Adherence to the AICR cancer prevention recommendations and subsequent morbidity and mortality in the Iowa Women's Health Study cohort.

In 1997, the American Institute for Cancer Research (AICR) published 14 recommendations related to diet for individuals to reduce cancer incidence on a global basis; smoking was also discouraged. We operationalized these into nine recommendations that are particularly relevant to western populations in a cohort of 29,564 women ages 55 to 69 years at baseline in 1986 who had no history of cancer or heart disease. The cohort was followed through 1998 for cancer incidence (n = 4,379), cancer mortality (n = 1,434), cardiovascular disease (CVD) mortality (n = 1,124), and total mortality (n = 3,398). The median number (range) of recommendations followed was 4 (0-8), and 33% of the cohort had ever smoked. Women who followed no or one recommendation compared with six to nine recommendations were at an increased risk of cancer incidence [relative risk (RR) 1.35, 95% confidence interval (CI) 1.15-1.58] and cancer mortality (RR 1.43, 95% CI 1.11-1.85), but there was no association with CVD mortality (RR 1.06, 95% CI 0.78-1.43). We calculated the population attributable risk (PAR) to estimate the proportion of cancer incidence, cancer mortality, and CVD mortality that theoretically would have been avoidable if the entire cohort had never smoked, had followed six to nine recommendations, or had done both. The PARs for smoking were 11% (95% CI 10-13) for cancer incidence, 21% (95% CI 17-24) for cancer mortality, and 20% (95% CI 16-23) for CVD mortality. The PARs for not following six to nine recommendations were 22% (95% CI 12-30) for cancer incidence, 11% (95% CI -5 to 24) for cancer mortality, and 4% (95% CI -20 to 19) for CVD mortality. When smoking and the operationalized AICR recommendations were combined together, the PARs were 31% (95% CI 19-37) for cancer incidence, 30% (95% CI 15-40) for cancer mortality, and 22% (95% CI 4-36) for CVD mortality. These data suggest that the adherence to the AICR recommendations, independently and in conjunction with not smoking, is likely to have a substantial public health impact on reducing cancer incidence and, to a lesser degree, cancer mortality at the population level.

A CTSA-sponsored program for clinical research coordination: networking, education, and mentoring.

Upon receipt of the National Institutes of Health Clinical and Translational Science Award, the University of Iowa's Institute for Clinical and Translational Science committed to develop an infrastructure for research professionals. Three goals were established: (1) identification of research professionals within the University of Iowa, (2) development of an educational series, including orientation and continuing education, and (3) development of a mentoring system. The purpose of this paper is to describe the process of development, initiation, and outcomes of a successful networking, educational, and mentoring system crafted for research professionals at the University of Iowa.

Development of the Iowa bone nutrient food frequency questionnaire based on data from the US Department of Agriculture Continuing Survey of the Food Intake by Individuals.

An easily administered food frequency questionnaire (FFQ)/dietary screener was developed for current (adult) and retrospective (adolescent) intakes of nutrients important for bone development and maintenance. This tool quantified serving sizes and nutrients from foods using gender and age specific techniques. Nutrients of interest were calcium, vitamin D, caffeine and alcohol, and 15 categories of foods were selected for inclusion based on frequency of intake and nutrient density. Calcium-contributing foods were selected from published dietary intake assessment tools. Foods contributing vitamin D, caffeine and alcohol were selected based on nutrient density and Midwest consumption practices. Serving sizes were quantified in standard serving units or as small, medium and large servings. Food items selected for the FFQ/dietary screener were matched to foods from the United States Department of Agriculture (USDA) Continuing Survey of Food Intakes by Individuals (CSFII). Calcium, caffeine and alcohol values were assigned using CSFII data files at median values per 100g intake. CSFII midpoint tertile frequency of intake values for males and females 14-18 and 25-45 years old were used to establish serving weights for small, medium and large servings. CSFII data files provide an efficient way for estimating typical intakes, serving sizes and nutrient values for target groups. Age- and gender-derived data provided realistic estimates of nutrient intakes when using FFQ/dietary screener assessment method.