To investigate trends in body mass index (BMI) and prevalence of obesity among adults in Finland from 1982 to 1997, and to identify population groups with increasing obesity.
Random samples from the national population register including men and women aged 25-64 y (n = 24604, total).
Four cross-sectional surveys carried out in three areas in Finland every fifth year since 1982.
Weight and height were measured, and data on occupation and education level were collected by a self-administered questionnaire.
The mean BMI increased in both genders. In men, the upward trend was greatest (the increase of 1.3 kg/m2 in 15 y) in the oldest age group (55-64 y), and was found also (the increase of 0.6 kg/m2) in the youngest age group (25-34 y), whereas in women, the upward trend was most prominent (the increase of 0.9 kg/m2) in the youngest age group. BMI increased in all educational groups in men, but in women the upward trend seemed to be greatest in the lowest educational group. The upward trends were most prominent among retired and unemployed men, while in women changes in BMI were similar in all occupational groups.
The strongest upward trend in BMI was found in the oldest men, in the youngest age group in both genders and, in particular, among men who were outside the labor force. Education is still a strong determinant of obesity, especially in women, although the social gradient in BMI has not widened in the 1990s.
The study was carried out to determine the associations of alcohol beverage drinking with macronutrients, antioxidants, and body mass index.
Dietary subsample of the 1992 Finmonica cardiovascular risk factor survey in Finland; a cross-sectional study.
985 women and 863 men were drawn from the population register in the four monitoring areas. All subjects were 25-64 y of age.
The mailed questionnaire included questions covering socioeconomic factors, physical activity, smoking, and alcohol consumption. The diet was assessed using a three-day food record.
The dietary differences between abstainers and alcohol consumers were more significant than between consumers of different alcoholic beverages. Among drinkers, fat intake as a percentage of energy was higher and carbohydrate intake was lower than among abstainers. Those who preferred wine, however, had the highest vitamin C intake; female wine drinkers also had the highest carotenoid intake. With the exception of those who mainly preferred spirits, alcohol energy was not added to the diet but seemed to substitute food items both in men and women. Despite the similar total daily energy intakes, daily energy expenditure, and physical activity index, male drinkers were leaner than abstainers. In women, the proportion of underreporters of energy intake increased with increasing alcohol consumption, and the association between alcohol and body mass index was similar to that in men after the exclusion of underreporters.
Alcohol consumers were leaner than abstainers, and wine drinkers in particular had more antioxidants in their diet.
We investigated the association between self-reported alcohol ingestion and colorectal cancer in a cohort of male smokers in Finland. Among 27,109 men aged 50 to 69 years, 87 colon and 53 rectal cases were diagnosed during the five to eight years of follow-up. Among drinkers, colorectal cancer risk increased with the amount of alcohol consumed (P trend = 0.01) with risk increasing by 17 percent for each drink consumed. Both beer and spirits contributed to this increased risk. Further analyses revealed that the positive association with alcohol was primarily for colon cancer (P trend = 0.01). Interestingly, risk of colorectal cancer associated with drinking (cf self-reported abstinence) changed with follow-up time, suggesting an inverse association for alcohol early in follow-up, and a positive association after about three-and-a-half years of follow-up. Follow-up time did not modify the positive association with amount of alcohol among drinkers, however. Results also indicated that beta-carotene supplementation may attenuate the effect of alcohol on colorectal cancer risk among drinkers. In conclusion, this study supports a role for alcohol in colon carcinogenesis and suggests that similar studies should evaluate carefully the effects of lifetime drinking habits and recent abstinence.
We have investigated the insertion/deletion polymorphism in the signal peptide region of the apoB gene in 106 Finnish individuals from North Karelia. The relative frequency of the insertion allele in this sample was 0.73. Strong linkage disequilibrium was detected between this apoB insertion/deletion polymorphism and the Ag(c/g) epitope pair of apoB, while weak linkage disequilibrium was detected between the polymorphism and the four other reported Ag epitope pairs [(a1/d), (x/y), (h/i) and (t/z)], as well as the apoB PvuII and the XbaI RFLPs. Using one-way analysis of variance there was a statistically significant association (P less than 0.05) between the apoB insertion/deletion polymorphism and serum triglyceride levels in this sample. Individuals homozygous for the insertion allele had higher triglyceride levels than individuals homozygous for the deletion allele, while individuals heterozygous for the polymorphism had intermediate levels. These differences were reduced when individuals were consuming a low fat diet but were statistically significant when the individuals returned to their normal diet. It is possible that insertion or deletion of three hydrophobic amino acids (leu-ala-leu) from the signal peptide of apoB may have a direct effect on plasma triglyceride levels by altering the intracellular processing of apoB or apoB-containing lipoproteins in the liver or intestine.
