbohydrate and low-fat diets lowered weight and improved
metabolic risk factors. Compared with participants on low-fat diets, persons on low-carbohydrate diets experi-
enced a slightly but statistically significantly lower reduction in total cholesterol (2.7 mg/dL; 95% confidence inter-
val: 0.8, 4.6), and low density lipoprotein cholesterol (3.7 mg/dL; 95% confidence interval: 1.0, 6.4), but a greater
increase in high density lipoprotein cholesterol (3.3 mg/dL; 95% confidence interval: 1.9, 4.7) and a greater de-
crease in triglycerides (−14.0 mg/dL; 95% confidence interval: −19.4, −8.7). Reductions in body weight, waist
circumference and other metabolic risk factors were not significantly different between the 2 diets. These
findings suggest that low-carbohydrate diets are at least as effective as low-fat diets at reducing weight and
improving metabolic risk factors. Low-carbohydrate diets could be recommended to obese persons with abnor-
mal metabolic risk factors for the purpose of weight loss. Studies demonstrating long-term effects of low-
carbohydrate diets on cardiovascular events were warranted.
carbohydrate-restricted diet; fat-restricted diet; meta-analysis; metabolic syndrome; obesity
Abbreviations: CI, confidence interval; HDL, high density lipoprotein cholesterol; LDL, low density lipoprotein cholesterol.
There were an estimated 937 million overweight and 396
million obese people worldwide in 2005 (1). Moreover, it
was estimated that 68.0% of American adults were either
overweight or obese in 2009 (2). Overweight and obesity
are important risk factors for diabetes, cardiovascular dis-
ease, cancer, and premature death. The high prevalence of
obesity has become a serious public health challenge. The
dietary recommendations for weight loss from the Ameri-
can Heart Association and the National Insti ...
RunningHead: PICOT Question 1
RunningHead: PICOT Question 7
PICOT Question
Avery Bryan
NRS-433V
Professor Christine Vannelli
May 19, 2019
Clinical Problem
A report from the Center for Disease Control and Prevention in 2015 revealed that (9.4%) 30.3 million Americans are diabetic and 84.1 million have prediabetes. This is a total population of over 100 million is at risk of developing type 2 diabetes which is a growing health problem being the seventh leading cause of death in the U.S. An estimated 1.5 million new cases were among 18-year old bracket and the rates of diagnosed diabetes increased proportionally to age. Below 44 years accounted for 4%, below 64 years at 17 % and 25% for those above 65 years across both genders. One-third of adults in America has prediabetes but sadly, they are unaware despite reports released by The National Diabetes Statistics Report every year. These reports elaborate on prevalence and incidence, prediabetes, long-term complications, risk factors, mortality, and cost. Diabetes poses the risk of serious complications like death, blindness, stroke, kidney disorders, cardiac diseases and health problems that lead to amputation of legs. However, the risks can be mitigated through physical body activities, proper dieting and prescribed use of insulin and other related measures to control the blood sugar levels. Diabetes Prevention Program was funded by NIH to research a yearly evidence-based program to improve healthy weight loss through diet and physical activities. There also efforts to determine the effectiveness of public service campaigns in improving the real-life experience in the diagnosis and treatment of diabetes.
PICOT Question.
The population affected by diabetes cuts across all ages, gender, race, and ethnicity. The prevalence is significantly high from 18 years and it increases with age to about 25% above 65 years. In terms of gender, men are at higher risk accounting for 37% while women are at 30% across races and educational levels. On races, the rates were higher among Indians/Alaska natives at 15%, non-Hispanic blacks at 12.7% and Hispanics at 12%. Among Asians, the rates were lower at 8% and 7.4% for non-Hispanic whites.
Intervention indicator for diabetes shows that individuals who do not observe a healthy diet are more exposed to the disease. Some risk behaviors include lack of exercise and excessive intake of junk foods that lead to obesity and increased blood sugar levels. Diabetes prevalence varied according to education levels were those with less than high school education at 12.6% and 7.2% for those higher than high school education.
Comparison and use of a control group from the popularity of Complementary and Alternative Medicine and Traditional Chinese Medicine showed distinct knowledge of diabetes, blood sugar control, and self-care. The experimental group received education through interactive multimedia for three months while the control group received.
Gestational diabetes mellitus (GDM) is a condition in which a hormone made by the placenta prevents the body from using insulin effectively. Glucose builds up in the blood instead of being absorbed by the cells.
