Diets rich in fruits and vegetables have been of interest because of their potential health benefits against chronic diseases such as cardiovascular disease (CVD) and cancer. The aim of this work was to assess the association of the dietary intake of a food group that includes fruits, berries and vegetables with all-cause, CVD-related and non-CVD-related mortality. The subjects were Finnish men aged 42-60 y examined in 1984-1989 in the prospective Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study. Dietary intakes were assessed by 4-d food intake record during the baseline phase of the KIHD Study. The risk of all-cause and non-CVD-related deaths was studied in 2641 men and the risk of CVD-related death in 1950 men who had no history of CVD at baseline. During a mean follow-up time of 12.8 y, cardiovascular as well as noncardiovascular and all-cause mortality were lower among men with the highest consumption of fruits, berries and vegetables. After adjustment for the major CVD risk factors, the relative risk for men in the highest fifth of fruit, berry and vegetable intake for all-cause death, CVD-related and non-CVD-related death was 0.66 [95% confidence interval (CI) 0.50-0.88], 0.59 (0.33-1.06), and 0.68 (0.46-1.00), respectively, compared with men in the lowest fifth. These data show that a high fruit, berry and vegetable intake is associated with reduced risk of mortality in middle-aged Finnish men. Consequently, the findings of this work indicate that diets that are rich in plant-derived foods can promote longevity.
To study the association between dietary intake of flavonoids and subsequent coronary mortality.
A cohort study based on data collected at the Finnish mobile clinic health examination survey from 1967-72 and followed up until 1992.
30 communities from different parts of Finland.
5133 Finnish men and women aged 30-69 years and free from heart disease at baseline.
Dietary intake of flavonoids, total mortality, and coronary mortality.
In women a significant inverse gradient was observed between dietary intake of flavonoids and total and coronary mortality. The relative risks between highest and lowest quarters of flavonoid intake adjusted for age, smoking, serum cholesterol concentration, blood pressure, and body mass index were 0.69 (95% confidence interval 0.53 to 0.90) and 0.54 (0.33 to 0.87) for total and coronary mortality, respectively. The corresponding values for men were 0.76 (0.63 to 0.93) and 0.78 (0.56 to 1.08), respectively. Adjustment for intake of antioxidant vitamins and fatty acids weakened the associations for women; the relative risks for coronary heart disease were 0.73 (0.41 to 1.32) and 0.67 (0.44 to 1.00) in women and men, respectively. Intakes of onions and apples, the main dietary sources of flavonoids, presented similar associations. The relative risks for coronary mortality between highest and lowest quarters of apple intake were 0.57 (0.36 to 0.91) and 0.81 (0.61 to 1.09) for women and men, respectively. The corresponding values for onions were 0.50 (0.30 to 0.82) and 0.74 (0.53 to 1.02), respectively.
The results suggest that people with very low intakes of flavonoids have higher risks of coronary disease.
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To study the associations between home food availability and dietary patterns among pre-school children.
Cross-sectional study in which parents of the participating children filled in an FFQ and reported how often they had certain foods in their homes. We derived dietary pattern scores using principal component analysis, and composite scores describing the availability of fruits and vegetables as well as sugar-enriched foods in the home were created for each participant. We used multilevel models to investigate the associations between availability and dietary pattern scores.
The DAGIS study, Finland.
The participants were 864 Finnish 3-6-year-old children recruited from sixty-six pre-schools. The analyses included 711 children with sufficient data.
