INTRODUCTION: The aim of the present study was to quantify the impact of different dietary factors on the mortality from ischaemic heart disease in Denmark. METHODS: Relative risks and knowledge on the distribution of different dietary factors were used to estimate etiological fractions. RESULTS: It is estimated that an intake of fruit and vegetables and saturated fat as recommended would prevent 12 and 22%, respectively, of deaths from ischaemic heart disease in Denmark. An intake of fish among those at high risk for ischaemic heart disease, would lead to a 26% lower mortality, while alcohol intake among abstainers would have no significant quantitative effect. DISCUSSION: These results suggest that changes in dietary habits according to current recommendations would have an impact on public health in Denmark.
Three hundred and seventy-four general practitioners (GPs) in Denmark filled in a questionnaire on attitudes to include information on gender and diet in the strategy for prevention of coronary heart disease, cancer, osteoporosis, and overweight/underweight. Risk factors for disease in general were ranked as follows: smoking, alcohol, stress, diet, physical exercise, heredity and hygiene. The patients' lack of motivation, insufficient time for each patient, and inadequate knowledge about nutrition were stated as barriers to dietary counselling. The GPs stated that the gender of the patient was important only to the counselling on osteoporosis. Lack of time and insufficient knowledge were perceived as barriers for including gender specific issues in prevention. It is concluded that GPs consider dietary counselling important but lack time and knowledge. The results point at a need for better pre- and postgraduate training in nutrition, and for a better reimbursement system for time spent on prevention.
In order to test hypotheses on diet and the risk of cancer, a prospective cohort study was established. A total of 57,055 persons living in Copenhagen and Aarhus, between 50 and 65 years of age, visited a study clinic between December 1993 and May 1997. The participants provided questionnaire data on diet and lifestyle. Furthermore, anthropometric measurements, blood pressure and biological material were collected. All participants will be followed by linkage to health registries including the Cancer Registry and by self-administered follow-up questionnaires. The purpose of this publication is to describe the data-base, which will be available for research in the years to come including the results of the first two years of follow-up.
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.
The average salt intake (sodium chloride) in Denmark is about 10 g/person/day, which is approximately 8 times higher than the estimated need. Salt added during industrial processing of foods constitutes more than 50% of the daily salt intake. Observational and experimental epidemiological studies indicate no decisive effects on blood pressure in humans caused by considerable variations in the daily salt intake. However, a small group of patients with hypertension may lower their blood pressure by reducing the daily intake of salt to 5 g. It has not been convincingly documented that high salt intake is an independent risk factor in the pathogenesis of asthma, osteoporosis, toxaemia of pregnancy or apoplectic stroke. On the other hand, several epidemiological studies point to the fact that the intake of salted foods may increase the risk of gastric cancer. It is recommended 1) that the food industry as far as possible limits the addition of salt, 2) that foods are supplied with a declaration of the salt content, and 3) that the research in this field is strengthened to facilitate the identification of persons at increased risk of developing disorders associated with high salt intake.
Variation in diet associated with drinking patterns may partly explain why wine seems to reduce ischaemic heart disease mortality. In a cross-sectional study conducted in Copenhagen and Aarhus from 1995 to 1997 including 23,284 men and 25,479 women aged 50-64 years, the relation between intake of different alcoholic beverages and selected indicators of a healthy diet was investigated. In multivariate analyses, wine, as compared with other alcoholic drinks, was associated with a higher intake of fruit, fish, cooked vegetables, salad, the use of olive oil for cooking and not using fat spread on rye bread. In conclusion, the association between wine drinking and an intake of a healthy diet may have implications for the interpretation of previous reports of the relation between type of alcoholic beverage and ischaemic heart disease mortality.
The aim of the study was to examine the effect of 24-hour nicotine patches in smoking cessation among over-the-counter customers in Denmark based on a randomized, double-blind, placebo-controlled trial. Participants were consecutive customers to whom nicotine patches were offered free of charge and as the only treatment. Forty-two pharmacies in the areas of Aarhus and Copenhagen in Denmark participated in the trial, and 522 customers who smoked 10 or more cigarettes per day were randomized to either nicotine or placebo patches from January to March 1994. Twenty-four-hour patches were offered for a three-month period. Those smoking 20 or more cigarettes per day started on 21 mg/day patches. Customers who smoked less started on 14 mg/day patches and all the participants were gradually reduced to 7 mg/day patches during the study period. Smoking behaviour and compliance were recorded by means of self-administered question-naires and telephone interviews. Smoking status was recorded following each four-week treatment period, and 26 weeks after inclusion. There was a significant increase in smoking cessations rates, but only among smokers who started on 21 mg/day patches after eight weeks of follow-up. No significant differences in smoking cessation rates were seen among smokers who started with the low dose nicotine or placebo patches.
Dietary risk factors for renal cell cancer were investigated in a population based case-control study of incident cases. A total of 351 cases and 340 controls matched for age and sex were interviewed about dietary habits as well as exposure to other known or suspected risk factors. An association was found between risk of renal cell cancer and energy intake, especially fats. There was no protective effect of fruits but a weak protective effect of cruceferous vegetables. The association with diet was present after adjusting for the effect of cigarette smoking, socioeconomic status and body mass index, all of which have been identified as risk factors for renal cell cancer.