Never, former or current drinker) was combined with alcohol intake from the food frequency questionnaire (in grams ethanol per day) and categorized into never drinkers (abstainers), light current drinkers (>0? g/day), moderate current drinkers (5?5 g/day) and heavy current drinkers (15 g/day). Furthermore, the amount of alcohol intake was analyzed among women who drank 1 g/day. For women who drank less, their intake may come from other products than alcoholic drinks, i.e. chocolate candy or sauces. Physical activity level. Physical activity level was assessed in the general questionnaire and categorized according to the validated Cambridge Physical Activity Index into inactive, moderately inactive, moderately PD98059 price active or active [24]. Diet. The modified Mediterranean Diet Score (mMDS) was used as a measure of a healthy diet [25]. Compared with the original Mediterranean Diet Score fish and poly-unsaturated fatty acids were additionally included in this score [26]. A high score is associated with lower risk of chronic diseases [27] and in the total EPIC-NL cohort with a longer healthy life expectancy [28]. Information of the food frequency questionnaire was used to score intake of eight components of the mMDS: vegetables; legumes; fruit, nuts and seeds; cereals; fish; the ratio of unsaturated to saturated fatty acids; meat; and dairy products. For the first 6 components intake equal to or above the study population median was assigned a value of 1, and intake below the median a value of 0. For meat and dairy products intake equal to or below the median was assigned a value of 1. Points were summed into the modified Mediterranean Diet Score, ranging from zero to eight points We did not include alcohol consumption in the score, as alcohol consumption was investigated as a separate JNJ-54781532 site lifestyle factor. A low self-reported modified Mediterranean Diet Score, i.e. a score below 4, was defined as an unhealthy diet. Furthermore, the score was analyzed continuously.CovariatesWe used age at start of the famine (1st October 1944) and educational level, which is considered to be a proxy for socioeconomic status, as covariates in our analyses. We categorized levels of education into very low (only primary school), low (lower vocational education), middle (secondary school or intermediate vocational training) and high education (higher vocational training or university). Next, body mass index (BMI) and energy intake (kcal/day) were included as covariates. BMI (kg/m2) was calculated from measured weight and height and used as a continuous variable. Energy intake was calculated in kcal/day using food frequency questionnaire data; and used as a continuous variable. For smoking as a covariate, smoking status and intensity were combined and categorized into 8 categories, i.e. current smoker (<15 cigarettes/day, 15?5 cigarettes/day, >25 cigarettes a day, pipe of cigar smoker), former smoker (quit <10 year ago, quit 10?0 year ago, quit >20 year ago) and never smoker.Statistical analysisMissing data on BMI (N = 10) and educational level (N = 9) were imputed, using single imputation regression modelling (SPSS-MVA). Characteristics of the study population are presented according to level of famine exposure as mean and standard deviation or as a percentage. Associations between famine exposure and lifestyle were determined for the total study population and by age category. For categorical variables, we used a Poisson regression model, because an odds ratio will overe.Never, former or current drinker) was combined with alcohol intake from the food frequency questionnaire (in grams ethanol per day) and categorized into never drinkers (abstainers), light current drinkers (>0? g/day), moderate current drinkers (5?5 g/day) and heavy current drinkers (15 g/day). Furthermore, the amount of alcohol intake was analyzed among women who drank 1 g/day. For women who drank less, their intake may come from other products than alcoholic drinks, i.e. chocolate candy or sauces. Physical activity level. Physical activity level was assessed in the general questionnaire and categorized according to the validated Cambridge Physical Activity Index into inactive, moderately inactive, moderately active or active [24]. Diet. The modified Mediterranean Diet Score (mMDS) was used as a measure of a healthy diet [25]. Compared with the original Mediterranean Diet Score fish and poly-unsaturated fatty acids were additionally included in this score [26]. A high score is associated with lower risk of chronic diseases [27] and in the total EPIC-NL cohort with a longer healthy life expectancy [28]. Information of the food frequency questionnaire was used to score intake of eight components of the mMDS: vegetables; legumes; fruit, nuts and seeds; cereals; fish; the ratio of unsaturated to saturated fatty acids; meat; and dairy products. For the first 6 components intake equal to or above the study population median was assigned a value of 1, and intake below the median a value of 0. For meat and dairy products intake equal to or below the median was assigned a value of 1. Points were summed into the modified Mediterranean Diet Score, ranging from zero to eight points We did not include alcohol consumption in the score, as alcohol consumption was investigated as a separate lifestyle factor. A low self-reported modified Mediterranean Diet Score, i.e. a score below 4, was defined as an unhealthy diet. Furthermore, the score was analyzed continuously.CovariatesWe used age at start of the famine (1st October 1944) and educational level, which is considered to be a proxy for socioeconomic status, as covariates in our analyses. We categorized levels of education into very low (only primary school), low (lower vocational education), middle (secondary school or intermediate vocational training) and high education (higher vocational training or university). Next, body mass index (BMI) and energy intake (kcal/day) were included as covariates. BMI (kg/m2) was calculated from measured weight and height and used as a continuous variable. Energy intake was calculated in kcal/day using food frequency questionnaire data; and used as a continuous variable. For smoking as a covariate, smoking status and intensity were combined and categorized into 8 categories, i.e. current smoker (<15 cigarettes/day, 15?5 cigarettes/day, >25 cigarettes a day, pipe of cigar smoker), former smoker (quit <10 year ago, quit 10?0 year ago, quit >20 year ago) and never smoker.Statistical analysisMissing data on BMI (N = 10) and educational level (N = 9) were imputed, using single imputation regression modelling (SPSS-MVA). Characteristics of the study population are presented according to level of famine exposure as mean and standard deviation or as a percentage. Associations between famine exposure and lifestyle were determined for the total study population and by age category. For categorical variables, we used a Poisson regression model, because an odds ratio will overe.
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