Running head MANAGEMENT OF DIABETES IN ELDERLY HISPANIC AMERICA.docxcowinhelen
Running head: MANAGEMENT OF DIABETES IN ELDERLY HISPANIC AMERICA
MANAGEMENT OF DIABETIS IN ELDERLY HISPANIC AMERICA
8
Nidhi Sharma
NRS433VN
Linnette Nolte
03/12/2017
Abstract
The study was conducted to analyze the management of diabetes within the Hispanic America ethnic group. The research was carried out in the different hospitals in the United States to determine the best management practices for the elderly Hispanic America suffering from diabetes. The research used interviews with the patients and the nurses who offer the services to the patients. The research focused on the population of 65years and above Hispanic America. The result indicates that the patients with good care from the family respond to treatment as the proper management results in glycemic control. The research also got that most of the diabetes has a biological origin.
Management of diabetes in Hispanic America
P)-Population: Adults aged 65 years and above from the ethnic group of Hispanic origin who are the leading majority with the diabetes cases across the country. The other adults aged over 65 years and above but not Hispanic America are excluded from the exercise.
I)-Intervention: The research analysis the best management of Type 2 diabetes which is the most dominant type of the Hispanic America. The research compares the effectiveness of the Bariatric surgery in patients with body mass index, the healthy eating habit, and weight control measures. The best approach will be taught in every hospital holding the patients with diabetes in every two weeks seminar.
C)-Comparison: The procedure will take approximately three months then the result will be compared in line the previous mortality related cases. The progress in the health status of the patients will be matched with prior data before the process started.
O)-Outcome: The healthy eating habit and the weight management proved better in improving the conditions required to sustain the patients. The patients with the caretakers who help them in Glycemic control management improves even faster compared to patients without helpers.
T) – Time: The procedure will be analyzed monthly after every two weeks collection of data in the different hospitals.
Articles
Foundation, C. H. (2003). Guidelines for improving the care of the older person with diabetes mellitus. Journal of the American Geriatrics Society, , 51(5s), 265-280.
The article was written with the efforts of the California Health Foundation in collaboration with America Geriatrics Society concerned with improving the health of the elderly with diabetes on February 25, 2003. The T2D is highly increasing among the Hispanic America who is and 65 years and above. The estimates indicate that the total of approximately 20% adult aged 65 years and above are suffering from the T2D. The research is, therefore, provides the critical analysis of the guidelines required to improve the care of the elder people with T2D by giving a series of recommendatio ...
Learn the basics of Diabetes Prevention, reversal and Management. The Science is clear, follow the five key behavior changes to live a diabetes-free life.
Use of Diet Pills and Other Dieting Aids in a CollegePopulat.docxdickonsondorris
Use of Diet Pills and Other Dieting Aids in a College
Population with High Weight and Shape Concerns
Christine I. Celio, MA1
Kristine H. Luce, PhD1
Susan W. Bryson, MS1
Andrew J. Winzelberg, PhD1
Darby Cunning, MA1
Roxanne Rockwell, BA2
Angela A. Celio Doyle, PhD3
Denise E. Wilfley, PhD2,4
C. Barr Taylor, MD1*
ABSTRACT
Objective: The current study examines
diet aid use among college women at
risk for eating disorders and explores
characteristics associated with diet aid
use.
Method: Participants were 484 college
women <30 years from 6 universities in
the San Francisco Bay Area (SF) and San
Diego who were at risk for developing
eating disorders. A checklist assessed
diet pill, fat blocker, diuretic, laxative,
and other diet aid use over the past
12 months.
Results: Thirty-two percent of the col-
lege women reported using a diet aid.
Diet aid use was double the rate in San
Diego (44%) compared with SF (22%) ( p ¼
.000). Weight and shape concerns were
higher among diet aid users than among
nonusers across sites.
Conclusion: A significant number of
college women at risk for eating disor-
ders are using diet aids. We recommend
that clinicians inquire about diet aid use
among college-aged patients. VVC 2006 by
Wiley Periodicals, Inc.
