In order to examine the levels of serum selenium in Europe, a collaborative study was conducted under the auspices of "The Working Group on Diet and Cancer" under "The European Organisation for Cooperation in Cancer Prevention Studies". A total of 502 serum samples was obtained from healthy, non-institutionized individuals, aged between 20 and 65 years, from 17 locations in 10 different countries in Europe. The selenium content of the samples was determined by a fluorometric method. All analyses were performed in one laboratory. Mean +/- standard deviation of the serum selenium given in microgram/l for the combined male and female data from the individual regions was: Belgium: 100 +/- 9; Denmark: Aarhus 78 +/- 15; France: Grenoble 79 +/- 15; Paris 82 +/- 11; W. Germany: Bavaria 70 +/- 10 Giessen 68 +/- 10, Heidelberg 76 +/- 9; Greece 63 +/- 14; Netherlands: 93 +/- 12; Portugal: Lissabon 102 +/- 10; Spain: Barcelona 87 +/- 14; Sweden: Göteborg 77 +/- 11, Malmö 90 +/- 14, Umeå 82 +/- 8, Uppsala 81 +/- 15; United Kingdom: Ipswich 107 +/- 13, London 109 +/- 14. None of the values represented toxic or overt deficiency levels.
Alkylresorcinols (AR), a group of phenolic lipids present in the outer parts of wheat and rye grain kernels, have been suggested as biomarkers of whole-grain wheat and rye intake. In this study, we investigated potential determinants of plasma AR concentration in a free-living population.
Non-fasting samples from post-menopausal women enrolled in the Danish Diet, Cancer and Health study (n = 360) were selected. Diet was assessed using a semi-quantitative food frequency questionnaires (FFQ) and the association between food items likely to contain AR and relevant non-dietary factors were studied by analysis of covariance models.
The median AR concentration was 78 nmol/l (interquartile range = 106.9 nmol/l). Intake of rye bread, identified as the main determinant, was associated with 87% higher plasma total AR concentration per 100 g of bread (95% confidence interval = 46-139%). About 8-12% of the total variation (depending on the AR homologue) in plasma AR concentration was explained by the selected dietary variables. At a nutrient level, total dietary fiber and cereal fiber were significantly associated with plasma total AR concentration (P = 0.05), but only ˜2% of the total plasma AR concentration was explained by the dietary fiber or cereal fiber intake.
In the studied population, AR plasma concentration was mainly affected by rye bread intake among investigated determinants.
We have evaluated the reproducibility and relative validity of a semiquantitative food frequency questionnaire (FFQ) used in a prospective study of risk factors for cervical neoplasia. The questionnaire is a modified version of one developed and evaluated in a middle-aged Danish population. In the present study, 122 women from the general population of Copenhagen, aged 20-29 years, completed the FFQ twice at a 1-year interval, and provided three 4-day dietary records during the intervening year. The mean nutrient intakes calculated from the first and second questionnaire were similar and, for most nutrients, close to those obtained from the dietary records. The Pearson correlation coefficients between the mean nutrient intakes from the two questionnaires ranged from 0.53 (95% CI, 0.39-0.65) for vitamin E to 0.76 (95% CI, 0.67-0.83) for vitamin B12 (median, 0.67 [95% CI, 0.56-0.76]). In comparisons between the second FFQ and the dietary records, the correlations ranged from 0.24 (95% CI, 0.07-0.40) for vitamin D to 0.63 (95% CI, 0.51-0.73) for sucrose (median, 0.42 [95% CI, 0.26-0.561). The correlations between FFQ and dietary records were generally higher after adjustment for energy intake (median, 0.53 [95% CI, 0.39-0.65]) and within-person variability (median, 0.64 [95% CI, 0.52-0.73]). On average, 71% of the women were classified in the same (+/- 1) quintile in the second FFQ and the dietary records. An average of 3.8% of the women were grossly misclassified into the highest and lowest quintiles by the dietary records. The relative validity of the FFQ in this population was similar to that reported earlier. It is concluded that the FFQ is reproducible and provides a useful scale for categorizing individuals according to their intake of energy and nutrients.
