The Nurses Health Study, established in 1976 by Dr. Frank Speizer, and the Nurses' Health Study II, established in 1989 by Dr. Walter Willett

Walter Willett

Walter Willett, MD, DrPH., is an American physician and nutrition researcher. Currently, Willett is the Fredrick John Stare Professor of Epidemiology and Nutrition, and Chair of the Department of Nutrition at Harvard School of Public Health...

, are the most definitive long-term epidemiological studies conducted to date on older women's health. The study has followed 121,700 female registered nurse

Registered nurse

A registered nurse is a nurse who has graduated from a nursing program at a university or college and has passed a national licensing exam. A registered nurse helps individuals, families, and groups to achieve health and prevent disease...

s since the mid-1970s to assess risk factors for cancer

Cancer

Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

 and cardiovascular disease. The studies are among the largest investigations into risk factors for major chronic diseases in women ever conducted. The studies include clinicians, epidemiologists, and statisticians at the Channing Laboratory. Participating organizations from the Massachusetts

Massachusetts

The Commonwealth of Massachusetts is a state in the New England region of the northeastern United States of America. It is bordered by Rhode Island and Connecticut to the south, New York to the west, and Vermont and New Hampshire to the north; at its east lies the Atlantic Ocean. As of the 2010...

 medical community include the Harvard Medical School

Harvard Medical School

Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts....

, Harvard School of Public Health

Harvard School of Public Health

The Harvard School of Public Health is one of the professional graduate schools of Harvard University, located in the Longwood Area of the Boston, Massachusetts neighborhood of Mission Hill, which is next to Harvard Medical School. HSPH is considered a significant school focusing on health in the...

, and several Harvard-affiliated hospitals, including Brigham and Women's Hospital

Brigham and Women's Hospital

Brigham and Women's Hospital is the largest hospital of the Longwood Medical and Academic Area in Boston, Massachusetts. It is directly adjacent to Harvard Medical School of which it is the second largest teaching affiliate with 793 beds...

, Dana–Farber Cancer Institute, Children's Hospital Boston

Children's Hospital Boston

Children's Hospital Boston is a 396-licensed bed children's hospital in the Longwood Medical and Academic Area of Boston, Massachusetts.At 300 Longwood Avenue, Children's is adjacent both to its teaching affiliate, Harvard Medical School, and to Dana-Farber Cancer Institute...

, and Beth Israel Deaconess Medical Center

Beth Israel Deaconess Medical Center

Beth Israel Deaconess Medical Center in Boston, Massachusetts is a major flagship teaching hospital of Harvard Medical School. It was formed out of the 1996 merger of Beth Israel Hospital and New England Deaconess Hospital...

.

The study is recruiting a new cohort of 100,000 female LPNs and RNs (or those studying to become one) aged 20-46 called the Nurses' Health Study 3 (NHS3). NHS3 is completely online, using social media for recruitment.

Design

A cohort of nurses aged 30 to 55 were initially surveyed in 1976 and biennially thereafter. A second cohort of nurses were enrolled in 1989.

Over time additional questions have been added, most notably the dietary assessment added in 1980. Deaths, usually reported by kin or by postal authorities, were followed up. Where possible and permitted, in cases suggestive of CVD/CHD the followup went beyond death certificates to gather available documentation from autopsy reports and other records. Mortality followup is better than 98 percent.

In 1996, over 16,000 children of women in the second Nurses' Health Study cohort were enrolled in their own follow-up study called the Growing Up Today Study

Growing Up Today Study

The Growing Up Today Study, established in 1996, follows over 26,000 individuals who are children of women in the second Nurses' Health Study cohort...

, or GUTS.

Selected studies

Studies to date have led to the publication of hundreds of peer-reviewed papers.

NHS researchers have examined the effect of exposures like smoking, oral contraceptive use, alcohol consumption, and diet on disease risk.

	Breast Cancer	Coronary Heart Disease (CHD)/Stroke	Colon Cancer	Hip Fracture	Cognitive Functioning	Eye Disease
Smoking	No relation with past or current smoking	Strong positive association with CHD and stroke; risk reduced within 2-4 years of smoking cessation.	Increases risk of colon cancer	Increases risk of hip fracture for current smokers. Risk increases with greater number of cigarettes smoked per day.	Not examined.	Increases risk of cataracts and “wet” AMD (the most severe form of Age-related Macular Degeneration).
Oral Contraceptives	Current use increases risk. Past use no association.	Current use increases risk. Past use no association.	Reduces risk of colon cancer.	Not examined.	Not examined.	Reduces risk of “wet” AMD.
Alcohol	One or more drinks per day increases risk.	Moderate alcohol intake reduces the risk of CHD.	Two or more drinks per day increases risk.	High consumption increases the risk of hip fracture. However, low or moderate consumption is associated with greater bone density.	Moderate intake (½ –1 serving per day) reduces risk of cognitive impairment.	No relation to age related eye diseases.
Diet	Higher intake of red meat increases risk of premenopausal breast cancer.	A Mediterranean-type diet reduces risk of incident CHD and stroke. Fish intake reduces risk of stroke. Nut and wholegrain consumption reduces risk of CHD. Refined carbohydrates and trans fats increase risk.	Higher intakes of folate, vitamin B6, calcium and vitamin D reduces risk. High intake of red and processed meats increases risk.	Reduction of risk with calcium supplement use among women with low calcium diets; higher dietary calcium intake has no effect. Vitamin D intake reduces risk and retinol intake increases risk.	Higher vegetable intake, especially green leafy vegetables, reduces risk of cognitive impairment.	Some antioxidants reduce risk of cataracts and AMD. Higher intake of fish may reduce risk of cataracts and AMD.

External links

• Harvard.edu - 'The Nurses' Health Study', Harvard University
  Harvard University
  Harvard University is a private Ivy League university located in Cambridge, Massachusetts, United States, established in 1636 by the Massachusetts legislature. Harvard is the oldest institution of higher learning in the United States and the first corporation chartered in the country...
  
  

Audio

• PBS Frontline interview with Walter Willett (April 8, 2004)