Keywords: diet aids; diet pills; college
women; high risk
(Int J Eat Disord 2006; 39:492–497)
Introduction
College women report high levels of body dissatis-
faction and weight concerns.1,2 Concerns about
one’s weight, dieting, and related behaviors are so
prevalent among college-aged women that they
often are considered to be a normative part of the
female college experience.2,3 For instance, in a
study of female college freshmen living in resi-
dence halls, >40% of women who were surveyed
were classified as casual dieters.4 Among a sample
of incoming female freshmen college students at-
tending a summer orientation, approximately 27%
reported dieting for weight control and 22% char-
acterized their dieting as always or often.5 In a pop-
ulation of high school and college women, Tylka
and Subich6 found that many young women re-
ported skipping meals (59%), eating <1,200 calories
a day (37%), eliminating fats (30%) and carbohy-
drates (26.5%) from their diets, and fasting for
>24 hr (26%).
Not only do college women diet by restricting
their caloric intake or avoiding certain categories of
food, but many women also report using over-the-
counter pills, herbal remedies, supplements, laxa-
tives, and diuretics to aid dieting efforts. Many types
of diet aids exist, including traditional diet pills or
appetite suppressants, home remedies such as
apple cider vinegar, and actively dangerous herbal
supplements such as ephedra.7 Diet aid use is con-
sidered to be risky because the safety and efficacy
of diet aids are unknown and are not evaluated by
the U.S. Food and Drug Administration.8 Accurate
information about diet aids is limited and Internet
sites make dubious claims of effective ...
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
2. sponses (never or less than one per
month, one to three per month, one per
week, two to four per week, five to six per
week, one per day, two to three per day,
four to five per day, and six or more per
day). In 1991, we also asked about the
usual method of preparing coffee with the
answer categories “mainly filtered,”
“mainly instant,” “mainly espresso or per-
culator,” and “no usual method/don’t
know/don’t use.” We assessed the total in-
take of caffeine by summing the caffeine
content for a specific amount multiplied
by a weight proportional to the frequency
of its use. Using U.S. Department of Agri-
culture food composition data supple-
mented with other sources, we estimated
that the caffeine content was 137 mg per
cup of coffee, 47 mg per cup of tea, 46 mg
per bottle or can of cola beverage, and 7
mg per serving of chocolate candy. In a
validation study in the original Nurses’
Health Study, we found high correlations
between intake of coffee and other caf-
feinated beverages assessed with food fre-
quency questionnaire and with four
1-week diet records (coffee, r ϭ 0.78; tea,
r ϭ 0.93; and caffeinated sodas, r ϭ 0.85)
(15).
Assessment of type 2 diabetes
Women who reported a diagnosis of
diabetes on a biennial follow-up ques-
tionnaire were sent a supplementary
questionnaire asking about diagnosis and
treatment of diabetes and history of keto-
acidosis to confirm the self-report and to
distinguish between type 1, type 2, and
gestational diabetes. In accordance with
the criteria of the National Diabetes Data
Group (16), confirmation of diabetes re-
quired at least one of the following for
cases that were diagnosed through 1997:
1) an elevated glucose concentration (fast-
ing plasma glucose Ն7.8 mmol/l [140
mg/dl], random plasma glucose Ն11.1
mmol/l [200 mg/dl], and/or plasma glu-
cose Ն2 h after an oral glucose load
Ն11.1 mmol/l) plus at least one classic
symptom (excessive thirst, polyuria,
weight loss, or hunger), 2) no symptoms
but elevated plasma glucose concentra-
tions as described above on at least two
different occasions, or 3) treatment with
insulin or oral hypoglycemic medication.
For cases that were diagnosed after 1998,
we changed the cutoff for fasting plasma
glucose concentrations to 7.0 mmol/l
[126 mg/dl] in accordance with the 1997
American Diabetes Association criteria
(17). In a validation study in the original
Nurses’ Health Study, 98% of the cases
ascertained by the same supplementary
questionnaire were confirmed by medical
record review (18).
Assessment of medical history,
anthropometry, and lifestyle
On the baseline questionnaires, we re-
quested information about age; weight
and height; smoking status; physical ac-
tivity; history of diabetes in first-degree
relatives; use of postmenopausal hor-
mone therapy; use of oral contraceptives;
and personal history of diabetes, cardio-
vascular diseases, and cancers. This infor-
mation has been updated every 2 years,
with the exception of physical activity
(only updated in 1997) and height and
family history. BMI was calculated as
weight in kilograms divided by the square
of height in meters, and physical activity
was assessed in metabolic equivalents per
week. Validation studies for the assess-
ment of body weight and physical activity
have been previously reported (19,20).
