Use of sugar in coffee and tea and long-term risk of mortality in older adult Danish men: 32 years of follow-up from a prospective cohort study.

BACKGROUND: Tea and coffee are the most consumed beverages worldwide and very often sweetened with sugar. However, the association between the use of sugar in tea or coffee and adverse events is currently unclear. OBJECTIVES: To investigate the association between the addition of sugar to coffee or tea, and the risk of all-cause mortality, cardiovascular mortality, cancer mortality and incident diabetes mellitus. METHODS: Participants from the prospective Copenhagen Male Study, included from 1985 to 1986, without cardiovascular disease, cancer or diabetes mellitus at inclusion, who reported regular coffee or tea consumption were included. Self-reported number of cups of coffee and tea and use of sugar were derived from the study questionnaires. Quantity of sugar use was not reported. Primary outcome was all-cause mortality and secondary endpoints were cardiovascular mortality, cancer mortality and incident diabetes mellitus, all assessed through the Danish national registries. The association between adding sugar and all-cause mortality was analyzed by Cox regression analysis. Age, smoking status, daily alcohol intake, systolic blood pressure, body mass index, number of cups of coffee and/or tea consumed per day and socioeconomic status were included as covariates. Vital status of patients up and until 22.03.2017 was assessed. Sugar could be added to either coffee, tea or both. RESULTS: In total, 2923 men (mean age at inclusion: 63±5 years) were included, of which 1007 (34.5%) added sugar. In 32 years of follow-up, 2581 participants (88.3%) died, 1677 in the non-sugar group (87.5%) versus 904 in the sugar group (89.9%). Hazard ratio of the sugar group compared to the non-sugar group was 1.06 (95% CI 0.98;1.16) for all-cause mortality. An interaction term between number of cups of coffee and/or tea per day and adding sugar was 0.99 (0.96;1.01). A subgroup analysis of coffee-only drinkers showed a hazard ratio of 1.11 (0.99;1.26). The interaction term was 0.98 (0.94;1.02). Hazard ratios for the sugar group compared to the non-sugar group were 1.11 (95% CI 0.97;1.26) for cardiovascular disease mortality, 1.01 (95% CI 0.87;1.17) for cancer mortality and 1.04 (95% CI 0.79;1.36) for incident diabetes mellitus. CONCLUSION: In the present population of Danish men, use of sugar in tea and/or coffee was not significantly associated with increased risk of mortality or incident diabetes.

The effect of daily self-measurement of pressure pain sensitivity followed by acupressure on depression and quality of life versus treatment as usual in ischemic heart disease: a randomized clinical trial.

BACKGROUND: Depressive symptoms and reduced quality of life (QOL) are parts of the chronic stress syndrome and predictive of adverse outcome in patients with ischemic heart disease (IHD). Chronic stress is associated with increased sensitivity for pain, which can be measured by algometry as Pressure Pain Sensitivity (PPS) on the sternum. AIM: To evaluate if stress focus by self-measurement of PPS, followed by stress reducing actions including acupressure, can decrease depressive symptoms and increase psychological well-being in people with stable IHD. DESIGN: Observer blinded randomized clinical trial over 3 months of either intervention or treatment as usual (TAU). STATISTICAL ANALYSIS: Intention to treat. METHODS: Two hundred and thirteen participants with IHD were included: 106 to active treatment and 107 to TAU. Drop-out: 20 and 12, respectively. The active intervention included self-measurement of PPS twice daily followed by acupressure as mandatory action, aiming at a reduction in PPS. Primary endpoint: change in depressive symptoms as measured by Major depression inventory (MDI). Other endpoints: changes in PPS, Well-being (WHO-5) and mental and physical QOL (SF-36). RESULTS: At 3 months PPS decreased 28%, to 58, in active and 11%, to 72, in TAU, p<0.001. MDI decreased 22%, to 6.5, in active group vs. 12%, to 8.3 in TAU, p = 0.040. WHO-5 increased to 71.0 and 64.8, active group and TAU, p = 0.015. SF-36 mental score sum increased to 55.3 and 53.3, active and TAU, p = 0.08. CONCLUSIONS: PPS measurements followed by acupressure reduce PPS, depressive symptoms and increase QOL in patients with stable IHD. TRIAL REGISTRATION: ClinicalTrials.gov NCT01513824.

