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Upper gastrointestinal endoscopy for gastric cancer screening has been implemented in Japan. However, its effectiveness for gastric cancer prevention has not been fully studied. We aimed to investigate the effectiveness of endoscopic screening to reduce mortality from gastric cancer. In a large prospective population‐based cohort study including 80,272 participants, we compared the risk of mortality and incidence of gastric cancer among participants who underwent endoscopic or radiographic screening compared with those who did not undergo any screening using multivariable Cox proportional hazards models. In the 1,023,364 person‐year observation period (median; 13.0 years), 1977 cases of gastric cancer were diagnosed, and 783 patients with gastric cancer died. In the endoscopic screening group, the mortality from gastric cancer and incidence of advanced gastric cancer were reduced by 61% (hazard ratio [HR] = 0.39 [95% CI: 0.30–0.51]) and 22% (HR = 0.78 [95% CI: 0.67–0.90]), respectively. The radiographic screening reduced the mortality from gastric cancer (HR = 0.63 [95% CI: 0.54–0.73]), but its effectiveness was lower than that of endoscopic screening. In conclusion, endoscopic screening reduced the incidence of advanced gastric cancer and mortality from gastric cancer in the Japanese population. In this Japanese prospective population‐based cohort study, endoscopic screening reduced the incidence of advanced gastric cancer by 22% and mortality from gastric cancer by 61% compared with no screening. The effectiveness of endoscopic screening on reducing gastric cancer mortality was greater than that of radiographic screening. The results provide a rationale for promoting endoscopic screening for gastric cancer, which has a high mortality rate and significant public health impact in Japan.

Background Understanding the relationship between relative skeletal muscle mass and newly proposed steatotic liver disease (SLD) is crucial, but research gaps still exist. Based on a cohort study, we investigated the impact of relative skeletal muscle mass on incident SLD and its subtypes and explored potential mediators involved in these relationships. Methods We followed 1964 subjects aged 55–70 years (median age: 61.4 [58.4–65.1] years; 45.5% male participants). Appendicular skeletal muscle mass (ASM) was measured using bioelectrical impedance analysis and adjusted for height squared (ASM/height2), weight (ASM/weight) and body mass index (ASM/BMI) to quantify relative skeletal muscle mass. SLD was diagnosed using ultrasonography and classified into metabolic dysfunction–associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol‐associated liver disease (MetALD) and alcohol‐associated liver disease (ALD). Results Over a mean 4.3‐year follow‐up period, 598 participants (30.4%) developed SLD: 539 MASLD (27.4%), 38 MetALD (1.9%) and 21 ALD (1.1%). Higher ASM/weight and ASM/BMI were associated with lower risks of SLD and MASLD (RR per SD [95% CI]: 0.71 [0.61–0.82], 0.59 [0.46–0.76]; 0.66 [0.58–0.76], 0.51 [0.40–0.64]; all p < 0.001). Associations of ASM/height2 with SLD and MASLD shifted from positive to negative after adjustment for BMI (from 1.67 [1.51–1.84] to 0.77 [0.67–0.89]; from 2.30 [1.92–2.76] to 0.61 [0.47–0.79], all p < 0.001). ASM/height2 and ASM/weight were negatively associated with MetALD (0.49 [0.26–0.94], p = 0.031; 0.50 [0.27–0.93], p = 0.029), whereas ASM/BMI was inversely associated with ALD (0.40 [0.18–0.88], p = 0.023). The effects of ASM/height2, ASM/weight and ASM/BMI on incident MASLD were partially mediated by adiponectin (percentage mediated [95% CI]: 6.3% [2.5%–11.1%]; 9.4% [5.0%–14.6%]; 9.5% [5.1%–15.5%]), uric acid (4.7% [1.6%–8.9%]; 5.3% [2.6%–8.5%]; 5.3% [2.4%–8.8%]), triglyceride (7.1% [3.9%–11.1%]; 7.5% [4.4%–10.9%]; 8.7% [5.3%–13.4%]) and homeostasis model assessment of insulin resistance (13.9% [9.5%–20.4%]; 15.0% [10.0%–20.2%]; 14.5% [9.9%–20.7%]). The effects of ASM/weight and ASM/BMI on incident MASLD were mediated by cholinesterase (8.2% [3.6%–13.1%]; 10.5% [6.1%–16.3%]), prealbumin (6.2% [2.9%–9.8%]; 6.0% [3.0%–10.1%]), retinol‐binding protein‐4 (5.4% [3.0%–8.5%]; 4.6% [1.9%–8.5%]) and osteocalcin (2.1% [0.1%–4.5%]; 2.9% [0.6%–5.7%]). Conclusions Relative skeletal muscle mass adjusted for weight or BMI, rather than height alone, better reflects protective effects against SLD. Mediation analysis reveals key metabolic factors linking muscle mass and liver health, offering insights into the pathogenic pathways involved in muscle–liver crosstalk.