Statistical analyses
Person-years of exposure were calculated
from the date of return of the baseline
questionnaire to the date of diagnosis of
type 2 diabetes, death, or 1 July 2001,
whichever came first. Cox proportional
hazards regression models stratified by
5-year age categories and 2-year time pe-
riods were used to examine the associa-
tion between coffee consumption and risk
of type 2 diabetes. To reduce within-
subject variation and to best represent
long-term exposure, we used the cumula-
tive average of coffee consumption and
other dietary variables from all available
dietary questionnaires up to the start of
each 2-year follow-up interval (21). We
stopped updating diet at the beginning of
the time interval during which individu-
als developed cancer (except nonmela-
noma skin cancer), cardiovascular diseases,
or gestational diabetes because changes in
diet after development of these conditions
may confound the relationship between
diet and diabetes (21). Nondietary covari-
ates were also updated during follow-up
using the most recent data for each 2-year
interval. To test for linear trends across
categories, we modeled the median of
each category of coffee consumption as a
continuous variable. For analyses that ex-
amined the association between coffee
consumption and risk of type 2 diabetes
for women who used a certain method of
preparing coffee, we excluded coffee con-
sumers who used other methods or did
not report what method they used. All
reported P values were two tailed, and P
values Ͻ0.05 were considered statisti-
cally significant. All analyses were per-
formed using SAS software, version 8.2
(SAS Institute, Cary, NC).
RESULTS — During 866,118 person-
years of follow-up, we documented 1,263
cases of type 2 diabetes. Characteristics of
the study population according to con-
sumption of caffeinated and decaffeinated
coffee and caffeine intake are presented in
Table 1. Higher caffeinated coffee con-
sumption, but not decaffeinated coffee
consumption, was strongly associated
with cigarette smoking and higher alco-
hol consumption. Both higher caffeinated
and higher decaffeinated coffee consump-
tion were associated with older age and
lower consumption of sugar-sweetened
soft drinks and tea. Women who did not
consume caffeinated or decaffeinated cof-
fee tended to have a higher BMI compared
with women who did consume either
type of coffee. Pearson correlations with
caffeine intake were 0.83 for total coffee,
0.94 for caffeinated coffee, Ϫ0.05 for de-
caffeinated coffee, and 0.09 for tea con-
sumption.
Higher coffee consumption was asso-
ciated with a lower risk of type 2 diabetes
(Table 2). Adjustment for potential con-
founders weakened this association,
mainly due to adjustment for BMI and al-
cohol consumption. After multivariate
adjustment, the relative risk (RR) of type 2
diabetes was 0.87 (95% CI 0.73–1.03) for
one cup per day, 0.58 (0.49–0.68) for
2–3 cups per day, and 0.53 (0.41–0.68)
for four or more cups per day. Additional
adjustment for magnesium, high- and
low-fat dairy consumption, tea consump-
tion, or sucrose intake; adjustment for
BMI as a continuous variable; use of base-
line coffee consumption instead of cumu-
lative updated coffee consumption; use of
baseline coffee consumption with exclu-
sion of the first 4 years of follow-up; and
exclusion of women who developed ges-
tational diabetes during follow-up did not
substantially change the association be-
tween coffee consumption and risk of
type 2 diabetes (RR for four or more cups
per day versus no cups per day ranged
from 0.51 to 0.60; all P values Ͻ0.0001).
Both higher caffeinated coffee and higher
decaffeinated coffee consumption were
associated with a lower risk of type 2 di-
abetes (Table 2). Tea consumption was
not substantially associated with risk of
type 2 diabetes after adjustment for po-
tential confounders (0.88 [0.64–1.23] for
van Dam and Associates
DIABETES CARE, VOLUME 29, NUMBER 2, FEBRUARY 2006 399
3. four or more versus no cups per day; P for
trend ϭ 0.81).
Higher caffeine intake was associated
with a lower risk of type 2 diabetes (Table
2). Because coffee and caffeine intake
were correlated, we attempted to identify
their possible independent effects by ex-
amination of cross-categories of coffee
and caffeine intake in relation to risk of
type 2 diabetes. Higher total coffee con-
sumption was associated with a lower risk
of type 2 diabetes in each category of caf-
feine intake. In contrast, higher caffeine
intake was not substantially associated
with risk of type 2 diabetes within catego-
ries of total coffee consumption (Table 3).