In the early 1980s, Doll and Peto estimated that about 35% of all deaths from cancer in the United States were attributable to dietary factors, with a margin of uncertainty ranging from 10 to 70%. Since then, several dietary factors, e.g. fat and meat, have been suggested to increase the risk for cancer, while other factors, e.g. fibre, fruit and vegetables, have been suggested to decrease the risk. The case-control and cohort studies have, however, given ambiguous results, and the overall evidence is far from conclusive. The major findings on dietary factors that increase risk have been reported from case-control studies, but have not been confirmed in large population-based cohort studies. Although the research in this area indicates that diet is important in cancer prevention, current knowledge does not allow reliable estimates of the numbers and proportions of cancers that could be avoided through well-described modifications of dietary habits. During the last 10 years, low physical activity has been pinpointed as a risk factor for cancers at various sites, especially the colon; however, the causal mechanism is still unknown. Obesity, defined as a body mass index of 30 or more, is consistently associated with endometrial and gall-bladder cancers in women and renal-cell cancer in both men and women. As the prevalence of obesity was between 5 and almost 20% in the Nordic populations in 1995, 625 cancer cases (310 endometrial cancers, 270 renal-cell cancers in men and women and 45 gall-bladder and bile-duct cancers among women) can be predicted in the Nordic countries around the year 2000 to be caused by obesity. This implies that about 1% of all cancers in Nordic women and less than 1% of those in Nordic men could be avoided around the year 2000 if a healthy body weight could be maintained by all inhabitants.
Different healthy food patterns may modify cardiometabolic risk. We investigated the effects of an isocaloric healthy Nordic diet on insulin sensitivity, lipid profile, blood pressure and inflammatory markers in people with metabolic syndrome.
We conducted a randomized dietary study lasting for 18-24 weeks in individuals with features of metabolic syndrome (mean age 55 years, BMI 31.6 kg m(-2) , 67% women). Altogether 309 individuals were screened, 200 started the intervention after 4-week run-in period, and 96 (proportion of dropouts 7.9%) and 70 individuals (dropouts 27%) completed the study, in the Healthy diet and Control diet groups, respectively. Healthy diet included whole-grain products, berries, fruits and vegetables, rapeseed oil, three fish meals per week and low-fat dairy products. An average Nordic diet served as a Control diet. Compliance was monitored by repeated 4-day food diaries and fatty acid composition of serum phospholipids.
Body weight remained stable, and no significant changes were observed in insulin sensitivity or blood pressure. Significant changes between the groups were found in non-HDL cholesterol (-0.18, mmol L(-1) 95% CI -0.35; -0.01, P = 0.04), LDL to HDL cholesterol (-0.15, -0.28; -0.00, P = 0.046) and apolipoprotein B to apolipoprotein A1 ratios (-0.04, -0.07; -0.00, P = 0.025) favouring the Healthy diet. IL-1 Ra increased during the Control diet (difference -84, -133; -37 ng L(-1) , P = 0.00053). Intakes of saturated fats (E%, beta estimate 4.28, 0.02; 8.53, P = 0.049) and magnesium (mg, -0.23, -0.41; -0.05, P = 0.012) were associated with IL-1 Ra.
Healthy Nordic diet improved lipid profile and had a beneficial effect on low-grade inflammation.
OBJECTIVE: There is consistent evidence that alcohol increases the risk of breast cancer. It has been suggested that the increased risk associated with alcohol intake may be reduced by adequate intake of folate. Since many women consume alcohol, detection of a risk-reducing mechanism would have major public health implications. DESIGN: We therefore evaluated the possible interaction between alcohol and folate in a paired nested case-control study among postmenopausal women. SETTING: A total of 24 697 postmenopausal women were included in the 'Diet, Cancer and Health' follow-up study between December 1993 and May 1997. The cohort was followed until December 2000. The study included 388 cases of breast cancer and 388 randomly selected controls were used to estimate the breast cancer incidence rate ratio (IRR) in conditional logistic regression analysis. RESULTS: A previously established association between alcohol intake and risk of breast cancer was present mainly among women with low folate intake. An IRR of 1.19 (95% CI: 0.99-1.42) per 10 g average daily alcohol intake was found for women with a daily folate intake below 300 mug, while among women with a folate intake higher than 350 mug, we could not show an association between the alcohol intake and the breast cancer incidence rate (e.g. folate intake >400 mug; IRR of 1.01 (95% CI: 0.85-1.20)). CONCLUSION: The findings support the evidence that adequate folate intake may attenuate the risk of breast cancer associated with high alcohol intake. SPONSORSHIP: The Danish Cancer Society.