Breast cancer is the leading cause of cancer in females and has become a major global health priority. This prospective cohort study investigated the association of dietary factors, including food items and dietary habits, with the risk of breast cancer in Korean women. Study participants were women aged 30 years or older, recruited from the National Cancer Center in South Korea between August 2002 and May 2007. They were followed until December 2014 using the Korea Central Cancer Registry to identify breast cancer cases. Among 5046 non-pre-diagnosed cancer participants, 72 breast cancer cases were prospectively identified. Participants with breast cancer had a significantly higher educational level (college or higher: 58.3% vs. 39.5%, p = 0.01), were more likely to have ever smoked (22.2% vs. 7.8%, p < 0.001), and were more likely to have a history of benign breast tumors (10% vs. 4%, p = 0.02) than non-cases. Consumption of grilled meat conferred a significantly higher risk of breast cancer in all women (hazard ratio (HR) 1.77, 95% confidence interval (CI) 1.09–2.85) and in postmenopausal women (HR 3.06, 95% CI 1.31–7.15). High-cholesterol food intake was associated with a higher risk in all women (HR 1.69, 95% CI 1.01–2.82). Irregular meal intake was associated with an elevated risk in all women (HR 2.19, 95% CI 1.20–3.98, p for trend = 0.01) and in premenopausal women (HR 2.35, 95% CI 1.13–4.91, p for trend = 0.03). Our findings suggest that grilled meat and high-cholesterol food intake and irregular eating habits may be associated with a higher risk of breast cancer. Further studies with longer follow-up periods that include information on portion size, hormone receptor status, carcinogen levels in grilled meat, and a classification of foods by source are required.

Later-borns tend to be shorter than first-borns in childhood and adulthood. However, large-scale prospective studies examining growth during infancy according to birth order are limited. We aimed to investigate the relationship between birth order and growth during the first 4 years of life in a Japanese prospective birth cohort study. A total of 26,249 full-term singleton births were targeted. General linear and multivariable logistic regression models were performed and adjusted for birth weight, parents’ heights, maternal age at delivery, gestational weight gain, maternal smoking and alcohol drinking status during pregnancy, household income, breastfeeding status, and Study Areas. The multivariate adjusted mean length Z-scores in “first-borns having no sibling”, “first-borns having siblings”, “second-borns”, and “third-borns or more” were −0.026, −0.013, 0.136, and 0.120 at birth and −0.324, −0.330, −0.466, and −0.569 at 10 months, respectively. Results similar to those at 10 months were observed at 1.5, 3, and 4 years. The adjusted odds ratios (95% confidence intervals) of short stature at 4 years in “first-borns having siblings”, “second-borns”, and “third-borns or more” were 1.08 (0.84–1.39), 1.36 (1.13–1.62), and 1.50 (1.20–1.88), respectively, versus “first-borns having no sibling”. Birth order was significantly associated with postnatal growth and may be a factor predisposing to short stature in early childhood.

Previous studies that have investigated the association between B-vitamin supplement use and risk for cataract yield conflicting results. The aim of this study was to examine the association between use of high-dose B-vitamin supplements (approximately 10 times recommended daily intake) and risk for age-related cataract in a population-based prospective study of 13 757 women from the Swedish Mammography Cohort and 22 823 men from the Cohort of Swedish Men. Dietary supplement use and potential confounders were assessed using a questionnaire at baseline. Information on cataract diagnosis and extraction was obtained through linkage to registers. During the follow-up period between January 1998 and December 2011, we identified 8395 cataract cases (3851 for women and 4544 for men). The use of B vitamins plus other supplements and B vitamins only was associated with 9 % (95 % CI 2, 17) and 27 % (95 % CI 12, 43) increased risk for cataract, respectively. The hazard ratios for use of B vitamins only and risk for cataract stratified by different age groups were as follows: <60 years: 1·88 (95 % CI 1·47, 2·39); 60–69 years: 1·21 (95 % CI 0·96, 1·53); and ≥70 years: 1·09 (95 % CI 0·91, 1·31) (P interaction=0·002). Our results suggest that the use of high-dose B-vitamin supplements was associated with an increased risk for cataract. This association might be confined to younger participants.