We also included total coffee consump-
tion and caffeine intake simultaneously in
the multivariate model as continuous
variables. The association between total
coffee consumption and risk of type 2 di-
abetes remained similar: the RR for a one-
cup increment in consumption was 0.86
(95% CI 0.82–0.89) after multivariate ad-
justment and 0.84 (0.79–0.91) after fur-
ther adjustment for caffeine intake. In
contrast, the association between caffeine
intake and risk of type 2 diabetes disap-
peared after adjustment for coffee con-
sumption (1.01 [0.96–1.07] for a 100 mg
per day higher intake). Consistent with
this observation, the strength of the in-
verse association with risk of type 2 dia-
betes was similar for decaffeinated
(multivariate RR 0.81 [95% CI 0.73–
0.90]) and caffeinated coffee consump-
tion (0.87 [0.83–0.91]) when expressed
for a one-cup increment in consumption
per day and simultaneously included in
the multivariate model.
We also examined whether the used
method of preparing coffee affected the
association between coffee consumption
and risk of type 2 diabetes. The multivar-
iate RR of type 2 diabetes associated with
a one-cup increment in coffee consump-
tion per day was similar for filtered coffee
(RR 0.86 [95% CI 0.82–0.90]) and in-
stant coffee (0.83 [0.74–0.93]). In con-
trast, consumption of espresso/perculator
coffee was not substantially associated
with a lower risk of type 2 diabetes (0.97
[0.85–1.10]), but the number of women
who regularly consumed espresso/
perculator coffee was relatively low (num-
ber of diabetes cases for consumption of
two or more cups per day: 254 for filtered
coffee, 27 for instant coffee, and 18 for
perculator/espresso coffee).
CONCLUSIONS — In this study of
U.S. women aged 26–46 years at base-
line, consumption of two or more cups of
coffee per day was associated with a sub-
stantially lower risk of type 2 diabetes
during 10 years of follow-up. This associ-
ation was similar for caffeinated and de-
caffeinated coffee and for filtered and
instant coffee. The inverse association be-
tween coffee consumption and risk of
type 2 diabetes was independent of caf-
feine intake.
The prospective design and high rate
of follow-up in this study minimizes the
possibility of recall bias or bias due to loss
Table 1—Baseline characteristics of the study population by level of caffeinated and decaffeinated coffee consumption
Caffeinated coffee Decaffeinated coffee
No cups
per day
Less than
one cup
per day
One cup
per day
Two to
three cups
per day
Four or
more cups
per day
No cups
day
Less than
one cup
per day
One cup
per day
Two or
more cups
per day
Median 0 0.40 1.1 2.5 4.5 0 0.14 1.0 2.5
n (participants) 33,375 14,020 11,292 21,672 7,900 56,728 19,605 5,999 5,927
Age (years) 35.6 35.4 36.2 36.8 37.6 35.8 36.2 37.1 38.2
BMI (kg/m2
) 24.9 24.6 24.2 24.1 24.6 24.8 24.1 24.0 24.2
Physical activity (MET h/week) 20.3 20.6 22.0 21.8 21.4 20.6 21.2 22.2 22.3
Current smoker (%) 6.7 7.7 10.0 16.9 35.6 13.7 9.0 8.7 13.3
Family history of diabetes (%) 16.1 15.6 15.4 15.7 17.6 16.3 15.0 15.7 15.7
Hypertension (%) 3.6 3.6 3.1 2.6 2.5 3.4 2.8 3.1 2.5
Hypercholesterolemia (%) 9.6 9.3 8.9 8.6 9.7 9.3 9.1 9.3 8.6
Ever hormone replacement therapy (%) 7.3 6.9 7.1 6.5 6.9 7.1 6.6 6.9 7.0
Current oral contraceptive use (%) 10.7 12.1 12.1 10.6 8.2 11.7 9.7 8.2 7.8
Dietary intake
Total energy (kcal/day) 1,777 1,781 1,787 1,788 1,832 1,768 1,822 1,819 1,829
Alcohol consumption (g/day) 1.8 2.8 3.5 4.7 4.6 3.0 3.4 3.0 3.6
P:S ratio 0.52 0.53 0.53 0.52 0.51 0.52 0.53 0.54 0.53
Cereal fiber (g/day) 5.6 5.7 5.8 5.6 5.3 5.4 5.9 6.1 6.0
Glycemic index 54.6 54.1 53.7 53.2 52.5 54.1 53.7 53.3 52.6
Processed meat (servings/day) 0.2 0.2 0.2 0.2 0.3 0.2 0.2 0.2 0.2
Sugar-sweetened soft drinks (servings/day) 0.4 0.3 0.3 0.2 0.2 0.3 0.2 0.2 0.2
High-fat dairy (servings/day) 0.8 0.9 1.0 1.1 1.2 0.9 1.0 0.9 1.0
Low-fat dairy (servings/day) 1.4 1.4 1.3 1.3 1.2 1.3 1.5 1.5 1.5
Tea (cups/day) 0.8 0.8 0.6 0.5 0.5 0.8 0.6 0.6 0.6
Decaffeinated coffee (cups/day) 0.3 0.5 0.4 0.3 0.2
Caffeinated coffee (cups/day) 1.2 1.4 1.1 1.0
Magnesium (g/day) 302 312 318 327 344 307 324 335 346
Caffeine (mg/day) 80 118 204 415 747 253 249 205 198
Data are means, unless otherwise indicated. Data, except age, were directly standardized to the age distribution of entire cohort. MET, metabolic equivalent, P:S ratio,
ratio of polyunsaturated and saturated fat intake.