We identified three dietary patterns explaining 16·7 % of the variance. The patterns were named 'sweets-and-treats' (high loadings of e.g. sweet biscuits, chocolate, ice cream), 'health-conscious' (high loadings of e.g. nuts, natural yoghurt, berries) and 'vegetables-and-processed meats' (high loadings of e.g. vegetables, cold cuts, fruit). In multivariate models, the availability of fruits and vegetables was inversely associated with the sweets-and-treats pattern (ß=-0·05, P
In April 1988, an outbreak of gastroenteritis occurred among employees in a large company in Helsinki, Finland. A retrospective cohort study, using a self-administered questionnaire, was carried out to ascertain the cause and extent of the outbreak. To meet the case definition, employees had to have had diarrhoea and/or vomiting since 2 April, 1998. A subanalysis was made in the biggest office, consisting of 360 employees, of whom 204 (57%) completed the questionnaire. Of these 108 (53%) met the case definition. Employees who had eaten raspberry dressing were more likely to meet the case definition than those who had not (Attack Rate (AR) 65% versus AR 18% Relative Risk, (RR) 3.7, 95%, Confidence Intervals (CI) 2.0-6.7). Four stool specimens obtained from affected kitchen staff who had all eaten the raspberry dressing and who had all become ill simultaneously with the employees were positive by polymerase chain reaction (PCR) for calicivirus. The data suggest that the primary source of the outbreak was imported frozen raspberries contaminated by calicivirus.
Flavonoids are effective antioxidants and, in theory, may provide protection against cancer, although direct human evidence of this is scarce. The relation between the intake of antioxidant flavonoids and subsequent risk of cancer was studied among 9,959 Finnish men and women aged 15-99 years and initially cancer free. Food consumption was estimated by the dietary history method, covering the total habitual diet during the previous year. During a follow-up in 1967-1991, 997 cancer cases and 151 lung cancer cases were diagnosed. An inverse association was observed between the intake of flavonoids and incidence of all sites of cancer combined. The sex- and age-adjusted relative risk of all sites of cancer combined between the highest and lowest quartiles of flavonoid intake was 0.80 (95% confidence interval 0.67-0.96). This association was mainly a result of lung cancer, which presented a corresponding relative risk of 0.54 (95% confidence interval 0.34-0.87). The association between flavonoid intake and lung cancer incidence was not due to the intake of antioxidant vitamins or other potential confounding factors, as adjustment for factors such as smoking and intakes of energy, vitamin E, vitamin C, and beta-carotene did not materially alter the results. The association was strongest in persons under 50 years of age and in nonsmokers with relative risks of 0.33 (95% confidence interval 0.15-0.77) and 0.13 (95% confidence interval 0.03-0.58), respectively. Of the major dietary flavonoid sources, the consumption of apples showed an inverse association with lung cancer incidence, with a relative risk of 0.42 (95% confidence interval 0.23-0.76) after adjustment for the intake of other fruits and vegetables. The results are in line with the hypothesis that flavonoid intake in some circumstances may be involved in the cancer process, resulting in lowered risks.
Studies on the association between plant foods and cerebrovascular diseases have given contradictory results suggesting the existence of some effect-modifying factors. The present study determines whether the consumption of plant foods (i.e. fruits and berries, vegetables, and cereals) predicts a decreased cerebrovascular disease incidence in a population with low fruit and vegetable and high wholegrain intake. This cohort study on 3932 men and women was based on data from the Finnish Mobile Clinic Health Examination Survey, conducted in 1968-72. The participants were 40-74 years of age and free of cardiovascular diseases at baseline. Data on the plant food consumption were derived from a 1-year dietary history interview. During a 24-year follow-up 625 cases of cerebrovascular diseases occurred, leading to either hospitalisation or death. An inverse association was found between fruit consumption and the incidence of cerebrovascular diseases, ischaemic stroke and intracerebral haemorrhage. The adjusted relative risks (RR) between the highest and lowest quartiles of intake of any cerebrovascular disease, ischaemic stroke and intracerebral haemorrhage were 0.75 (95 % CI 0.59, 0.94), 0.73 (95 % CI 0.54, 1.00) and 0.47 (95 % CI 0.24, 0.92), respectively. These associations were primarily due to the consumption of citrus fruits and occurred only in men. Total consumption of vegetables or cereals was not associated with the cerebrovascular disease incidence. The consumption of cruciferous vegetables, however, predicted a reduced risk of cerebrovascular diseases (RR 0.79; 95 % CI 0.63, 0.99), ischaemic stroke (RR 0.67; 95 % CI 0.49, 0.92) and intracerebral haemorrhage (RR 0.49; 95 % CI 0.25, 0.98). In conclusion, the consumption of fruits, especially citrus, and cruciferous vegetables may protect against cerebrovascular diseases.