Systemic inflammation markers have been linked to increased cancer risk and mortality in a number of studies. However, few studies have estimated pre-diagnostic associations of systemic inflammation markers and cancer risk. Such markers could serve as biomarkers of cancer risk and aid in earlier identification of the disease. This study estimated associations between pre-diagnostic systemic inflammation markers and cancer risk in the prospective UK Biobank cohort of approximately 440,000 participants recruited between 2006 and 2010. We assessed associations between four immune-related markers based on blood cell counts: systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-tolymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and risk for 17 cancer sites by estimating hazard ratios (HR) using flexible parametric survival models. We observed positive associations with risk for seven out of 17 cancers with SII, NLR, PLR, and negative associations with LMR. The strongest associations were observed for SII for colorectal and lung cancer risk, with associations increasing in magnitude for cases diagnosed within one year of recruitment. For instance, the HR for colorectal cancer per standard deviation increment in SII was estimated at 1.09 (95% CI 1.02–1.16) in blood drawn five years prior to diagnosis and 1.50 (95% CI 1.24–1.80) in blood drawn one month prior to diagnosis. We observed associations between systemic inflammation markers and risk for several cancers. The increase in risk the last year prior to diagnosis may reflect a systemic immune response to an already present, yet clinically undetected cancer. Blood cell ratios could serve as biomarkers of cancer incidence risk with potential for early identification of disease in the last year prior to clinical diagnosis.

Background Findings from earlier research have established that insulin resistance (IR) is implicated in atherosclerosis progression, representing a noteworthy risk factor for cardiovascular disease (CVD). Recently, the triglyceride glucose-body mass index (TyG-BMI) has been introduced as a straightforward and robust alternative indicator for early detection of IR. Nevertheless, there is a scarcity of studies that have examined the capability of TyG-BMI for predicting incident CVD. Consequently, the core objective of this study was to determine whether the cumulative average TyG-BMI correlated with CVD incidence. Methods All data was sourced from the China Health and Retirement Longitudinal Study (CHARLS). The exposure was the cumulative average TyG-BMI, determined by the average of TyG-BMI values for the baseline and follow-up investigations (Wave 1 in 2011, Wave 3 in 2015, respectively). The calculation of TyG-BMI involved a combination of triglyceride, fasting blood glucose, and body mass index. The primary outcome was incident CVD. Logistic regression analyses as well as restricted cubic spline (RCS) regression analyses were performed for examining the association between the cumulative average TyG-BMI and CVD incidence. Results In all, 5,418 participants were enrolled in our analysis, with 2,904 (53.6%) being female, and a mean (standard deviation, SD) age of 59.6 (8.8) years. The mean (SD) cumulative average TyG-BMI among all participants was 204.9 (35.7). Totally, during a 4-year follow-up, 543 (10.0%) participants developed CVD. The fully adjusted logistic regression analysis revealed a significant association between the cumulative average TyG-BMI and incident CVD [odds ratio (OR), 95% confidence interval (CI): 1.168, 1.040–1.310, per 1 SD increase]. The RCS regression analysis displayed a positive, linear association of the cumulative average TyG-BMI with CVD incidence (P for overall = 0.038, P for nonlinear = 0.436). Conclusions Our study revealed a noteworthy correlation between the cumulative average TyG-BMI and incident CVD among the middle-aged and older population. The cumulative average TyG-BMI emerges as a valuable tool that may enhance the primary prevention and treatment of CVD.

The Hamburg City Health Study (HCHS) is a large, prospective, long-term, population-based cohort study and a unique research platform and network to obtain substantial knowledge about several important risk and prognostic factors in major chronic diseases. A random sample of 45,000 participants between 45 and 74 years of age from the general population of Hamburg, Germany, are taking part in an extensive baseline assessment at one dedicated study center. Participants undergo 13 validated and 5 novel examinations primarily targeting major organ system function and structures including extensive imaging examinations. The protocol includes validate self-reports via questionnaires regarding lifestyle and environmental conditions, dietary habits, physical condition and activity, sexual dysfunction, professional life, psychosocial context and burden, quality of life, digital media use, occupational, medical and family history as well as healthcare utilization. The assessment is completed by genomic and proteomic characterization. Beyond the identification of classical risk factors for major chronic diseases and survivorship, the core intention is to gather valid prevalence and incidence, and to develop complex models predicting health outcomes based on a multitude of examination data, imaging, biomarker, psychosocial and behavioral assessments. Participants at risk for coronary artery disease, atrial fibrillation, heart failure, stroke and dementia are invited for a visit to conduct an additional MRI examination of either heart or brain. Endpoint assessment of the overall sample will be completed through repeated follow-up examinations and surveys as well as related individual routine data from involved health and pension insurances. The study is targeting the complex relationship between biologic and psychosocial risk and resilience factors, chronic disease, health care use, survivorship and health as well as favorable and bad prognosis within a unique, large-scale long-term assessment with the perspective of further examinations after 6 years in a representative European metropolitan population.