Coffee and type 2 diabetes
400 DIABETES CARE, VOLUME 29, NUMBER 2, FEBRUARY 2006
4. of follow-up. Furthermore, the extensive
information on potential confounders al-
lowed us to examine confounding in de-
tail. Self-reported diabetes was confirmed
by a supplementary questionnaire, and a
validation study of this method to assess
type 2 diabetes in older nurses using med-
ical records indicated that reporting of di-
abetes is accurate for U.S. women of this
profession (18). Because screening for
blood glucose was not feasible given the
size of the cohort, some underdiagnosis of
diabetes is likely. However, compared
with the general population, the degree of
underdiagnosis was probably smaller in
this cohort of nurses with ready access to
medical care. Moreover, underascertain-
ment of cases, if not associated with expo-
sure, would not be expected to affect the
RR estimates (22). Dietary validation
studies have indicated that the frequency
of coffee consumption reported on a food
frequency questionnaire is highly repro-
ducible and agrees well with assessments
using diet records (15). Although be-
tween-person variation in cup size and
strength of the coffee brew have probably
contributed to some misclassification
with regard to the exposure to relevant
coffee constituents, this would have
weakened rather than strengthened the
observed associations between coffee
consumption and risk of type 2 diabetes.
This study agrees with previous find-
ings from a meta-analysis of cohort stud-
ies (1). The summary RR of type 2
diabetes was 0.65 (95% CI 0.54–0.78)
for six to seven or more cups of coffee per
day and 0.72 (0.62–0.83) for four to six
cups of coffee per day compared with the
reference category (1). In the European
studies, coffee consumption was much
higher than in the current population,
and few participants did not consume cof-
fee. As a result, the lower range could be
studied less well, but three to four cups of
coffee per day was still associated with a
lower risk compared with two or fewer
cups per day (1). In previous U.S. studies,
consumption of four to five cups of coffee
per day, but not of one to three cups per
day, was associated with a lower risk of
type 2 diabetes compared with no coffee
consumption (14). The stronger inverse
Table 2—Relative risk of type 2 diabetes according to coffee and tea consumption and caffeine intake
Categories of intake
P value
for trend
No cups
per day
Less than
one cup
per day
One cup
per day
Two to
three cups
per day
Four or
more cups
per day
Total coffee
Median (cups/day) 0 0.43 1.2 2.5 4.6
n (cases) 479 280 199 227 78
Person-years 235,047 155,431 140,041 253,351 82,248
Age-adjusted RR 1 0.82 (0.71–0.95) 0.59 (0.50–0.70) 0.36 (0.31–0.43) 0.39 (0.30–0.49) Ͻ0.0001
Multivariate RR* 1 0.93 (0.80–1.09) 0.87 (0.73–1.03) 0.58 (0.49–0.68) 0.53 (0.41–0.68) Ͻ0.0001
Caffeinated coffee
Median (cups/day) 0 0.40 1.0 2.5 4.5
n (cases) 549 285 184 185 60
Person-years 291,336 166,146 139,048 208,945 60,643
Age-adjusted RR 1 0.81 (0.71–0.94) 0.60 (0.51–0.71) 0.41 (0.34–0.48) 0.48 (0.36–0.62) Ͻ0.0001
Multivariate RR 1 1.00 (0.86–1.17) 0.89 (0.75–1.07) 0.62 (0.52–0.74) 0.61 (0.46–0.81) Ͻ0.0001
Decaffeinated coffee
Median (cups/day) 0 0.14 1.0 2.5
n (cases) 841 313 77 32
Person-years 503,799 253,866 65,122 43,332
Age-adjusted RR 1 0.62 (0.55–0.71) 0.58 (0.46–0.73) 0.39 (0.27–0.55) 0.0001
Multivariate RR 1 0.86 (0.74–0.99) 0.87 (0.68–1.11) 0.52 (0.36–0.74) 0.005
Tea
Median (cups/day) 0 0.21 1.0 2.5 4.5
n (cases) 271 586 222 142 42
Person-years 213,433 415,827 123,772 89,878 23,209
Age-adjusted RR 1 0.90 (0.78–1.05) 1.18 (0.99–1.41) 1.07 (0.87–1.31) 1.32 (0.95–1.83) 0.005
Multivariate RR 1 0.97 (0.83–1.12) 1.17 (0.97–1.40) 0.98 (0.79–1.20) 0.88 (0.64–1.23) 0.81
Caffeine Quintile 1 Quintile 2 Quintile 3 Quintile 4 Quintile 5
