Pub Date : 2025-11-28DOI: 10.1007/s10654-025-01328-4
Paolo Vineis
{"title":"Causality and exposome","authors":"Paolo Vineis","doi":"10.1007/s10654-025-01328-4","DOIUrl":"https://doi.org/10.1007/s10654-025-01328-4","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"32 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145611107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-24DOI: 10.1007/s10654-025-01314-w
Mark P. Little, Jim Z. Mai, Jill S. Barnholtz-Sloan, Martha S. Linet, Michelle Fang, Pavel Chernyavskiy, Victoria Kennerley, Elizabeth K. Cahoon, Myles G. Cockburn, Gerald M. Kendall, Michael G. Kimlin
Brain tumour is the second most common type of childhood cancer and the most common solid tumour in children, but its aetiology is largely unknown. Some previous studies have suggested that elevated ultraviolet radiation (UVR) exposures decrease brain tumour risk, but the evidence is inconsistent. We conducted a cross-sectional study (with census-derived population counts) to assess age < 20 malignant/non-malignant brain tumour incidence overall and for major categories in Surveillance, Epidemiology and End Results 2000–2021 data, using ground-based UVR-irradiance measures, via quasi-likelihood models accounting for over/under-dispersion, adjusted for age, sex, race/ethnicity and other socioeconomic variables. There were 29,088/18,585 cases of malignant/non-malignant brain tumour, with generally significant decreasing trends of both types of tumour with UVR irradiance [relative risk (RR) = 0.754/mW/cm 2 (95% CI 0.659, 0.862, p < 0.0001) for malignant brain tumour, RR = 0.466/mW/cm 2 (95% CI 0.382, 0.567, p < 0.0001] for non-malignant brain tumour), although there was significant heterogeneity by histopathologic subtype, race/ethnicity, and sex. Equally, there is a highly significant decreasing trend of both types of tumour with UVR-cumulative radiant exposure ( p < 0.0001). These trends are also significant in many malignant/non-malignant brain tumour histopathological subtypes and racial/ethnic groups. However, there are certain non-malignant brain tumour subtypes, for example tumours of the pineal region and meningeal tumours, where RR significantly exceed 1 in relation to UVR irradiance ( p = 0.0330, p = 0.0024 respectively). Our finding, of a generally protective effect of UVR on brain tumour risk is not clear-cut, and warrants large studies of specific histopathological pediatric/adolescent brain tumours using individual-level data on solar exposures and key effect modifiers and potential confounders.
脑瘤是儿童癌症中第二常见的类型，也是儿童中最常见的实体瘤，但其病因在很大程度上是未知的。先前的一些研究表明，增加的紫外线辐射（UVR）暴露会降低脑肿瘤的风险，但证据并不一致。我们进行了一项横断面研究（使用人口普查得出的人口计数），使用地面uvr辐照度测量，通过准似然模型，通过年龄、性别、种族/民族和其他社会经济变量进行调整，评估年龄和20岁恶性/非恶性脑肿瘤的总体发病率，以及2000-2021年监测、流行病学和最终结果数据中的主要类别。恶性/非恶性脑肿瘤共有29,088/18,585例，两种肿瘤在UVR照射下的相对危险度(RR) = 0.754/mW/ cm2 （95% CI 0.659, 0.862, p < 0.0001）和非恶性脑肿瘤的相对危险度(RR = 0.466/mW/ cm2 （95% CI 0.382, 0.567, p < 0.0001）总体上呈显著下降趋势，但组织病理亚型、种族/民族和性别存在显著异质性。同样，在uvr累积辐射照射下，两种类型的肿瘤的发病率都有非常显著的下降趋势（p < 0.0001）。这些趋势在许多恶性/非恶性脑肿瘤组织病理学亚型和种族/民族群体中也很重要。然而，某些非恶性脑肿瘤亚型，例如松果体区肿瘤和脑膜肿瘤，其相对于UVR辐照度的RR显著超过1 （p = 0.0330, p = 0.0024）。我们的研究发现，紫外线辐射对脑肿瘤风险的一般保护作用尚不明确，需要对儿童/青少年特定组织病理学脑肿瘤进行大量研究，使用个人水平的太阳照射数据、关键效应调节剂和潜在混杂因素。
