Stool weight and transit time through the gut were measured in 4 groups of 30 men, aged 50-59 years, randomly selected from populations in urban (Copenhagen) and rural (Them) Denmark and urban (Helsinki) and rural (Parikkala) Finland. These populations exhibited a 3-4 fold difference in risk for large bowel cancer. Mean transit time (37 +/- 1 hours, Copenhagen; 43 +/- 1 hours, Helsinki; 40 +/- 1 hours, Them; 37 +/- 1 hours, Parikkala) was not significantly different among populations, but average 24-hour stool weights (136 +/- 13 g, Copenhagen; 176 +/- 17 g, Helsinki; 169 +/- 16 g, Them; 196 +/- 15 g, Parikkala) were different and had a significant inverse relationship to total large bowel cancer incidence, with larger stool weights being found in the low-risk population. A high proportion of study subjects, especially in Finland, were found to be taking medication or to have a history of gastrointestinal illness, but neither of these variables related to bowel habit.
Four-day weighing and 24-hour recall were used to record food consumption in groups of 30 men, aged 50-59 years, in 2 areas of Denmark: Them, a rural Danish community, and Copenhagen. Fat consumption was found to be higher in Them, whereas alcohol consumption was higher in Copenhagen. The absolute daily intake of dietary fiber was higher in Them than in Copenhagen. These observations document changes due to industrialization of food production, modern distribution, and marketing methods.
In 403 elderly people residing in their own homes a dietary interview was undertaken with special reference to the intakes of vitamins and minerals. The group was randomly selected. The data were compared with the Recommended Dietary Allowances, Joint Nordic Recommendations and the absolute minimal necessary amounts. Intakes of folacin was low in 100% of the interviewed, intakes of cholecalciferol was low in 62% and in 83% intakes of pyridoxine was low as compared to the recommendations. The majority had sufficient amounts of ascorbic acid, thiamine, riboflavin, retinol and cobalamin from the diet. The intake of zinc was low in 87% of the interviewed, but risk of zinc deficiency might only be present in 0.5%. The intakes of iron and calcium was judged to be sufficient. The physiological needs of the elderly may, however, vary from the standards used here and recommendations with special reference to the elderly are in request. The conclusion is that the diet of the elderly, possibly with exception of folacin, is well above their absolute minimal requirements, but the margin towards malnutrition is small. This means that elderly people should be considered a vulnerable group with respect to the intakes of vitamins and minerals.
Average intakes of nonstarch polysaccharides (dietary fiber), foods, and nutrients were measured in representative samples of 30 men aged 50-59 in 4 Scandinavian populations with a 3-4 fold difference in risk for large bowel cancer. The assessment technique, a 4-day weighed record of food consumed and duplicate collections of all food eaten, was validated by chemical analysis of the duplicates, by measuring 24-hour urine and fecal nitrogen excretion, and by comparing the constituents of the urine samples collected during the survey with similar collections 1-2 weeks later. There were good agreements between estimates of fat and protein intake obtained by food-table calculations of the 4-day weighed record and the chemically analyzed duplicates. Urinary plus fecal nitrogen excretion was equal to estimated nitrogen intake during the survey, and no discernable changes in urinary output occurred after the survey, thereby implying that dietary habits had not changed as a result of the investigative technique. It is concluded that the dietary data are indicative of current patterns of food consumption and are sufficiently valid for comparison with data on cancer risk in the 4 areas.
Nonstarch polysaccharide (NSP) intake was measured in representative samples of 30 men aged 50-59 in 2 urban and 2 rural Scandinavian populations that exhibited a 3-4 fold difference in incidence of large bowel cancer. Intake was measured by chemical analysis of complete duplicate portions of all food eaten over one day by each individual. NSP intakes showed a rural-urban gradient, with 18.4 +/- 7.8 g/day in rural Finland and 18.0 +/- 6.4 g/day in rural Denmark versus 14.5 +/- 5.4 g/day in urban Finland and 13.2 +/- 4.8 g/day in urban Denmark. NSP intakes were also calculated (using food tables) from weighed food records kept over 4 days, one of which was the day on which the duplicate collection was made. Intakes were 2-2.5 g/day higher with this method than with direct chemical analysis, mainly because published tables of values have become outdated and inaccurate as a result of improved methods for measuring NSP in food. Individual variation from day to day in NSP intake was considerable. Average NSP intake and intake of some of its component sugars were inversely related to colon cancer incidence in this geographical comparison. To show a relationship at the individual level between diet and cancer risk in a prospective study would require detailed and accurate methods for the assessment of NSP consumption.