Median (mg/day) 22 93 180 341 528
n (cases) 281 308 291 218 165
Person-years 173,758 173,430 172,858 172,867 173,206
Age-adjusted RR 1 1.05 (0.89–1.23) 0.97 (0.82–1.14) 0.67 (0.56–0.80) 0.51 (0.42–0.62) Ͻ0.0001
Multivariate RR 1 0.88 (0.75–1.04) 0.89 (0.75–1.05) 0.74 (0.62–0.89) 0.55 (0.45–0.67) Ͻ0.0001
Data are RR (95% CI), unless otherwise indicated. *Adjusted for age (5-year categories), smoking status (never, past, and current), BMI (13 categories), physical
activity (quintiles of metabolic equivalent hours per week), alcohol consumption (0, 0.1–4.9, 5.0–9.9, or Ն10 g/day), use of hormone replacement therapy (ever
or never), oral contraceptive use (never, past, or current), family history of type 2 diabetes (yes/no), history of hypertension (yes/no), history of hypercholesterolemia
(yes/no), consumption of sugar-sweetened soft drinks (4 categories), consumption of punch (4 categories), and quintiles of processed meat consumption, the
polyunsaturated-to-saturated fat intake ratio, total energy intake, the glycemic index, and cereal fiber intake. Caffeinated coffee consumption and decaffeinated coffee
consumption were simultaneously included in the multivariate model, and the multivariate model for tea included coffee consumption.
van Dam and Associates
DIABETES CARE, VOLUME 29, NUMBER 2, FEBRUARY 2006 401
5. association between coffee consumption
and risk of type 2 diabetes in the current
study may have been related to the more
recent start of the study, possibly reflect-
ing secular changes in brew strength or
cup size in the U.S., or the younger age of
the participants. In a recent prospective
analysis of National Health and Nutrition
Examination Survey data, decaffeinated
coffee consumption was associated with a
lower risk of type 2 diabetes only in
younger participants (aged Յ60 years)
(3). However, individuals may decide to
switch from caffeinated to decaffeinated
coffee because of health-related condi-
tions. This could weaken the association
between decaffeinated coffee consump-
tion and risk of type 2 diabetes, and this
bias is more likely to occur in older and
less healthy populations than in younger
populations.
Caffeine has acutely reduced insulin
sensitivity in short-term intervention
studies (9–11). However, whether this ef-
fect pertains to long-term coffee con-
sumption is unclear because other
components of coffee may modify this ef-
fect and because tolerance may develop
(23). The similar findings for caffeinated
and decaffeinated coffee in our study sug-
gest that the detrimental acute effect of
caffeine on insulin sensitivity may not
substantially affect the relation between
long-term caffeinated coffee consumption
and incidence of type 2 diabetes. Based on
animal studies, beneficial effects of caf-
feine on insulin sensitivity have also been
suggested (12). We observed an inverse
association between caffeine intake and
risk of type 2 diabetes, but further analy-
ses suggested that this association may
have been a result of confounding by cof-
fee consumption. The inverse association
between decaffeinated coffee consump-
tion and risk of type 2 diabetes in the cur-
rent study and in three other U.S. cohorts
(3,14) also supports the hypothesis that
coffee components other than caffeine
may reduce risk of type 2 diabetes. In ad-
dition, decaffeinated coffee consumption
was associated with lower C-peptide con-
centrations in U.S. women, which sug-
gests a beneficial effect on insulin
sensitivity (24). Furthermore, beneficial
effects of coffee components other than
caffeine on glucose metabolism are bio-
logically plausible. Coffee has strong
antioxidant properties in vivo (25), chlo-
rogenic acid may delay glucose absorp-
tion in the intestine (26), and intake of
coffee components improved glucose me-
tabolism in rats (4–8).