{"title":"Solar ultraviolet radiation exposure, and incidence of childhood (0–19 years) malignant and non-malignant brain tumour in a US population-based dataset, 2000–2021","authors":"Mark P. Little, Jim Z. Mai, Jill S. Barnholtz-Sloan, Martha S. Linet, Michelle Fang, Pavel Chernyavskiy, Victoria Kennerley, Elizabeth K. Cahoon, Myles G. Cockburn, Gerald M. Kendall, Michael G. Kimlin","doi":"10.1007/s10654-025-01314-w","DOIUrl":"https://doi.org/10.1007/s10654-025-01314-w","url":null,"abstract":"Brain tumour is the second most common type of childhood cancer and the most common solid tumour in children, but its aetiology is largely unknown. Some previous studies have suggested that elevated ultraviolet radiation (UVR) exposures decrease brain tumour risk, but the evidence is inconsistent. We conducted a cross-sectional study (with census-derived population counts) to assess age < 20 malignant/non-malignant brain tumour incidence overall and for major categories in Surveillance, Epidemiology and End Results 2000–2021 data, using ground-based UVR-irradiance measures, via quasi-likelihood models accounting for over/under-dispersion, adjusted for age, sex, race/ethnicity and other socioeconomic variables. There were 29,088/18,585 cases of malignant/non-malignant brain tumour, with generally significant decreasing trends of both types of tumour with UVR irradiance [relative risk (RR) = 0.754/mW/cm <jats:sup>2</jats:sup> (95% CI 0.659, 0.862, <jats:italic>p</jats:italic> < 0.0001) for malignant brain tumour, RR = 0.466/mW/cm <jats:sup>2</jats:sup> (95% CI 0.382, 0.567, <jats:italic>p</jats:italic> < 0.0001] for non-malignant brain tumour), although there was significant heterogeneity by histopathologic subtype, race/ethnicity, and sex. Equally, there is a highly significant decreasing trend of both types of tumour with UVR-cumulative radiant exposure ( <jats:italic>p</jats:italic> < 0.0001). These trends are also significant in many malignant/non-malignant brain tumour histopathological subtypes and racial/ethnic groups. However, there are certain non-malignant brain tumour subtypes, for example tumours of the pineal region and meningeal tumours, where RR significantly exceed 1 in relation to UVR irradiance ( <jats:italic>p</jats:italic> = 0.0330, <jats:italic>p</jats:italic> = 0.0024 respectively). Our finding, of a generally protective effect of UVR on brain tumour risk is not clear-cut, and warrants large studies of specific histopathological pediatric/adolescent brain tumours using individual-level data on solar exposures and key effect modifiers and potential confounders.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"153 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145583354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-24DOI: 10.1007/s10654-025-01326-6
Emelie Rietz Liljedahl, Kari Nielsen, Malin Engfeldt, Anna Saxne Jöud, Christel Nielsen
The incidence of cutaneous melanoma (CM) has risen sharply over the past 30 years, coinciding with the rapidly growing tattoo trend. In Sweden, 20% of the population is tattooed. Repeated reports of the presence of carcinogenic chemicals, such as polyaromatic hydrocarbons, aromatic amines and heavy metals in tattoo ink justifies the investigation of CM risk in relation to tattooing. We aimed to investigate the potential association between tattoo exposure and CM. We identified 2880 individuals who were diagnosed with CM at age 20–60 years, in the Swedish National Cancer Register. For each case, we sampled three random age- and sex-matched controls from the Swedish Total Population Register. Exposure data and data on potential confounders were collected through a questionnaire in 2021. We estimated the relative risk of CM in tattooed compared with nontattooed individuals using multivariable logistic regression, rendering incidence rate ratios (IRR). Of the participants, 22% of the cases (354/1598) had a tattoo before the index date, vs. 20% of the controls (815/4097). We observed an adjusted relative risk of CM in tattooed compared to nontattooed individuals of 1.29 (95% confidence interval [CI]: 1.07–1.56). The results suggested that tattoos may be a risk factor for CM, but further studies are needed to establish causality.