The present study investigated the association between 24-h urinary sodium excretion and heart rate in the determination of blood pressure (BP) levels in a large random population sample from eastern Finland. Three independent risk factor surveys were performed in 1979, 1982 and 1987 using the same methodology. Data from each survey was pooled for subjects aged 25-64 years who reported a complete 24-h urine collection and were not on the current antihypertensive treatment (1640 men and 1686 women). The effect of urinary sodium excretion and heart rate was examined by regressing BP on urinary sodium excretion and pulse rate, together with age and body mass index (BMI). Analyses stratified by quintiles of heart rate were also performed. There was no association between urinary sodium and BP either in men or in women. There was a significant correlation between heart rate and both systolic and diastolic BP in both men and women. A significant interaction between age and BMI with heart rate was also found in both sexes. Interaction between urinary sodium and heart rate was found neither in men nor in women. Among men, after adjustment for age and BMI, there was a curvilinear relation between 24-h urinary excretion of sodium and diastolic BP (P = 0.054) in the lowest quintile of heart rate (
The aim was to examine (1) whether health habits are associated with body fat distribution, as measured by the waist/hip girth ratio, and (2) to what extent environmental factors, including anthropometric characteristics, explain the variability in levels of cardiovascular risk factors.
The study was a population based cross sectional survey, conducted in the spring of 1987 as a part of an international research project on cardiovascular epidemiology.
The survey was conducted in three geographical areas of eastern and south western Finland.
2526 men and 2756 women aged 25-64 years took part in the study, corresponding to a survey participation rate of 82%.
In men, waist/hip ratio showed stronger associations with exercise (Pearson's r = -0.24), resting heart rate (r = 0.10), alcohol consumption (r = 0.07), smoking (r = 0.05), and education (r = -0.23) than did body mass index. Jointly, exercise, resting heart rate, alcohol consumption, education, and age explained 18% of variance in male waist/hip ratio, but only 9% of variance in male body mass index. In women, environmental factors were more predictive for body mass index than for waist/hip ratio, with age and education being the strongest determinants. Waist/hip ratio and body mass index were approximately equally strong predictors of cardiovascular risk factor levels. The additional predictive power of waist/hip ratio over and above body mass index was tested in a hierarchical, stepwise regression. In this conservative type of analysis the increase in explained variance uniquely attributable to waist/hip ratio was 2-3% for female and 1-2% for male lipoprotein levels, and less than 0.5% for female and 0-2% for male blood pressure values.
The distribution of abdominal obesity in Finland is significantly influenced by health habits and sociodemographic factors in both men and women. This in turn is obviously one reason for the relatively small "independent" effect of body fat distribution on cardiovascular risk factor levels.
The association of body fat distribution as measured by the ratio of waist to hip girth (WHR) to age, to serum total cholesterol and HDL-cholesterol and to blood pressure was studied in a population-based sample of 2461 men and 2768 women aged 25 to 64 years not treated with cardiovascular drugs. In men, the relationships of age with WHR and age with body mass index (BMI) were similar, an increase levelling at the age of about 50 years. In women, BMI increased linearly, but WHR exponentially with age. In both sexes, age-adjusted WHR and BMI associated positively with non-HDL cholesterol, and with systolic and diastolic blood pressure, and inversely with HDL-cholesterol and the HDL/non-HDL cholesterol ratio. WHR and BMI were independently related to several cardiovascular risk factors. HDL-cholesterol concentration was 19% lower in men, and 17% lower in women who belonged to the upper tertile of both WHR and BMI, than in the subjects in the lower tertiles of WHR and BMI. Age-adjusted WHR and BMI also predicted fasting and 2-hour post-challenge blood glucose values in women aged 45 to 64 years, but not in men. The WHR provides additional information on elevated cardiovascular risk factors in cross-sectional analysis among middle-aged men and women independently of BMI. The measurement of WHR in large-scale risk factor surveys should be recommended, in order to assess the independent contribution of WHR to the risk of cardiovascular disease, and to find out the importance of WHR for the prevention of chronic diseases.
Data on the body mass index (BMI) from four Scandinavian countries are compared. The Finnish values are markedly higher than those of the other countries. This holds for both sexes. Among these the Norwegians deviate by showing higher values for females, though not reaching the Finnish level, but lower values for the males. The populations from which the observations are drawn are differently sampled. There is no evidence that differences as to composition in rural/urban populations can explain the differences.
BACKGROUND: The cardiovascular risk factor levels of the population have been assessed in Finland since 1972. In the beginning the surveys were done to evaluate the North Karelia Project, which was a community-based preventive programme. A national cardiovascular disease (CVD) prevention strategy was developed and implemented during the late 1970s. Subsequently, a national cardiovascular risk factors monitoring system was developed to assess the effectiveness of the national strategy. METHODS: Cross-sectional population samples were studied in 1972 and 1977 in North Karelia and Kuopio provinces in eastern Finland. An area in southwestern Finland was included in 1982, followed by the Helsinki metropolitan area in 1992 and Oulu province in northern Finland in 1997. A total of 19 761 men and 20 761 women aged 30-59 participated in the six surveys (1972, 1977, 1982, 1987, 1992, 1997). RESULTS: The serum cholesterol levels of both genders have continuously declined. Systolic blood pressure levels have declined since 1972, but no further decline in diastolic blood pressure was found in 1997. Smoking prevalence among men continued to decline mainly due to an increase in the percentage of never-smokers. For the first time the increase in smoking prevalence among women levelled off and started to decline, mainly because the number of female quitters had increased. CONCLUSIONS: These data suggest that the cardiovascular health programme in Finland has succeeded in decreasing the general risk factor level of the population.