Our observation that instant coffee
consumption was also inversely associ-
ated with risk of type 2 diabetes is plausi-
ble as the composition is similar to drip-
filtered coffee (27,28). In a previous U.S.
study, instant coffee was not associated
with risk of type 2 diabetes (3). However,
the number of participants with substan-
tial instant coffee consumption in that
smaller study may have been too low to
have adequate power to detect an associ-
ation with risk of type 2 diabetes. Simi-
larly, consumption of espresso/perculator
coffee was not common enough in our
study to have sufficient power to exclude
an inverse association with risk of type 2
diabetes. Results of one previous study
suggested that higher consumption of un-
filtered Scandinavian pot-boiled coffee is
associated with a lower risk of type 2 di-
abetes (13). However, high consumption
of unfiltered coffee increases plasma LDL
concentrations (29) and may thus in-
crease risk of coronary heart disease.
In this population of younger and
middle-aged U.S. women, consumption
of two or more cups of coffee was associ-
ated with a substantially lower risk of type
2 diabetes. This finding suggests that the
inverse association between coffee con-
sumption and risk of type 2 diabetes is not
limited to very high levels of coffee con-
sumption. However, given the interna-
tional variation in strength of the coffee
brew, cup size, natural composition of
coffee beans, and processing of coffee, our
findings for specific numbers of cups may
not be directly generalizable to other pop-
ulations. Possible detrimental effects of
frequent use of high-caloric additions to
coffee on energy balance and body weight
should also be considered. Weight man-
agement and increased physical activity,
which can lower risk of multiple chronic
diseases, should be the mainstay of pre-
ventive efforts to reduce incidence of type
2 diabetes. For individual choices regard-
ing coffee consumption, the potential ef-
fects of coffee consumption on risk of type
2 diabetes may be relevant but should be
considered in combination with other
health effects of coffee. Consumption of
decaffeinated coffee may reduce risk of
type 2 diabetes, while avoiding potential
Table 3—Risk of type 2 diabetes by combinations of total coffee consumption and caffeine intake
Quintiles of caffeine intake
Q1–Q2 Q3 Q4–Q5
Total coffee less than one cup per day
Median coffee consumption (cups/day) 0 0 0
Median caffeine intake (mg/day) 52 173 287
Number of cases/person-years 533/292,658 184/79,183 42/18,638
RR (95% CI) 1 (ref.) 1.02 (0.86–1.21) 0.85 (0.62–1.16)
Total coffee 1.0–1.9 cups/day
Median coffee consumption (cups/day) 1.1 1.1 1.6
Median caffeine intake (mg/day) 74 186 297
Number of cases/person-years 38/31,550 87/68,142 74/40,348
RR (95% CI) 0.89 (0.63–1.23) 0.88 (0.70–1.10) 0.90 (0.70–1.16)
Total coffee two or more cups per day
Median coffee consumption (cups/day) 2.5 2.5 2.6
Median caffeine intake (mg/day) 51 189 430
Number of cases/person-years 18/22,979 20/25,533 267/287,087
RR (95% CI) 0.52 (0.32–0.83) 0.50 (0.32–0.79) 0.59 (0.50–0.69)
RRs were multivariate adjusted as described in the legend of Table 2.
Coffee and type 2 diabetes
402 DIABETES CARE, VOLUME 29, NUMBER 2, FEBRUARY 2006
6. detrimental effects on blood pressure (30)
and sleep quality.
Acknowledgments— This study was funded
by research grants CA50385 and DK58845
from the National Institutes of Health.
We are indebted to the participants of the
Nurses’ Health Study II for their continued co-
operation and to Ms. E. Konstantis for the fol-
low-up of type 2 diabetes.
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