A simplified model not requiring a clinic visit is important for cardiovascular prevention. We compared such a model, with one requiring clinical measurements for prediction of ischemic stroke.
Five population-based Finnish cohorts comprising 14?296 men and 16?065 women aged 25-64 years were randomly recruited from 1982, and followed up using the national registers until the end of the 2007. The final Cox model included age, prior history of diabetes and hypertension, happy marriage, capability to walk 500 m (self-estimate), regular exercise, vegetable/fruit intake, smoking, body mass index, and systolic blood pressure; the layperson-oriented model was developed by taking blood pressure away from the final model.
Four hundred sixty-nine men and 371 women developed ischemic stroke events. The area under the receiver operating characteristic curve (95% confidence interval) for 10 years incidence of ischemic stroke was 0·817 (0·791-0·843) and 0·813 (0·787-0·839) for the model with and without systolic blood pressure in men and 0·815 (0·782-0·848) and 0·812 (0·779-0·844), respectively, in women (P?>?0·10). The predicted 10-year events rate matched well with the observed one across deciles of the predicted risk in men (?(2) ?=?11·57, 9df, P?=?0·239) and in women (?(2) ?=?11·18, P?=?0·263). The overall net reclassification improvement after adding blood pressure was 8·8% (P?=?0·016) in men and 3·2% (P?=?0·234) in women. The predicted 10-year risk of the ischemic stroke based on global vascular event models that includes coronary heart diseases did not match well with the observed stroke risk.
The layperson model performed as well as the clinical-based one.
The consumption of different foods was studied for their ability to predict type II diabetes mellitus.
The study design was a cohort study, based on the Finnish Mobile Clinic Health Examination Survey.
A total of 30 communities from different parts of Finland.
A total of 4304 men and women, 40-69 y of age and free of diabetes at baseline in 1967-1972 and followed up for incidence of diabetes medication during 23 y (383 incident cases).
Higher intakes of green vegetables, fruit and berries, oil and margarine, and poultry were found to predict a reduced risk of type II diabetes. The relative risks of developing type II diabetes between the extreme quartiles of the intakes were 0.69 (95% confidence interval (CI) = 0.50-0.93; P for trend (P) = 0.02) for green vegetables, 0.69 (CI = 0.51-0.92; P = 0.03) for fruit and berries, 0.71 (CI = 0.52-0.98; P = 0.01) for margarine and oil, and 0.71 (CI = 0.54-0.94; P = 0.01) for poultry.
The results suggest that prevention of type II diabetes might be aided by consumption of certain foods that are rich in nutrients with hypothesized health benefits.
Healthy diet rich in fruits and vegetables is an important factor in prevention of cardiovascular diseases (CVD). Some previous epidemiological studies have suggested that dietary and serum carotenoids are associated with decreased CVD mortality, but the results have been inconsistent. We assessed relations between the concentrations of serum carotenoids and CVD mortality among Eastern Finnish men.
The study population consisted of 1031 Eastern Finnish men aged 46-65 years in the Kuopio Ischaemic Heart Disease Risk Factor (KIHD) cohort. Subjects were classified quartiles according to concentrations of carotenoids and subgroups according to risk factors. Hazard ratios of serum lycopene, a-carotene and ß-carotene were estimated by the Cox proportional hazard model after adjusting for potential confounding factors. During the median 15.9-year follow-up, 122 deaths from CVDs, were identified among the cohort subjects. Low serum concentrations of ß-carotene were strongly related to an increased CVD mortality risk after adjustment for confounders. For ß-carotene, the hazard ratio (95% confidence interval) for the lowest versus highest quartile was 2.23 (1.26-3.93; P=0.006). However, the strongest risk of CVD mortality was observed among smokers with lowest levels of ß-carotene (HR=3.15, 95%, CI: 1.19-8.33; P=0.020). Other carotenoids and the sum of carotenoids were not significantly related to increased risk of CVD mortality.
Low concentrations of serum ß-carotene concentrations may increase the risk for CVD mortality among Eastern Finnish men; thus elevated serum concentrations of ß-carotene may have clinical and public health relevance.