The association between changes in pressure pain sensitivity and changes in cardiovascular physiological factors associated with persistent stress.

OBJECTIVES: To evaluate the possible association between pressure pain sensitivity of the chest bone (PPS) and cardiovascular physiological factors related to persistent stress in connection with a three-month PPS-guided stress-reducing experimental intervention programme. METHODS: Forty-two office workers with an elevated PPS (≥ 60 arbitrary units) as a sign of increased level of persistent stress, completed a single-blinded cluster randomized controlled trial. The active treatment was a PPS (self-measurement)-guided stress management programme. Primary endpoints: Blood pressure (BP), heart rate (HR) and work of the heart measured as Pressure-Rate-Product (PRP); Secondary endpoints: Other features of the metabolic syndrome. RESULTS: PPS decreased and changes in PPS after the intervention period were significantly associated with HR, PRP, body mass index (BMI) and visceral fat index (all correlation coefficients > 0.2, p < 0.05). Compared to the control cluster group, the active cluster group obtained a significant reduction in PPS, Low-density lipoprotein (LDL) cholesterol and total number of elevated risk factors (p < 0.05). On an individual level, significant and clinically relevant between-group reductions were observed in respect to BP, HR, PRP, total and LDL cholesterol, and total number of elevated risk factors (p < 0.05). CONCLUSIONS: The stress intervention method applied in this study induced a decrease in PPS which was associated with a clinically relevant decrease in resting blood pressure, heart rate, work of the heart and serum cholesterols.

Serum selenium level and risk of lung cancer mortality: a 16-year follow-up of the Copenhagen Male Study.

Serum selenium has been implicated as a risk factor for lung cancer, but the issue remains unsettled. In a cohort of 3,333 males aged 53-74 yrs, we tested the hypothesis that a low serum selenium concentration would be associated with an increased risk of lung cancer mortality. Over 16 yrs, 167 (5.1%) subjects died of lung cancer: 48 (5.0%) out of 965 with low serum selenium (0.4-1.0 µmol · L(-1)), 57 (5.1%) out of 1,141 with medium serum selenium (1.1-1.2 µmol · L(-1)) and 62 (5.1%) out of 1,227 with high serum selenium (1.3-3.0 µmol · L(-1)). After adjustment for age, referencing the lowest level of serum selenium, hazard ratios (HRs) for medium and high levels of serum selenium were 0.97 (95% CI 0.66-1.43) and 0.99 (95% CI 0.68-1.45), respectively. Taking into account pack-years of smoking, spirits intake, dietary markers (salt and fat preferences) and health measures (chronic bronchitis and peak flow), referencing the lowest level of serum selenium, HRs were 1.17 (95% CI 0.79-1.75) and 1.43 (95% CI 0.96-2.14), for medium and high levels respectively. Among heavy smokers, a high serum selenium concentration was associated with a significantly increased risk of lung cancer mortality after taking into account all potential confounders. The hypothesis that low serum selenium is an independent risk factor for lung cancer was not supported.

Sugar in coffee or tea and risk of obesity: A neglected issue.

AIM: In the Copenhagen Male Study sugar intake in coffee or tea is inversely associated with obesity. We analyzed the association of sugar intake with obesity among men with and without lifestyle factors indicating health awareness. METHODS: A cross-sectional study of 3,290 men aged 53-75 years including information about smoking, alcohol, physical activity, tea and coffee use, avoidance of fatty food, social class, self-assessed health, and family obesity. RESULTS: Overall, 291 men (8.8%) were obese, body mass index > or =30. Among men using sugar in coffee or tea (36%), the prevalence was 6.2%; among others, 10.3% (odds ratio [95% confidence interval]=0.6 [0.4-0.8]). An inverse association between use of sugar in hot beverages and prevalence of obesity was consistent in subgroups, and most pronounced among the least health-conscious [odds ratio [95% confidence interval]=0.4 [0.2-0.8]). INTERPRETATION: The results indicate a weight-controlling or reducing effect of small amounts of sucrose ingested several times a day.