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Lina J. Leurs, (1) Leo J. Schouten, (1) Margreet N. Mons, (2) Roentgen. Alexandra Goldbohm, (3) and you can PietA. van den Brandt (1)
Interested in a powerful design to own examining exposure-state relationships inside a put together cohort
(1) Maastricht College, GROW-College getting Oncology and you will Developmental Biology, Department out-of Epidemiology, Maastricht, the netherlands; (2) KWR, Watercycle Look Institute, Nieuwegein, the netherlands; (3) TNO Total well being, Service of Avoidance and you may Fitness, Leiden, holland
Address communications to L.J. Leurs, Maastricht School, GROW-College to have Oncology and you can Developmental Biology, Department off Epidemiology, P.O. Field 616, 6200 MD Maastricht, the netherlands. Telephone: 29 0 43 3882392. Fax: 30 0 43 3884128. E-mail:
Our company is in financial trouble to the players for the studies and need saying thanks to new Dutch Central Bureau off Genealogy and Analytics Netherlands to own bringing study. I including give thanks to A beneficial. Volovics and An excellent. Kester having mathematical advice; S. van de Crommert, H. Brants, J. Nelissen, C. de- Zwart, M. Moll, W. van Dijk, and you may A. Pisters to own direction; and you may H. van Montfort, T. van Moergasiel, L. van den Bosch, R. Schmeitz, and you will J. Berben for coding guidelines.
Which investment try used inside Mutual Research System of your Dutch liquids organizations because of the experts regarding Maastricht School and KWR, Watercycle Search Institute. This research is actually funded by KWR, Watercycle Lookup Institute.
R.A great.G. and you may Yards.N.Meters. benefit contacting people (TNO Standard of living and you will KWR, respectively); not, neither have previously did people earlier in the day research toward most recent matter described in the manuscript. In addition, exterior report about the shape and you may show try held from the a beneficial Scientific Consultative Panel consisting of P. Hunter (College away from Eastern Anglia), Roentgen. Rylander (emeritus professor), and Yards.I. Sinclair (Drinking water Quality Research Australian continent Minimal, Monash University).
Extremely education you to reported a keen inverse association ranging from h2o hardness and IHD otherwise coronary arrest mortality have been ecologic knowledge (Kousa et al. 2004, 2006, 2008; Maheswaran ainsi que al. 1999; ; Sauvant and you will Pepin 2000). The precision ones style of degree can be questioned while the of your it is possible to ecologic fallacy. Some case-handle and you will cohort degree with little or no improvement to have confounding activities together with advised a prospective protective effectation of liquid firmness, calcium otherwise magnesium concentrations into the h2o, with the mortality because of IHD or heart attack (Luoma et al. 1983; Punsar and you will Karvonen 1979; Rubenowitz ainsi que al. 1996, 1999; Yang 1998; Yang ainsi que al. 2006). At the same time, most case-handle and you can cohort studies one to adjusted having several thousand possible confounders, eg aerobic exposure circumstances and liquids characteristics, located no dating between liquids firmness and you can IHD otherwise coronary attack death (Comstock mais aussi al. 1980; Morris et al. 2001; Rosenlund ainsi que al. 2005). The latest exclusion is actually the fact-manage study conducted by Rubenowitz ainsi que al. (2000) you to definitely claimed down death out of intense myocardial infarction ( not with the complete occurrence) and you will magnesium in h2o just after modifying having a general spectrum regarding prospective confounders.
Mineral consumption was modified getting time consumption from the residual strategy (Willett and you will Stampfer 1986). Brand new survey research were key-entered twice https://datingranking.net/de/wicca-dating/ and you may processed in a standardized trends dazzled in respect so you can instance/subcohort updates to reduce observer bias when you look at the programming and you can research interpretation.
The analyzed exposure variables were total tap water hardness, tap water magnesium, and calcium concentration. In the multivariate analysis, we corrected for potential confounding of other known IHD risk factors: age at baseline (years), cigarette smoking (coded as current vs. never/former smoker and number of cigarettes smoked per day, and years of active smoking), hypertension (yes/no), diabetes (yes/no), body mass index (BMI) (coded as < 18.5 kg/[m.sup.2], 18.5-25 kg/[m.sup.2], 25-30 kg/[m.sup.2], [greater than or equal to] 30 kg/[m.sup.2]), nonoccupational physical activity (coded in tour categories: very little, average, active, or very active), educational level [coded as primary school, lower vocational, high school (junior and senior), and higher vocational/university], total energy intake (kilocalories per day), alcohol consumption (coded in five categories: 0 g/day, 0.1-5 g/day, 5-15 g/day, 15-30 g/day, 2 30 g/day). energy-adjusted saturated/monounsaturated/ polyunsaturated fat consumption (grams per day), and fruit and vegetable consumption (grams per day). We included additional factors that influence the amount of calcium or magnesium absorption from tap water: use of diuretics (yes/no), multivitamin intake (yes/no), calcium supplement intake (yes/no), energy-adjusted dietary calcium and magnesium consumption (milligrams per clay), and total volume of tap water consumption (milliliters per day) (Elin 1988; Greenland et al. 2003; Hornstra et al. 1998; Wilson 1999). When tap water calcium concentration (milligrams per liter) was analyzed, additional adjustment for tap water magnesium concentration (milligrams per liter) occurred and vice versa.
Gillies Me personally, Paulin HV. 1983. Variability from nutrient consumption out of liquid: a possible explanation for the controversy across the matchmaking from water high quality to help you cardiovascular illnesses. Int J Epidemiol several(1):45-50.
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