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School Achievement and Risk of Eating Disorders in a Swedish National Cohort.

ABSTRACT: High achievement in school has been associated with increased risk of eating disorders, including anorexia nervosa (AN) and bulimia nervosa (BN), but causality of these relationships is unclear. We sought to examine the association between school achievement and AN or BN in a national cohort and to determine the possible contribution of familial confounding using a co-relative design.This national cohort study involved 1,800,643 persons born in Sweden during 1972 to 1990 who were still living in Sweden at age 16 years and were followed up for AN and BN identified from inpatient and outpatient diagnoses through 2012. We used Cox regression to examine the association between school achievement and subsequent risk of AN or BN, and stratified Cox models to examine the gradient in this association across different strata of co-relative pairs (first cousins, half siblings, full siblings).School achievement was positively associated with risk of AN among females and males (hazard ratio [HR] per additional 1 standard deviation, females: HR = 1.29; 95% CI = 1.25-1.33; males: HR = 1.29; 95% CI = 1.10-1.52), and risk of BN among females but not males (females: HR = 1.16; 95% CI = 1.11-1.20; males: HR = 1.05; 95% CI = 0.84-1.31). In co-relative analyses, as the degree of shared genetic and environmental factors increased (e.g., from first-cousin to full-sibling pairs), the association between school achievement and AN or BN substantially decreased.In this large national cohort study, high achievement in school was associated with increased risk of AN and BN, but this appeared to be explained by unmeasured familial (genetic and environmental) factors.

SUBMITTER: Sundquist J

PROVIDER: S-EPMC4691282 | biostudies-literature | 2016 Jan

REPOSITORIES: biostudies-literature

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School Achievement and Risk of Eating Disorders in a Swedish National Cohort.

Sundquist Jan J Ohlsson Henrik H Winkleby Marilyn A MA Sundquist Kristina K Crump Casey C

Journal of the American Academy of Child and Adolescent Psychiatry 20151022 1

<h4>Objective</h4>High achievement in school has been associated with increased risk of eating disorders, including anorexia nervosa (AN) and bulimia nervosa (BN), but causality of these relationships is unclear. We sought to examine the association between school achievement and AN or BN in a national cohort and to determine the possible contribution of familial confounding using a co-relative design.<h4>Method</h4>This national cohort study involved 1,800,643 persons born in Sweden during 1972 ...[more]

PMID: 26703908

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Project description:BackgroundFollowing progressive aging of the population worldwide, the prevalence of Parkinson disease is expected to increase in the next decades. Primary prevention of the disease is hampered by limited knowledge of preventable causes. Recent evidence regarding diet and Parkinson disease is inconsistent and suggests that dietary habits such as fat intake may have a role in the etiology.ObjectiveTo investigate the association between intake of total and specific types of fat with the incidence of Parkinson disease.MethodsParticipants from the Swedish National March Cohort were prospectively followed-up from 1997 to 2016. Dietary intake was assessed at baseline using a validated food frequency questionnaire. Food items intake was used to estimate fat intake, i.e. the exposure variable, using the Swedish Food Composition Database. Total, saturated, monounsaturated and polyunsaturated fat intake were categorized into quartiles. Parkinson disease incidence was ascertained through linkages to Swedish population-based registers. Cox proportional hazards regression models were used to estimate hazard ratios (HR) with 95% confidence intervals (CI) of the association between fat intake from total or specific types of fats and the incidence of Parkinson disease. The lowest intake category was used as reference. Isocaloric substitution models were also fitted to investigate substitution effects by replacing energy from fat intake with other macronutrients or specific types of fat.Results41,597 participants were followed up for an average of 17.6 years. Among them, 465 developed Parkinson disease. After adjusting for potential confounders, the highest quartile of saturated fat intake was associated with a 41% increased risk of Parkinson disease compared to the lowest quartile (HR Q4 vs. Q1: 1.41; 95% CI: 1.04-1.90; p for trend: 0.03). Total, monounsaturated or polyunsaturated fat intake were not significantly associated with Parkinson disease. The isocaloric substitution models did not show any effect.ConclusionsWe found that a higher consumption of large amounts of saturated fat might be associated with an increased risk of Parkinson disease. A diet low in saturated fat might be beneficial for disease prevention.

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School Achievement and Risk of Eating Disorders in a Swedish National Cohort.

Publications

School Achievement and Risk of Eating Disorders in a Swedish National Cohort.

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