Objective: Research is limited on whether mistrust of tap water discourages plain water intake and leads to a greater intake of sugar-sweetened beverages (SSB). The objective of the present study was to examine demographic differences in perceptions of tap water safety and determine if these perceptions are associated with intake of SSB and plain water. Design: The study examined perceptions of tap water safety and their cross-sectional association with intake of SSB and plain water. Racial/ethnic differences in the associations of tap water perceptions with SSB and plain water intake were also examined. Setting: Nationally weighted data from the 2010 HealthStyles Survey (n 4184). Subjects: US adults aged $18 years. Results: Overall, 13?0 % of participants disagreed that their local tap water was safe to drink and 26?4 % of participants agreed that bottled water was safer than tap water. Both mistrust of tap water safety and favouring bottled water differed by region, age, race/ethnicity, income and education. The associations of tap water mistrust with intake of SSB and plain water were modified by race/ethnicity (P , 0?05). Non-white racial/ethnic groups who disagreed that their local tap water was safe to drink were more likely to report low intake of plain water. The odds of consuming $1 SSB/d among Hispanics who mistrusted their local tap water was twice that of Hispanics who did not (OR 5 2?0; 95 % CI 1?2, 3?3). Conclusions: Public health efforts to promote healthy beverages should recognize the potential impact of tap water perceptions on water and SSB intake among minority populations.

Asthma has been associated with atherosclerotic disease in several studies with some evidence that this association may be limited to women. However, most previous studies have failed to account for the heterogeneity of asthma subtypes. We previously reported increased carotid intima medial thickness among women with adult-onset asthma. In this study, we examine the association of adult and child-onset asthma with incident coronary heart disease (CHD) and stroke. Subjects were classified according to self-report of physician diagnosed asthma and age of asthma onset. We used Cox proportional hazards models to test the association of adult and child-onset asthma with incident CHD and stroke, testing for gender interaction. Subanalysis was also performed using only neversmokers. Women with adult-onset asthma experienced a 2-fold increase in incident CHD and stroke which was independent of other risk factors including smoking, body mass index, and physical activity and persisted when the analysis was restricted to never-smokers. No significant association was found among women with child-onset asthma or among men. In conclusion, adult-onset asthma may be a significant risk factor for CHD and stroke among women but not men. Keywords ASTHMA; CORONARY DISEASE; STROKE; SEX FACTORSAsthma has been associated with vascular disease, carotid atherosclerosis, coronary heart disease (CHD), or stroke in at least nine studies. 1-9 Among studies that present results stratified by gender, there is a suggestion that the association may be stronger among or entirely limited to women. 1-4 However, asthma is not a single disease but rather a collection of distinct underlying subtypes, with somewhat differing etiologies. 10,11 Child and adult-onset asthma differ in regards to asthma triggers 11 , gender distribution 11 , and systemic inflammation. 12 We previously reported an association between carotid intima medial thickness and adult-onset Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conflicts of NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript asthma among women in the Atherosclerosis Risk in Communities (ARIC) study. 4 This association was not observed among women with child-onset asthma or among men with either adult or child-onset asthma. In this study, we examined the association of asthma age of onset phenotypes with incidence of CHD and stroke according to gender within the ARIC cohort. Methods Study populationThe Atherosclerosis Risk in Communities (ARIC) Study is a prospective study of the etiology of atherosclerotic, cardiovascular, and cerebrova...

Serum phosphorus levels in the general population have been reported to be associated with cardiovascular morbidity and mortality and increased carotid intima-media thickness. The authors examined gender heterogeneity in the association of phosphorus with all-cause mortality and incident coronary artery disease using data from the Atherosclerosis Risk in Communities Study (1987-2001). Baseline phosphorus levels were higher in women and were associated differently among men and women with traditional atherosclerosis risk factors such as age, low density lipoprotein cholesterol, diabetes mellitus, and hypertension. In a multivariable-adjusted model, men in the highest quintile of serum phosphorus level (>3.8 mg/dL) had an increased mortality rate (hazard ratio = 1.45, 95% confidence interval: 1.12, 1.88), while women did not (hazard ratio = 1.18, 95% confidence interval: 0.89, 1.57). The multivariable likelihood ratio test of effect modification by gender was significant at alpha = 0.1 (P = 0.085) for all-cause mortality. Although the associations of phosphorus with coronary artery disease also appeared to differ substantially by gender, the multivariable test for effect modification suggested that the difference was consistent with random variation (P = 0.195). These results suggest the need for further investigation into gender differences in the contribution of mineral metabolism to cardiovascular disease in the general population.