{"title":"Does tattoo exposure increase the risk of cutaneous melanoma? A population-based case-control study","authors":"Emelie Rietz Liljedahl, Kari Nielsen, Malin Engfeldt, Anna Saxne Jöud, Christel Nielsen","doi":"10.1007/s10654-025-01326-6","DOIUrl":"https://doi.org/10.1007/s10654-025-01326-6","url":null,"abstract":"The incidence of cutaneous melanoma (CM) has risen sharply over the past 30 years, coinciding with the rapidly growing tattoo trend. In Sweden, 20% of the population is tattooed. Repeated reports of the presence of carcinogenic chemicals, such as polyaromatic hydrocarbons, aromatic amines and heavy metals in tattoo ink justifies the investigation of CM risk in relation to tattooing. We aimed to investigate the potential association between tattoo exposure and CM. We identified 2880 individuals who were diagnosed with CM at age 20–60 years, in the Swedish National Cancer Register. For each case, we sampled three random age- and sex-matched controls from the Swedish Total Population Register. Exposure data and data on potential confounders were collected through a questionnaire in 2021. We estimated the relative risk of CM in tattooed compared with nontattooed individuals using multivariable logistic regression, rendering incidence rate ratios (IRR). Of the participants, 22% of the cases (354/1598) had a tattoo before the index date, vs. 20% of the controls (815/4097). We observed an adjusted relative risk of CM in tattooed compared to nontattooed individuals of 1.29 (95% confidence interval [CI]: 1.07–1.56). The results suggested that tattoos may be a risk factor for CM, but further studies are needed to establish causality.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"164 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145583184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-21DOI: 10.1007/s10654-025-01332-8
Whitney Wells,M Maria Glymour
{"title":"Individualizing social determinants of health: is educational attainment a community resource?","authors":"Whitney Wells,M Maria Glymour","doi":"10.1007/s10654-025-01332-8","DOIUrl":"https://doi.org/10.1007/s10654-025-01332-8","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"79 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145559114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-12DOI: 10.1007/s10654-025-01303-z
Ulrike Haug,Mingyang Song,Vanessa Didelez
{"title":"No \"prevalence bias\" in randomized controlled trials on colorectal cancer screening: the importance of clarifying the research question.","authors":"Ulrike Haug,Mingyang Song,Vanessa Didelez","doi":"10.1007/s10654-025-01303-z","DOIUrl":"https://doi.org/10.1007/s10654-025-01303-z","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"54 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-08DOI: 10.1007/s10654-025-01319-5
Hermann Brenner, Thomas Heisser, Michael Hoffmeister
{"title":"Overcoming prevalence bias in colorectal cancer screening studies by sensible analyses rather than ignoring it or giving up relevant effect measures","authors":"Hermann Brenner, Thomas Heisser, Michael Hoffmeister","doi":"10.1007/s10654-025-01319-5","DOIUrl":"https://doi.org/10.1007/s10654-025-01319-5","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"92 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-06DOI: 10.1007/s10654-025-01317-7
Gibran Hemani, Stefan Stender, Frank J. Wolters, Albert Hofman, George Davey Smith
{"title":"The rapid growth in Mendelian randomization studies","authors":"Gibran Hemani, Stefan Stender, Frank J. Wolters, Albert Hofman, George Davey Smith","doi":"10.1007/s10654-025-01317-7","DOIUrl":"https://doi.org/10.1007/s10654-025-01317-7","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"93 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145448177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-03DOI: 10.1007/s10654-025-01327-5
Kenny Mendoza, Frank B. Hu
{"title":"Are all ultra-processed foods created equal? Relevance of food processing and nutritional quality","authors":"Kenny Mendoza, Frank B. Hu","doi":"10.1007/s10654-025-01327-5","DOIUrl":"https://doi.org/10.1007/s10654-025-01327-5","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"28 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-03DOI: 10.1007/s10654-025-01329-3