Background There is limited prospective evidence on the association between meat consumption and many common, non-cancerous health outcomes. We examined associations of meat intake with risk of 25 common conditions (other than cancer). Methods We used data from 474,985 middle-aged adults recruited into the UK Biobank study between 2006 and 2010 and followed up until 2017 (mean follow-up 8.0 years) with available information on meat intake at baseline (collected via touchscreen questionnaire), and linked hospital admissions and mortality data. For a large sub-sample (~ 69,000), dietary intakes were re-measured three or more times using an online, 24-h recall questionnaire. Results On average, participants who reported consuming meat regularly (three or more times per week) had more adverse health behaviours and characteristics than participants who consumed meat less regularly, and most of the positive associations observed for meat consumption and health risks were substantially attenuated after adjustment for body mass index (BMI). In multi-variable adjusted (including BMI) Cox regression models corrected for multiple testing, higher consumption of unprocessed red and processed meat combined was associated with higher risks of ischaemic heart disease (hazard ratio (HRs) per 70 g/day higher intake 1.15, 95% confidence intervals (CIs) 1.07–1.23), pneumonia (1.31, 1.18–1.44), diverticular disease (1.19, 1.11–1.28), colon polyps (1.10, 1.06–1.15), and diabetes (1.30, 1.20–1.42); results were similar for unprocessed red meat and processed meat intakes separately. Higher consumption of unprocessed red meat alone was associated with a lower risk of iron deficiency anaemia (IDA: HR per 50 g/day higher intake 0.80, 95% CIs 0.72–0.90). Higher poultry meat intake was associated with higher risks of gastro-oesophageal reflux disease (HR per 30 g/day higher intake 1.17, 95% CIs 1.09–1.26), gastritis and duodenitis (1.12, 1.05–1.18), diverticular disease (1.10, 1.04–1.17), gallbladder disease (1.11, 1.04–1.19), and diabetes (1.14, 1.07–1.21), and a lower IDA risk (0.83, 0.76–0.90). Conclusions Higher unprocessed red meat, processed meat, and poultry meat consumption was associated with higher risks of several common conditions; higher BMI accounted for a substantial proportion of these increased risks suggesting that residual confounding or mediation by adiposity might account for some of these remaining associations. Higher unprocessed red meat and poultry meat consumption was associated with lower IDA risk.

Although consumption of sugar-sweetened beverages (SSBs) and artificially sweetened beverages (ASBs) has increasingly been linked with obesity, type 2 diabetes mellitus, hypertension, and all-cause mortality, evidence remains conflicted and dose–response meta-analyses of the associations are lacking. We conducted an updated meta-analysis to synthesize the knowledge about their associations and to explore their dose–response relations. We comprehensively searched PubMed, EMBASE, Web of Science, and Open Grey up to September 2019 for prospective cohort studies investigating the associations in adults. Summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated for the dose–response association. Restricted cubic splines were used to evaluate linear/non-linear relations. We included 39 articles in the meta-analysis. For each 250-mL/d increase in SSB and ASB intake, the risk increased by 12% (RR = 1.12, 95% CI 1.05–1.19, I 2  = 67.7%) and 21% (RR = 1.21, 95% CI 1.09–1.35, I 2  = 47.2%) for obesity, 19% (RR = 1.19, 95% CI 1.13–1.25, I 2  = 82.4%) and 15% (RR = 1.15, 95% CI 1.05–1.26, I 2  = 92.6%) for T2DM, 10% (RR = 1.10, 95% CI 1.06–1.14, I 2  = 58.4%) and 8% (RR = 1.08, 95% CI 1.06–1.10, I 2  = 24.3%) for hypertension, and 4% (RR = 1.04, 95% CI 1.01–1.07, I 2  = 58.0%) and 6% (RR = 1.06, 95% CI 1.02–1.10, I 2  = 80.8%) for all-cause mortality. For SSBs, restricted cubic splines showed linear associations with risk of obesity ( P non-linearity  = 0.359), T2DM ( P non-linearity  = 0.706), hypertension ( P non-linearity  = 0.510) and all-cause mortality ( P non-linearity  = 0.259). For ASBs, we found linear associations with risk of obesity ( P non-linearity  = 0.299) and T2DM ( P non-linearity  = 0.847) and non-linear associations with hypertension ( P non-linearity  = 0.019) and all-cause mortality ( P non-linearity  = 0.048). Increased consumption of SSBs and ASBs is associated with risk of obesity, T2DM, hypertension, and all-cause mortality. However, the results should be interpreted cautiously because the present analyses were based on only cohort but not intervention studies.