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Sauvant MP, Pepin D. 2000. Geographical adaptation of death away from cardiovascular disease and you may liquid in a great French quick area (Puy de Dome). Environ Res 84(3):219-227.

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Lina J. Leurs, (1) Leo J. Schouten, (1) Margreet Letter. Mons, (2) R. Alexandra Goldbohm, (3) and you will PietA. van den Brandt (1)

(1) Maastricht School, GROW-School for Oncology and you can Developmental Biology, Agency from Epidemiology, Maastricht, holland; (2) KWR, Watercycle Look Institute, Nieuwegein, holland; (3) TNO Standard of living, Institution of Prevention and you can Fitness, Leiden, holland

Address interaction to L.J. Leurs, Maastricht University, GROW-School to have Oncology and you may Developmental Biology, Service regarding Epidemiology, P.O. Box 616, 6200 MD Maastricht, holland. Telephone: 31 0 43 3882392. Fax: 29 0 43 3884128. E-mail:

We are in debt into the professionals of this study and want to thank new Dutch Central Bureau of Family history and Statistics Netherlands getting delivering research. I and additionally give thanks to A beneficial. Volovics and A great. Kester to possess analytical suggestions; S. van de- Crommert, H. Brants, J. Nelissen, C. de Zwart, Meters. Moll, W. van Dijk, and you can Good. Pisters having guidance; and you may H. van Montfort, T. van Moergasiel, L. van den Bosch, R. Schmeitz, and you will J. Berben for programming recommendations.

It enterprise try held when you look at the Shared Research System of the Dutch h2o companies of the scientists out of Maastricht School and you can KWR, Watercycle Lookup Institute. This study was financed of the KWR, Watercycle Look Institute.

R.A.G. and you may Yards.Letter.Meters. benefit contacting companies (TNO Quality of life and you may KWR, respectively); yet not, neither features actually did one previous search towards newest matter explained regarding the manuscript. Furthermore, outside writeup on the design and you can results try conducted by a Scientific Consultative Committee comprising P. Huntsman (College regarding Eastern Anglia), R. Rylander (emeritus teacher), and you will M.I. Sinclair (Liquids Top quality Browse Australian continent Limited, Monash University).

Very degree one to said a keen inverse association between liquids firmness and you will IHD otherwise coronary attack death was in fact ecologic studies (Kousa et al. 2004, 2006, 2008; Maheswaran ainsi que al. 1999; ; Sauvant and you can Pepin 2000). This new precision of them particular studies might be questioned as the of your you are able to ecologic fallacy. Some case-control and cohort training with little to no or no improvement to own confounding products also suggested a potential defensive effectation of h2o stiffness, calcium or magnesium levels during the liquid, towards the death on account of IHD otherwise coronary arrest (Luoma mais aussi al. 1983; Punsar and Karvonen 1979; Rubenowitz mais aussi al. 1996, 1999; sugar daddy New Mexico Yang 1998; Yang ainsi que al. 2006). Concurrently, very instance-control and you may cohort education that adjusted to have 1000s of prospective confounders, instance cardiovascular risk points and you will liquids attributes, receive zero dating between h2o firmness and IHD or coronary attack death (Comstock ainsi que al. 1980; Morris ainsi que al. 2001; Rosenlund et al. 2005). The new exception are your situation-manage data conducted because of the Rubenowitz et al. (2000) one to reported lower death of acute myocardial infarction ( not towards full incidence) and you can magnesium in h2o immediately following changing having a broad spectrum of possible confounders.

Mineral intake try adjusted getting times consumption from the residual approach (Willett and you may Stampfer 1986). Brand new questionnaire investigation had been key-entered double and you will processed inside a standardized fashion dazzled with respect in order to circumstances/subcohort status to attenuate observer bias during the coding and you will studies 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 consumption off drinking water: a possible reason towards debate along the dating out-of liquids top quality to help you cardiovascular illnesses. Int J Epidemiol a dozen(1):45-50.