Isa Amalie Olofsson, Jes Olesen, Kaare Christensen, Eva R. Hoffmann, Thomas Folkmann Hansen
The Danish Monozygotic Twin Study on Migraine is a population-based twin study established in 2023–2024. The cohort was created to lay the foundation for innovative studies of the role of environmental, genetic, and epigenetic factors and their complex interactions in the pathogenesis of migraine. The aim of this paper is to describe data collection, content, characteristics of participants and to assess the representativeness of the cohort by comparing participants to non-responders. Danish monozygotic twins born between 1967 and 2000 were invited to participate. Self-reported questionnaires were sent out to 9,036 possible participants. The questionnaires assessed migraine and migraine subtypes, life satisfaction, resilience, stress, childhood trauma and the relationship of the participant to their family. Through linkage to the nationwide Danish registries the cohort contains individual level information on education, income, patient data from hospitals, prescription medication and childbirth. The Danish registries also enable longitudinal data collection on health outcomes. Individuals who responded to the migraine questionnaire were defined as participants. The cohort consists of 3,893 individuals, including 1,822 complete twin pairs, 1,173 individuals with migraine and 280 migraine discordant twin pairs. 123 participants were included in a substudy with a migraine diagnostic interview and collection of blood samples for both genetic and epigenetic studies. Comparison between participants and non-responders showed a higher participation rate among women. For both genders participants were older, had a higher level of education and a higher level of income compared to non-responders. Sociodemographic differences in participation should be considered to avoid biased estimates in future studies based on the cohort.
{"title":"Cohort profile and representativeness of participants in the Danish monozygotic twin study on migraine","authors":"Isa Amalie Olofsson, Jes Olesen, Kaare Christensen, Eva R. Hoffmann, Thomas Folkmann Hansen","doi":"10.1007/s10654-025-01329-3","DOIUrl":"https://doi.org/10.1007/s10654-025-01329-3","url":null,"abstract":"The Danish Monozygotic Twin Study on Migraine is a population-based twin study established in 2023–2024. The cohort was created to lay the foundation for innovative studies of the role of environmental, genetic, and epigenetic factors and their complex interactions in the pathogenesis of migraine. The aim of this paper is to describe data collection, content, characteristics of participants and to assess the representativeness of the cohort by comparing participants to non-responders. Danish monozygotic twins born between 1967 and 2000 were invited to participate. Self-reported questionnaires were sent out to 9,036 possible participants. The questionnaires assessed migraine and migraine subtypes, life satisfaction, resilience, stress, childhood trauma and the relationship of the participant to their family. Through linkage to the nationwide Danish registries the cohort contains individual level information on education, income, patient data from hospitals, prescription medication and childbirth. The Danish registries also enable longitudinal data collection on health outcomes. Individuals who responded to the migraine questionnaire were defined as participants. The cohort consists of 3,893 individuals, including 1,822 complete twin pairs, 1,173 individuals with migraine and 280 migraine discordant twin pairs. 123 participants were included in a substudy with a migraine diagnostic interview and collection of blood samples for both genetic and epigenetic studies. Comparison between participants and non-responders showed a higher participation rate among women. For both genders participants were older, had a higher level of education and a higher level of income compared to non-responders. Sociodemographic differences in participation should be considered to avoid biased estimates in future studies based on the cohort.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"91 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-23DOI: 10.1007/s10654-025-01292-z
