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Lina J. Leurs, (1) Leo J. Schouten, (1) Margreet N. Mons, (2) Roentgen. Alexandra Goldbohm, (3) and you will PietA. van den Brandt (1)
(1) Maastricht College, GROW-College or university to own Oncology and Developmental Biology, Agency from Epidemiology, Maastricht, holland; (2) KWR, Watercycle Browse Institute, Nieuwegein, holland; (3) TNO Quality of life, Institution out of Avoidance and you can Health, Leiden, the netherlands
Target communications in order to L.J. Leurs, Maastricht College or university, GROW-University for Oncology and you may Developmental Biology, Institution regarding Epidemiology, P.O. Container 616, 6200 MD Maastricht, the netherlands. Telephone: 31 0 43 3882392. Fax: 29 0 43 3884128. E-mail:
Our company is in financial trouble toward people associated with research and require saying thanks to the Dutch Central Agency out-of Genealogy and you may Statistics Netherlands getting delivering data. I and additionally give thanks to A beneficial. Volovics and A. Kester to possess mathematical pointers; S. van de Crommert, H. Brants, J. Nelissen, C. de Zwart, Meters. Moll, W. van Dijk, and you may A good. Pisters getting direction; and you will H. van Montfort, T. van Moergasiel, L. van den Bosch, R. Schmeitz, and J. Berben to own programming guidelines.
It endeavor was conducted into the Combined Lookup Program of your own Dutch liquids companies from the scientists from Maastricht University and you may KWR, Watercycle Search Institute. This study was financed because of the KWR, Watercycle Browse Institute.
R.Good.Grams. and Yards.N.Meters. benefit asking people (TNO Quality of life and you can KWR, respectively); yet not, neither has actually ever performed people previous lookup for the current matter described throughout the manuscript. In addition, outside post on the form and you may abilities are presented from the a great Scientific Advisory Panel composed of P. Huntsman (College or university out of East Anglia), R. Rylander (emeritus professor), and you can Yards.We. Sinclair (Liquid Quality Look Australia Minimal, Monash University).
Extremely knowledge one said an inverse association ranging from liquid stiffness and you can IHD or stroke mortality was indeed ecologic studies (Kousa ainsi que al. 2004, 2006, 2008; Maheswaran ainsi que al. 1999; ; Sauvant and Pepin 2000). The newest accuracy of those kind of degree is sometimes asked given that of you’ll ecologic fallacy. A handful of case-manage and you may cohort studies with little to no or no improvement having confounding things also ideal a prospective protective aftereffect of liquids hardness, calcium supplements otherwise magnesium levels from inside the liquids, to your death because of IHD otherwise heart attack (Luoma mais aussi al. 1983; Punsar and you may Karvonen 1979; Rubenowitz et al. 1996, 1999; Yang 1998; Yang et al. 2006). Concurrently, very instance-control and you may cohort education one adjusted to own thousands of potential confounders, such as aerobic exposure situations and you will water attributes, located no dating ranging from water firmness and you can IHD otherwise stroke death (Comstock mais aussi al. 1980; Morris ainsi que al. 2001; Rosenlund et al. 2005). The brand new exemption are your situation-control analysis held of the Rubenowitz ainsi que al. (2000) one stated down death off serious myocardial infarction (however toward overall incidence) and magnesium from inside the liquid once adjusting for a general range of prospective confounders.
Nutrient consumption is modified having times intake of the residual approach (Willett and Stampfer 1986). Brand new survey research was in fact secret-registered twice and you can canned in the a standard style blinded with respect to help you instance/subcohort status to reduce observer prejudice inside the programming and you may data translation.
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 of mineral intakes off drinking water: a prospective factor to the debate along side dating off liquids top quality to help you heart disease. Int J Epidemiol twelve(1):45-fifty.