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21 Purpose 22Both low levels of vitamin D and of physical activity are associated with all-cause, cancer and 23 cardiovascular disease mortality. There is some evidence based on self-reported activity levels that 24 physically more active individuals have higher vitamin D serum levels. The aim was to investigate 25 associations between objectively measured and self-reported physical activity, respectively, and 26 vitamin D serum concentrations in the US population. 27Methods 28Data from NHANES 2003-06 (n=6370, aged≥18 years) were analyzed using multiple regression 29 analyses. 6370 individuals aged 18 years and older with valid data on vitamin D serum levels and 30 physical activity were included. Objective physical activity was assessed using accelerometers, self-31 reported physical activity was based on the NHANES physical activity questionnaire. 32Results 33An increase of 10 minutes of objectively measured and self-reported moderate-to-vigorous activities 34 per day was associated with an increase in circulating vitamin D of 0.32 ng/ml (95% CI 0.17, 0.48) 35 and of 0.18 ng/ml (95% CI 0.12, 0.23), respectively. The odds ratio for being vitamin D deficient 36

The association between selenium status and risk of acute myocardial infarction was examined in a multicenter case-control study in 10 centers from Europe and Israel in 1991-1992. Selenium in toenails was assessed for 683 nonfatal male cases with first acute myocardial infarction and 729 controls less than 70 years of age. Median toenail selenium content was 0.553 /xg/g for cases and 0.590 jxg/g for controls. After adjustment for age, center, and smoking, the odds ratio for myocardial infarction in the highest quintile of selenium as compared with the lowest was 0.63 (95 percent confidence interval 0.37-1.07, p for trend = 0.08). The observed inverse trend was somewhat stronger when the authors adjusted for vitamin E status (p = 0.05). Analysis stratified for smoking habits showed an inverse association in former smokers (odds ratio for the 75th-25th percentile contrast = 0.63 (95 percent confidence interval 0.43-0.94)), but not in current smokers (odds ratio = 0.97 ( 0.71-1.32)) or in those who had never smoked (odds ratio = 1.55 (0.87-2.76)). Analysis stratified by center showed a significant inverse association between selenium levels and risk of myocardial infarction for Germany (Berlin) only (75th to 25th percentile odds ratio = 0.62 (95 percent confidence interval 0.42-0.91)), which was the center with the lowest selenium levels. It appears that the increased risk of acute myocardial infarction at low levels of selenium intake is largely explained by cigarette smoking; selenium status does not appear to be an important determinant of risk of myocardial infarction at the levels observed in a large part of Europe. Am J Epidemiol 1997;145:373-9. antioxidants; case-control studies; myocardial infarction; selenium Evidence is accumulating that oxidation of low density lipoprotein particles and cytotoxic effects of lipid peroxides enhance the formation of foam cells and atherosclerotic lesions (1, 2). Selenium is part of the enzyme glutathione peroxidase, which plays an important role in the antioxidant defense of the body against the deleterious actions of free radicals and lipid per-

LTPA clearly predicts all-cause mortality. However, associations between OPA and all-cause mortality are unclear and need further research with special regard to ethnic differences.