Juliane Menzel, Fabian Spinka, Maria J Pie, Andrea Deichl, Sven Knüppel, Anke Ehlers, Britta Nagl, Frank Edelmann, Cornelia Weikert
In recent years, acute cardiovascular effects of high energy drink (ED) consumption have been described, but no data are available on chronic high consumption of EDs and cardiovascular risk in adolescents. As a first study, the present study investigated differences in a variety of cardiological parameters in adolescents (aged 15-18 years) with a chronic high consumption of EDs (ED consumption: ≥ four days/week for ≥ last 12 months, > 3 mg caffeine from EDs/kg bodyweight/day) compared to a control group. In study phase 1 of the cross-sectional EDKAR-study, data from 5100 pupils in Berlin (Germany) on their ED consumption and lifestyle factors were assessed using an online questionnaire. Based on these, adolescents with a chronic high ED consumption (n = 97) and a control group (n = 160) were cardiologically examined at Charité - Universitätsmedizin Berlin. Blood pressure, heart rate, electrocardiographic and echocardiographic parameters were assessed. Cardiological risk factors like educational background, smoking, alcohol consumption and sleep duration were investigated. The study noticed no significant and/or clinically relevant differences in any of the cardiological parameters e.g., heart rate (Chronic high ED consumption: Geometric mean (95%-CI): 74.8 BPM (68.5-81.8) vs. control group: 71.9 BPM (65.2-79.2), p = 0.23). However, half of the high consumers reported having experienced adverse effects after consuming EDs. Furthermore, adolescents with chronic high ED consumption reported a considerably higher intake of alcohol, higher smoking rates and shorter sleep duration in comparison to the control group. Accordingly, chronic high ED consumption is associated with lifestyle factors with a potential negative impact on the cardiovascular system.
{"title":"Chronic high consumption of energy drinks and cardiovascular risk in adolescents-results of the EDKAR-study.","authors":"Juliane Menzel, Fabian Spinka, Maria J Pie, Andrea Deichl, Sven Knüppel, Anke Ehlers, Britta Nagl, Frank Edelmann, Cornelia Weikert","doi":"10.1007/s10654-025-01292-z","DOIUrl":"10.1007/s10654-025-01292-z","url":null,"abstract":"<p><p>In recent years, acute cardiovascular effects of high energy drink (ED) consumption have been described, but no data are available on chronic high consumption of EDs and cardiovascular risk in adolescents. As a first study, the present study investigated differences in a variety of cardiological parameters in adolescents (aged 15-18 years) with a chronic high consumption of EDs (ED consumption: ≥ four days/week for ≥ last 12 months, > 3 mg caffeine from EDs/kg bodyweight/day) compared to a control group. In study phase 1 of the cross-sectional EDKAR-study, data from 5100 pupils in Berlin (Germany) on their ED consumption and lifestyle factors were assessed using an online questionnaire. Based on these, adolescents with a chronic high ED consumption (n = 97) and a control group (n = 160) were cardiologically examined at Charité - Universitätsmedizin Berlin. Blood pressure, heart rate, electrocardiographic and echocardiographic parameters were assessed. Cardiological risk factors like educational background, smoking, alcohol consumption and sleep duration were investigated. The study noticed no significant and/or clinically relevant differences in any of the cardiological parameters e.g., heart rate (Chronic high ED consumption: Geometric mean (95%-CI): 74.8 BPM (68.5-81.8) vs. control group: 71.9 BPM (65.2-79.2), p = 0.23). However, half of the high consumers reported having experienced adverse effects after consuming EDs. Furthermore, adolescents with chronic high ED consumption reported a considerably higher intake of alcohol, higher smoking rates and shorter sleep duration in comparison to the control group. Accordingly, chronic high ED consumption is associated with lifestyle factors with a potential negative impact on the cardiovascular system.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":"1355-1368"},"PeriodicalIF":5.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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