BACKGROUND: Psychological stress and alcohol are both suggested as risk factors for stroke. Further, there appears to be a close relation between stress and alcohol consumption. Several experimental studies have found alcohol consumption to reduce the immediate effects of stress in a laboratory setting. We aimed to examine whether the association between alcohol and stroke depends on level of self-reported stress in a large prospective cohort. METHODS: The 5,373 men and 6,723 women participating in the second examination of the Copenhagen City Heart Study in 1981-1983 were asked at baseline about their self-reported level of stress and their weekly alcohol consumption. The participants were followed-up until 31st of December 1997 during which 880 first ever stroke events occurred. Data were analysed by means of Cox regression modelling. RESULTS: At a high stress level, weekly total consumption of 1-14 units of alcohol compared with no consumption seemed associated with a lower risk of stroke (adjusted RR: 0.57, 95% CI: 0.31-1.07). At lower stress levels, no clear associations were observed. Regarding subtypes, self-reported stress appeared only to modify the association between alcohol intake and ischaemic stroke events. Regarding specific types of alcoholic beverages, self-reported stress only modified the associations for intake of beer and wine. CONCLUSIONS: This study indicates that the apparent lower risk of stroke associated with moderate alcohol consumption is confined to a group of highly stressed persons. It is suggested that alcohol consumption may play a role in reducing the risk of stroke by modifying the physiological or psychological stress response.
OBJECTIVES: To study the association between alcohol drinking pattern and obesity. DESIGN: Cross-sectional population study with assessment of quantity and frequency of alcohol intake, waist and hip circumference, height, weight, and lifestyle factors including diet. SUBJECTS: In all, 25 325 men and 24 552 women aged 50-65 y from the Diet, Cancer and Health Study, Denmark, 1993-1997 participated in the study. MEASUREMENTS: Drinking frequency, total alcohol intake, body mass index (BMI), and waist and hip circumference. RESULTS: Among men, total alcohol intake was positively associated with high BMI (>/=30 kg/m(2)), large waist circumference (>/=102 cm) and inversely associated with small hip circumference (/=88 cm), and small hips only for the highest intake (28+ drinks/week). The most frequent drinkers had the lowest odds ratios (OR) for being obese. Among men, OR for having a high BMI were 1.39 (95% confidence interval: 1.36-1.64), 1.17 (1.02-1.34), 1.00 (reference), 0.87 (0.77-0.98), and 0.73 (0.65-0.82) for drinking 1-3 days/month, 1 day/week, 2-4 days/week, 5-6 days/week, and 7 days/week, respectively. Similar estimates were found for waist circumference. Corresponding results were found for women. CONCLUSION: For a given level of total alcohol intake, obesity was inversely associated with drinking frequency, whereas the amount of alcohol intake was positively associated with obesity. These results indicate that frequent drinking of small amounts of alcohol is the optimal drinking pattern in this relation.
Three hundred and seventy-four general practitioners (GPs) in Denmark filled in a questionnaire on practices regarding prevention of coronary heart disease (CHD), cancer, osteoporosis, and overweight/underweight. Half of the GPs were questioned about the issue of prevention based upon female case stories and the other half on male case stories with identical wording. The GPs more often in relation to: Prevention of CHD gave dietary counselling and recommended weight loss to slightly overweight male than female patients. Prevention of cancers gave dietary counselling and recommended weight loss and increase of exercise to female than to male patients. Prevention of osteoporosis recommended a supplement of calcium and vitamin D to female than to male patients. Treatment of underweight recommended weight gain and discussion of psycho-social issues to underweight female than male patients. In conclusion, GPs distinguish between men and women in relation to prevention strategies in general practice. There is a need for well-described prevention and action strategies with relevant gender differentiation for use in general practice.